Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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Effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living in persons with acute stroke: a preliminary study

  • Jeon, Min-Jae (Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, National Rehabilitation Center) ;
  • Moon, Jong-Hoon (Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, National Rehabilitation Center) ;
  • Cho, Hwi-young (Department of Physical Therapy, College of Health Science, Gachon University)
  • Received : 2019.11.11
  • Accepted : 2019.12.02
  • Published : 2019.12.31
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Abstract

Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.

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References

  1. Kim OS, Ryu HS. The study on blood lipid levels according to the food habits and food intake patterns in Korean elderly. Korean J Food Nutr 2009;22:421-9.
  2. Schmid AA, Miller KK, Van Puymbroeck M, DeBaun-Sprague E, Shively C, Peterson E, et al. Feasibility and results of a pilot study of group occupational therapy for fall risk management after stroke. Br J Occup Ther 2015;78:653-60. https://doi.org/10.1177/0308022615593764
  3. Mackintosh SF, Hill K, Dodd KJ, Goldie P, Culham E. Falls and injury prevention should be part of every stroke rehabilitation plan. Clin Rehabil 2005;19:441-51. https://doi.org/10.1191/0269215505cr796oa
  4. Sveen U, Bautz-Holter E, Sodring KM, Wyller TB, Laake K. Association between impairments, self-care ability and social activities 1 year after stroke. Disabil Rehabil 1999;21:372-7. https://doi.org/10.1080/096382899297477
  5. Huxhold O, Li SC, Schmiedek F, Lindenberger U. Dual-tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Res Bull 2006;69:294-305. https://doi.org/10.1016/j.brainresbull.2006.01.002
  6. Saeys W, Vereeck L, Truijen S, Lafosse C, Wuyts FP, Heyning PV. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabil Neural Repair 2012;26:231-8. https://doi.org/10.1177/1545968311416822
  7. Kang H, Chung Y. Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: a pilot randomized controlled trial. Phys Ther Rehabil Sci 2012;1:33-9.
  8. Pollock AS, Durward BR, Rowe PJ, Paul JP. What is balance? Clin Rehabil 2000;14:402-6. https://doi.org/10.1191/0269215500cr342oa
  9. Oliveira CB, Medeiros IR, Greters MG, Frota NA, Lucato LT, Scaff M, et al. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke. Clinics (Sao Paulo) 2011;66:2043-8. https://doi.org/10.1590/S1807-59322011001200008
  10. Anderson K, Behm DG. Trunk muscle activity increases with unstable squat movements. Can J Appl Physiol 2005;30:33-45. https://doi.org/10.1139/h05-103
  11. Kang TW, Kim BR. Comparison of task-oriented balance training on stable and unstable surfaces for fall risk, balance, and gait abilities of patients with stroke. J Korean Soc Phys Med 2019;14:89-95. https://doi.org/10.13066/kspm.2019.14.2.89
  12. Park JH, Chung Y. The effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in persons with stroke: a pilot study. Phys Ther Rehabil Sci 2016;5:125-31. https://doi.org/10.14474/ptrs.2016.5.3.125
  13. Lee J, Hwang S, Ahn S. Effects of sit-to-stand imagery group training on balance performance in individuals with chronic hemiparetic stroke: a randomized control trial. Phys Ther Rehabil Sci 2016;5:63-9. https://doi.org/10.14474/ptrs.2016.5.2.63
  14. Bang DH, Shin WS. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: a randomized controlled pilot trial. NeuroRehabilitation 2016;38:343-9. https://doi.org/10.3233/NRE-161325
  15. Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil 2004;83:81-7. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  16. Tankisheva E, Bogaerts A, Boonen S, Feys H, Verschueren S. Effects of intensive whole-body vibration training on muscle strength and balance in adults with chronic stroke: a randomized controlled pilot study. Arch Phys Med Rehabil 2014;95:439-46. https://doi.org/10.1016/j.apmr.2013.09.009
  17. Tyson SF, Sadeghi-Demneh E, Nester CJ. The effects of transcutaneous electrical nerve stimulation on strength, proprioception, balance and mobility in people with stroke: a randomized controlled cross-over trial. Clin Rehabil 2013;27:785-91. https://doi.org/10.1177/0269215513478227
  18. Kim JH, Jang SH, Kim CS, Jung JH, You JH. Use of virtual reality to enhance balance and ambulation in chronic stroke: a double-blind, randomized controlled study. Am J Phys Med Rehabil 2009;88:693-701. https://doi.org/10.1097/PHM.0b013e3181b33350
  19. Burdea GC. Virtual rehabilitation--benefits and challenges. Methods Inf Med 2003;42:519-23. https://doi.org/10.1267/METH03050519
  20. Reid D, Hirji T. The influence of a virtual reality leisure intervention program on the motivation of older adult stroke survivors: a pilot study. Phys Occup Ther Geriatr 2004;21:1-19. https://doi.org/10.1080/J148v21n04_01
  21. Bang YS, Son KH, Kim HJ. Effects of virtual reality training using Nintendo Wii and treadmill walking exercise on balance and walking for stroke patients. J Phys Ther Sci 2016;28:3112-5. https://doi.org/10.1589/jpts.28.3112
  22. Kim EJ, Ryu IT, Park HJ. Effects of virtual reality training on the balance of chronic stroke patients on an unstable surface. Neurotherapy 2018;22:7-11.
  23. Chen L, Lo WL, Mao YR, Ding MH, Lin Q, Li H, et al. Effect of virtual reality on postural and balance control in patients with stroke: a systematic literature review. Biomed Res Int 2016; 2016:7309272.
  24. Miyamoto S, Kondo T, Suzukamo Y, Michimata A, Izumi S. Reliability and validity of the Manual Function Test in patients with stroke. Am J Phys Med Rehabil 2009;88:247-55. https://doi.org/10.1097/PHM.0b013e3181951133
  25. Riddle DL, Stratford PW. Interpreting validity indexes for diagnostic tests: an illustration using the Berg balance test. Phys Ther 1999;79:939-48. https://doi.org/10.1093/ptj/79.10.939
  26. Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995;27:27-36.
  27. Jung HY, Park BK, Shin HS, Kang YK, Pyun SB, Paik NJ, et al. Development of the Korean version of Modified Barthel Index (K-MBI): multi-center study for subjects with stroke. J Korean Acad Rehabil Med 2007;31:283-97.
  28. Park J, Woo YK, Park SY. Effects of sit-to-stand training on unstable surface on balance in subject with stroke. Phys Ther Korea 2013;20:1-8.
  29. Seo HW, Kim MC. Study on the correlation between muscle activity of lower extremity and sway speed of chronic stroke patients according to unstable surface training. J Korean Soc Integr Med 2013;1:75-83. https://doi.org/10.15268/KSIM.2013.1.4.075
  30. French B, Thomas L, Leathley M, Sutton C, McAdam J, Forster A, et al. Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabil Med 2010;42:9-15. https://doi.org/10.2340/16501977-0473
  31. Lee HS, Choi JH. Correlation between BBS, FRT, STI, TUG, MBI, and falling in stroke patients. J Korean Soc Phys Ther 2008;20:1-6.
  32. Woo HS, Park WK, Cha TH. Correlation between Korean-WMFT functional score and activities of daily living. Korean J Occup Ther 2012;20:95-104.
  33. Kim JO, Lee BH. Effect of upper extremity coordination exercise during standing on the paretic side on balance, gait ability and activities of daily living in persons with stroke. Phys Ther Rehabil Sci 2017;6:53-8. https://doi.org/10.14474/ptrs.2017.6.2.53

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