Heo, Seoyoon
(Department of Occupational Therapy, School of Medical and Health Care, Kyungbok University)
,
Kim, Mooki
(Department of Occupational Therapy, Pohang University)
,
Choi, Wansuk
(Department of Physical Therapy, International University of Korea)
Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Ob...
Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.
Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.
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문제 정의
There are many papers that induce curiosity, motivation, and fundamental interest,7 but since the fact that the combined form of the intrinsic VR and Robot has been commonly used, various research methods and many additional studies are needed for the true validity of this treatment form. This clinical trial is aimed to figure out the effects of robot-mediated gait training combined with VR program.
제안 방법
All the data was statistically analyzed using IBM SPSS 20 software and for assessing each session, we examined descriptive statistics and Wilcoxon signed rank test and the patients’ general information of disorder was reported (Table 1).
They were recruited from community health care center in Seoul, Korea. All the participants allocated to two types of robotic system as a rehabilitative approach; (1) conventional robot-mediated gait training: robot-assisted gait training without VR (RGT), (2) VR-combined robot-mediated gait training: robot-assisted gait training with VR (RGT-VR) (Figure 1). In the RGT session, the screen was set to off.
The order of these process was randomly allocated using Excel (Microsoft) random macro function. Each robot treatment per session was performed intensively for 4 months (30 minutes duration, once a day, 3 times for a week). All treatments were conducted under the supervision of an occupational therapists or physical therapists.
In this study, we analyzed with a parameter called muscle activity for clinical inference of robot-assisted gait training with or without VR, which is currently being performed mainly in Korea. As a result, less muscle activity was measured in the treatment accompanied by VR.
The authors assessed muscle activities (%MVIC; maximum voluntary isometric contraction) during each section to indicate person’s physical status and changes.
The shape of the cross design can also be determined in various ways depending on the specific purpose of the study and the content of the study.17The first design is the simplest form of a two-period cross-over design, and half of the patients selected for study are randomly selected to apply RGT or RGT-VR, and after a certain period of time, RGT-VR and treatment respectively. It is changed to RGT and assigned.
The second design is a design of a typical two-period cross-design, and the effect of the training that was first administered from the patient's body before the treatment was changed after randomly assigning treatments to patients in the first study and performing treatment for a certain period of time.
This research is corresponding case series research including cross-over trial; design to test the effect of the independent variable by applying each treatment condition of the independent variable in turn to the same subject. All the experimental procedure was fully explained for researchers and written informed consent was provided for the participants.
To allow patients to adapt themselves to the concept of gait therapy, a general gait therapy by a physical therapist was run for 30 minutes duration, once a day for a week as a run-in period. Since there is possibility for increased muscle strength in the initial session, the researchers provided a sufficient adaptation period.
대상 데이터
Eleven adults diagnosed as stroke from medical doctor were participated in this study. They were recruited from community health care center in Seoul, Korea.
Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor, within 10 months of their onset, were engaged. Participants were excluded if they had (1) positive neurologic symptoms on their own foot; (2) need orthosis or assistive devices; (3) previous history of leg surgery; (4) previous history of fractures and significant traumas on lower body; (5) similar level of upper extremity in stages of stroke recovery: the Brunnstrom stage 4-5.
성능/효과
Patients profile and general characteristics were reported via Table 1. The differences were reported in Table 2. It showed less muscle activities during training in RGT-VR session and the indicated muscle were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle. This clinical assessment differences were statistically significant (P<.
The result presented less muscle activities during training in RGT-VR session and the indicated muscle were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle; in the remaining muscles involved in walking, gluteus maximus muscle, vastus lateralis muscle, soleus muscle, the average value of near-activity measured in real time during RGT-VR was measured higher than that of the data group that only RGT performed.
후속연구
Configuring out factors of VR with robot rehabilitation is most crucial prior task for regular clinical field usage. This study could contribute to building evidence and future randomized controlled trials or even case-control studies.
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