[논문]뇌졸중 후 환자의 일상생활활동 및 손 기능 개선에 대한 가상현실 훈련의 효과 : 예비 연구

문종훈; 전민재

doi:10.14400/jdc.2019.17.11.349

[국내논문] 뇌졸중 후 환자의 일상생활활동 및 손 기능 개선에 대한 가상현실 훈련의 효과 : 예비 연구
The Effects of Virtual Reality Training on Improving Hand Function and Activities of Daily Living in Patients Living Post-Stroke: A Pilot Study 원문보기

디지털융복합연구 = Journal of digital convergence, v.17 no.11, 2019년, pp.349 - 355

문종훈 (국립재활원 재활연구소 건강보건연구과) , 전민재 (국립재활원 재활연구소 건강보건연구과)

초록
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가상현실 훈련은 신체 기능을 개선하기 위한 중재로 제안되었다. 그러나 급성 뇌졸중 환자의 ADL 개선에 초점을 둔 가상현실 훈련의 효과는 명확하지 않다. 본 연구의 목적은 급성 뇌졸중 환자의 손 기능 및 일상생활활동(ADL)에 대한 가상 현실 훈련의 효과를 조사하는 것이다. 급성 뇌졸중 환자 16명이 본 연구에 포함되었다. 실험 군(VRA군)은 각 세션마다 ADL에 중점을 둔 30분의 가상현실 훈련을 받았으며, 통제군은 30분의 보편적인 가상현실 훈련을 받았다. 피험자의 손기능과 ADL을 조사하기 위해 JTHFT(Jebsen-Tylor Hand Function Test)와 K-MBI (Korean Modified Barthel Index)를 각각 사용했다. 두 그룹 모두 중재 후 마비측과 비마비측의 손기능 및 K-MBI 총점에서 유의미한 개선을 보였다. 실험군은 통제군보다 중재 후 K-MBI의 자가관리 영역에서 유의하게 큰 향상을 보였다. 이러한 결과는 급성 뇌졸중 환자에서 ADL에 중점을 둔 가상 현실 훈련이 기존의 가상 현실 훈련보다 자기관리에 더 나은 영향을 줄 수 있음을 시사한다.

Abstract ▼ AI-Helper

The virtual reality training has been suggested as an intervention to improve physical function. But, the effects of virtual reality training focused on improving ADL in patients with acute stroke are unclear. Purpose of this study was to examine the effect of virtual reality training on hand function and activities of daily living (ADL) in patients with acute stroke. Sixteen patients with acute stroke were included in this study. The experimental group (VRA group) received 30 minutes of virtual reality training focused on ADL for each session, while the control group received 30 minutes of conventional virtual reality training. To examine the hand function and ADL of the subjects, the study used Jebsen-Tylor Hand Function Test (JTHFT) and Korean Modified Barthel Index (K-MBI), respectively. Both groups showed significant improvements in hand function of affected and unaffected sides, and in K-MBI total score before and after the intervention. The experimental group showed significantly greater improvements in the self-care domain of K-MBI after intervention than the control group. These findings suggest that the virtual reality training focused on ADL may have a better effect on self-care than conventional virtual reality training in patients with acute stroke.

주제어

표/그림 (4)

표 Table 1. Characteristics of subjects (N=18)
표 Table 2. Comparison of hand function and ADL before intervention (Mean ± SD) (N=18)
표 Table 3. Changes of hand function and ADL within groups (Mean ± SD) (N=18)
표 Table 4. Comparison of Change score of hand function and ADL after intervention (Mean ± SD) (N=18)

AI 본문요약
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문제 정의

The purpose of this pilot study was to examine the effect of virtual reality training focused on hand function training and ADL training in patients with acute stroke. The VRA group showed significantly greater improvements in the self-care domain of K-MBI after intervention than the control group.
Improvement of ADL in stroke patients is closely related to social participation and quality of life [14]. Thus, the aim of this pilot study was to investigate the effects of virtual reality training focused on improving ADL in patients with acute stroke.

제안 방법

Pre-assessment was performed after placement. Both groups received conventional rehabilitation therapy for 30 minutes, 5 times a week, for a total of 4 weeks. Physical and occupational therapy were the main components of conventional rehabilitation therapy.
Hand function was measured using the Jebson-Taylor Hand function Test (JTHFT). In this study, measurements were performed on the affected and unaffected side of the hand. The subtests consisted of writing, simulated page turning, simulated feeding, stacking checkers, picking up large light objects, and picking up large heavy objects.
This study involved 16 patients with acute stroke who received rehabilitation treatment in a I general hospital located in Incheon between January and May 2019. The criteria for selection were as follows: (1) a stroke diagnosed by a neurologist, (2) a stroke with an onset of 30 days or less, (3) a Korean Mini-Mental Status Examination score of 21, and (4) the ability to follow instructions. The exclusion criteria were as follows: (1) visual and auditory problems, and (2) severe apraxia.
Moto Cog consists of a touch screen, a handle, and an electronic key. The program consists of three training courses: a hand function training course, a cognitive training course, and an ADL training course. The difficulty level of each training program is divided into 5 levels.
In this study, measurements were performed on the affected and unaffected side of the hand. The subtests consisted of writing, simulated page turning, simulated feeding, stacking checkers, picking up large light objects, and picking up large heavy objects. The time required for each item was recorded in seconds and scored.
This pilot study investigated the effect of virtual reality training on hand function and ADL in patients with acute stroke. Both groups showed significant improvements in hand function and ADL before and after the intervention.

대상 데이터

This study involved 16 patients with acute stroke who received rehabilitation treatment in a I general hospital located in Incheon between January and May 2019. The criteria for selection were as follows: (1) a stroke diagnosed by a neurologist, (2) a stroke with an onset of 30 days or less, (3) a Korean Mini-Mental Status Examination score of 21, and (4) the ability to follow instructions.

데이터처리

Mann-Whitney U test, Chi-square test or Fisher's exact test were used to compare the general characteristics, hand function, and ADL, while Wilcoxon signed rank tests was used to compare functions before and after the intervention.
05 and the collected data were analyzed using SPSS 21. The general characteristics of the subjects were confirmed using frequency analysis. Mann-Whitney U test, Chi-square test or Fisher's exact test were used to compare the general characteristics, hand function, and ADL, while Wilcoxon signed rank tests was used to compare functions before and after the intervention.

이론/모형

Hand function was measured using the Jebson-Taylor Hand function Test (JTHFT). In this study, measurements were performed on the affected and unaffected side of the hand.

성능/효과

[18] that tested the effect of virtual reality training for enhancing upper limb function to improve ADL before and after intervention was not positive. In this study, the performance of the upper limb function was improved by using haptic force feedback before and after intervention in 5 stroke patients, but only one patient was reported to improve his ADL.
Recently, a comparative study of virtual reality training and conventional training for the improvement of upper limb function in stroke patients was reported [12]. The results of previous study reported that virtual reality training was more helpful for the upper limb function improvement than conventional training, but a clear effect on ADL improvement was not found.

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