[논문]The Effects of Virtual Upper Extremity Training Using the RAPAEL Smart Glove on Physical and Cognitive Function in Stroke Survivors -A Single Group Study-

Song, Chiang-Soon; Lim, Jae-Heon; Jeon, Byeong-Hyeon; Lee, Hye-Sun

doi:10.21598/jkpnfa.2019.17.2.199

The Effects of Virtual Upper Extremity Training Using the RAPAEL Smart Glove on Physical and Cognitive Function in Stroke Survivors -A Single Group Study- 원문보기

Song, Chiang-Soon (Department of Occupational Therapy, College of Health Science, Chosun University) , Lim, Jae-Heon (Department of Physical Therapy, Wonkwang Health Science University) , Jeon, Byeong-Hyeon (Department of Physical Therapy, Graduate School, Honam University) , Lee, Hye-Sun (Department of Occupational Therapy, Kwangju Women's University)

Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.

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문제 정의

The participant conducted in a variety of functional activities on the RAPAEL smart board such as cooking and fishing in a virtual reality environment. The participant performed functional activities upon RAPAEL smart board to maintain motivation and passion on his/her rehabilitation surroundings in this study. After the training, the participant showed improvement functional activities on upper extremity as well as cognitive function in this study.
The purpose of this study was to evaluate the effects of virtual upper extremity training program used a RAPAEL smart board on upper extremity function for stroke survivors with chronic hemiparesis and was to focus training program development using a smart glove as a feasibility study. At week 8, upon completion of the intervention, all participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to baseline WMFT, JTT, BBT, grip strength, and trail-making score at week 0.
RAPAEL smart glove consists of smart glove, as a 9-axis movement and position sensor, and rehab solution that provides various kinds of motion tasks such as activities of daily living-related tasks entertainment while considering both clinical effectiveness and fun factors. The purpose of this study was to evaluate the effects of virtual upper extremity training program used a RAPAEL smart glove on upper extremity function for stroke survivors with chronic hemiparesis and was to focus training program development using a smart glove as a feasibility study.
This study evaluated the effects of virtual upper extremity training used a RAPAEL smart board on upper extremity function for stroke survivors. The results of this study show a feasible and beneficial effectiveness on upper extremity function and cognitive function for stroke.
This study investigated the effects of virtual reality training using a RAPAEL smart board on upper extremity function for stroke patients. Summarizing the results of this study was that the manual dexterity, functional activities, grip strength and cognitive speed improved after virtual reality program with RAPAEL smart board compared to before the training.
The results of this study show a feasible and beneficial effectiveness on upper extremity function and cognitive function for stroke. This study shows virtual reality new feasibility towards improving the upper extremity function following stroke but has some shortcomings. This study was a single-group pretest-posttest research design.
At week 8, upon completion of the intervention, all participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to baseline WMFT, JTT, BBT, grip strength, and trail-making score at week 0. This study suggests that the virtual upper extremity training using the RAPAEL smart board has a reasonable and beneficial effects on upper extremity function for chronic hemiparetic stroke survivors.
This study shows virtual reality new feasibility towards improving the upper extremity function following stroke but has some shortcomings. This study was a single-group pretest-posttest research design. The study used blinded assessment to control the causal validity, but conventional therapeutic effects, history, test effects and regression effects couldn’t be controlled.

제안 방법

All participants had conducted 24 sessions of virtual reality program with RAPAEL smart glove for a total of 12 hours over 8 weeks, 3 times per week, 30 min per session. The RAPAEL smart glove is designed to enable to customize a personalized exercise by selecting the game and constraining the degree of freedom in the handle to induce targeted movements in therapeutically more desirable movements.
Descriptive statistics, including frequency, mean, standard deviation, were performed to analyze the common and clinical characteristics of participants. Differences between single variable measurements in participants were evaluated with paired t-tests at the end of the virtual reality program.
Informed consent was obtained prior to study enrollment from the participants. Outcome assessments for this study was performed by two occupational therapists who blinded to research program.
The RAPAEL smart board as a game-based wearable glove with 9-axis bending sensors induces the targeted movements of paretic wrists and finger based on sensations on wrist and finger movements. The participant conducted in a variety of functional activities on the RAPAEL smart board such as cooking and fishing in a virtual reality environment. The participant performed functional activities upon RAPAEL smart board to maintain motivation and passion on his/her rehabilitation surroundings in this study.
RAPAEL smart glove is a wireless connection unit with five bending sensors on thumb and fingers and 9-axis IMU sensor (3 acceleration channels, 3 angular rate channels, and 3 magnetic field channels) on hand palm, and is a design for various joint moving and easy wearing even for stiff hand. This study used functional electrical stimulation (FES, Cyber Medic, Korea) applied with conventional rehabilitation to activate the upper extremity muscles.
This study used the RAPAEL smart rehab solution (NEOFECT Co., Yung-in) as a virtual therapeutic program to improve upper extremity function. The RAPAEL smart rehab solution consisted of smart glove as a wireless, real-time biofeedback device and smart rehab platform involved game-like exercises and data visualization.
This study was a single group, pre-test and post-test research design to testify to feasible effects of Rafael’s smart glove as a virtual therapeutic training on upper extremity function for stroke.
This study was conducted over∼10 weeks period from 10 October 2018 to 31 December 2018 at two outpatient rehabilitation facility.

대상 데이터

Ten participants who had a diagnosis of first stroke conducted in this study. Inclusion criteria of the participants included first-ever clinical stroke confirmed on neuroimaging, duration >6 months following stroke, mini-mental state examination score >18, pain assessed by visual analog scale score <4/10, no severe spasticity assessed by modified Ashworth scale <2 in any shoulder, elbow, or wrist/finger muscles, no severe depression, no severe visuospatial impairment, and no unilateral neglect (Crum et al.

데이터처리

Descriptive statistics, including frequency, mean, standard deviation, were performed to analyze the common and clinical characteristics of participants. Differences between single variable measurements in participants were evaluated with paired t-tests at the end of the virtual reality program. The statistical analysis of the data was collected using SPSS version 21.

이론/모형

Four outcome assessments, box-and-block test (BBT), Jebsen-Taylor hand function test (JTT), grip strength, and Wolf motor function test (WMFT) were measured in this study (Allgower & Hermsdorfer, 2017; Bae et al., 2015; Chen et al., 2009; Hodics et al., 2012).

성능/효과

This study investigated the effects of virtual reality training using a RAPAEL smart board on upper extremity function for stroke patients. Summarizing the results of this study was that the manual dexterity, functional activities, grip strength and cognitive speed improved after virtual reality program with RAPAEL smart board compared to before the training. The results show the feasibility of therapeutic intervention on upper extremity function but also cognitive function for stroke survivors.
This study evaluated the effects of virtual upper extremity training used a RAPAEL smart board on upper extremity function for stroke survivors. The results of this study show a feasible and beneficial effectiveness on upper extremity function and cognitive function for stroke. This study shows virtual reality new feasibility towards improving the upper extremity function following stroke but has some shortcomings.
, 2017). The results of this study show the improvement of upper extremity physical function as well as cognitive speed. Trail-making test provide information about visual search speed, scanning, speed of processing, mental flexibility, as well as executive functioning.
The study used blinded assessment to control the causal validity, but conventional therapeutic effects, history, test effects and regression effects couldn’t be controlled.
After the training, the participant showed significantly improved the trail-making test compared to before the training. Therefore, the results of this study suggest the feasibility of using the RAPAEL smart glove as a therapeutic tool for improving the upper extremity physical function as well as for improving cognitive function for stroke survivors.

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The Effects of Virtual Upper Extremity Training Using the RAPAEL Smart Glove on Physical and Cognitive Function in Stroke Survivors -A Single Group Study- 원문보기

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The Effects of Virtual Upper Extremity Training Using the RAPAEL Smart Glove on Physical and Cognitive Function in Stroke Survivors -A Single Group Study- 원문보기

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