[논문]가상현실 기반의 일상생활활동 훈련이 외상성 뇌손상 환자의 일상생활활동 및 재활동기에 미치는 효과 : 예비연구

문종훈; 전민재

doi:10.22683/tsnr.2019.8.4.041

가상현실 기반의 일상생활활동 훈련이 외상성 뇌손상 환자의 일상생활활동 및 재활동기에 미치는 효과 : 예비연구
Effects of Virtual Reality-Based Activities of Daily Living Training on Activities of Daily Living and Rehabilitative Motivation in Patients With Traumatic Brain Injury: A Pilot Study 원문보기

Therapeutic science for rehabilitation = 재활치료과학, v.8 no.4, 2019년, pp.41 - 51

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

초록
AI-Helper

목적 : 본 예비 연구는 가상현실 기반의 일상생활활동 훈련이 외상성 뇌손상 환자의 일상생활활동 및 재활동기에 미치는 영향을 알아보고자 한다. 연구방법 : 본 연구는 7명의 외상성 뇌손상 환자를 대상으로 중재 전-후 설계를 수행하였다. 대상자들은 하루 30분, 주 2~3회, 4주간 가상현실 기반의 일상생활활동 훈련을 수행하였다. 중재 전과 후로 평가를 수행하였다. 측정은 수정바델지수, 기능적 독립척도(인지), 의지 설문지가 평가되었다. 중재 전과 후의 변화는 윌콕슨 부호순위 검정으로 분석하였고, 상관관계는 스피어만 상관분석을 이용하였다. 결과 : 중재 후, 외상성 뇌손상 환자는 한국판 수정바델지수에서 유의한 향상을 보였다(p<.05). 기능적 독립척도(인지)와 재활동기는 유의한 변화가 없었다(p>.05). 기능적 독립척도(인지)는 재활동기와 유의한 상관이 있었다(p<.05, r=.755). 기능적 독립척도(인지)의 사회인지영역은 재활동기와 유의한 상관이 있었다(p<.05, r=826). 결론 : 가상현실 기반의 일상생활활동 훈련은 일상생활활동 수행능력을 향상시킬 수 있으나, 사회인지와 재활동기의 개선여부가 가능한지에 대해서는 연구가 더 필요하다.

Abstract ▼ AI-Helper

Objective : The purpose of this study was to investigate the effects of virtual reality-based activities of daily living (ADL) training on ADL and rehabilitative motivation in patients with traumatic brain injury. Methods : This study was performed using a pre-post design with seven traumatically brain injured patients. Subjects were subjected to virtual reality-based ADL training for 30 minutes a day, 2 to 3 times a week for 4 weeks. Evaluation was conducted before and after the intervention using the Korean Modified Barthel Index (K-MBI), Cognitive Functional Independence Measure (C-FIM), and Volitional Questionnaire (VQ). Changes before and after intervention were analyzed by Wilcoxon signed-rank test, and correlations were analyzed using Spearman's coefficient. Results : After intervention, patients with traumatic brain injury showed significant improvements in K-MBI (p.05). Total C-FIM score correlated significantly with VQ score (p<.05, r=.755). The social cognition domain of C-FIM had a significant correlation with VQ score (p<.05, r=826). Conclusions : Virtual reality-based ADL training can improve ADL performance, but further research is needed to determine whether improvements in social cognition and rehabilitative motivation are possible.

주제어

표/그림 (4)

그림 Figure 1. Virtual Reality-Based ADL Training(Moto Cog)
표 Table 1. The General Characteristics, Activities of Daily Living, and Rehabilitative Motivation in Subjects
표 Table 2. Change of Activities of Daily Living, and Rehabilitative Motivation in Subjects
표 Table 3. The Correlation Relationship Between Activities of Daily Living, and Rehabilitative Motivation in Subjects (N = 7)

AI 본문요약
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* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

The VQ can also be measured by subjects who are difficult to interview, and occupational therapists can observe and measure the behavior of subjects. In this study, occupational therapists evaluated the rehabilitative motivation for treatment by observing patient behavior during the experiment. The inter-tester reliability of VQ is 0.
Therefore, this preliminary study examines the effects of virtual reality-based ADL training on ADL and rehabilitative motivation of patients with traumatic brain injury.
This preliminary study examined the effects of virtual reality-based ADL training on ADL and rehabilitative motivation in patients with traumatic brain injury. After intervention, patients with traumatic brain injury showed significant improvement in K-MBI, which implies the effect of virtual reality-based ADL training.
Moto Cog is a program developed to promote ADL by improving hand use and cognitive function. This study focused on the training program for ADL improvement. Moto Cog consists of a hand function training course, a cognitive training course, and an ADL training course.

가설 설정

In this preliminary study, we investigated whether virtual reality-based ADL training improved ADL and rehabilitative motivation in patients with traumatic brain injury. The results of the study showed that after intervention, patients with traumatic brain injury showed a significant improvement in K-MBI score.

제안 방법

After pre-assessment, the subjects underwent virtual reality-based ADL training for 30 minutes a day, 2 to 3 times a week for 4 weeks. Virtual reality-based ADL training was applied using Moto Cog (Cybermedic, Korea)(Figure 1).
All subjects underwent conventional rehabilitation for 4 weeks according to the rehabilitation schedule, and this included occupational therapy and physical therapy. Occupational therapy was performed by identifying a specific, reduced function and activity of the subject.
, 1996). In this study, only social cognition (social interaction, problem solving, memory) and comprehension (expressions, comprehension) were used to evaluate the C-FIM.
The ADL training course requires upper limb function and cognitive function. The program items of the hand function training course and the ADL training course performed by the subjects included: Turning on a gas stove, opening a door lock, opening various shape handles, squeezing, hammering, and pizza making. The cognitive training course was composed of activities including card matching, piano playing, arm wrestling, shooting, fencing, boxing and bomb removal.

대상 데이터

80, the effect sizes of C-FIM and VQ were calculated. As a result, when the C-FIM was set as the primary outcome, 18 subjects were required. When VQ was set as the primary outcome, 20 subjects were required.
This study was performed using a pre-post intervention design for seven patients with traumatic brain injury. The inclusion criteria were: 1) medical diagnosis of traumatic brain injury, 2) cognitive impairment with a score of less than 23 on the Korean Mini-Mental State Examination (K-MMSE) score, 3) ability to communicate, 4) the incidence of injury>3 months (Scheid, Preul, Gruber, Wiggins, & Von Cramon, 2003), and 5) a change in Korean Modified Barthel Index (K-MBI) scores of two points or less when compared with the previous month.
As a result, when the C-FIM was set as the primary outcome, 18 subjects were required. When VQ was set as the primary outcome, 20 subjects were required.

데이터처리

The general characteristics of patients with traumatic brain injury, ADL, and rehabilitation motivation were confirmed by frequency analysis. Changes in ADL and rehabilitation motivation before and after intervention were analyzed by Wilcoxon signed-rank test. The correlation between ADL and rehabilitation motivation was analyzed using Spearman correlation analysis.
Changes in ADL and rehabilitation motivation before and after intervention were analyzed by Wilcoxon signed-rank test. The correlation between ADL and rehabilitation motivation was analyzed using Spearman correlation analysis.

성능/효과

The average total K-MBI score was 86.57±5.29, the average total C-FIM was 20.00±2.83, and the total mean VQ score was 35.14±7.63 (Table 1).
In this preliminary study, we investigated whether virtual reality-based ADL training improved ADL and rehabilitative motivation in patients with traumatic brain injury. The results of the study showed that after intervention, patients with traumatic brain injury showed a significant improvement in K-MBI score. However, there were no significant changes in total C-FIM score and rehabilitative motivation.

후속연구

The findings of this preliminary study can be used to inform on optimal sample size for a future study. The authors performed a sample size calculation (G Power 3.

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저자의 다른 논문 :

표제어: PCR

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