DOI QR코드

DOI QR Code

가상현실재활프로그램이 뇌졸중 환자의 상지기능, 인지와 일상생활활동에 미치는 효과

The Effect of Virtual Reality Rehabilitation Program on Upper function, Cognition and Activity of Daily of Living in the with Stroke Patients

  • 박우권 (경복대학교 작업치료과) ;
  • 부정아 (경복대학교 작업치료과) ;
  • 김보중 (가톨릭대학교 은평성모병원)
  • 투고 : 2023.05.15
  • 심사 : 2023.07.01
  • 발행 : 2023.07.31

초록

본 연구의 목적은 가상현실재활프로그램이 뇌졸중 환자의 상지기능, 인지와 일상생활활동에 미치는 영향을 조사하는 것이다. 프로그램 참여한 25명 중 무작위로 실험군 13명과 대조군 12명으로 분류하였다. 실험군 가상현실재활훈련 기기를 활용하여 재활훈련을 주 3회와 일반 작업치료 주 2회 적용하였고, 대조군은 일반 작업치료만 매주 5회, 회당 30분씩 진행하였다. 가상현실재활프로그램 진행한 결과 인지기능은 가상현실재활프로그램 실시한 실험군은 3.39점 증가 하였고, 일반 작업치료만 실시한 대조군은 실험 후 1.5점이 증가하였다, 상지기능은 가상현실재활프로그램 실시한 실험군은 4.84점 증가 하였고, 일반 작업치료만 실시한 대조군은 1.34점이 증가하였다, 일상생활활동은 가상현실재활프로그램 실시한 실험군은 20.38점 증가 하였고, 일반 작업치료만 실시한 대조군은 7.61점이 증가하였다, 이 결과를 통해 가상현실프로그램이 뇌졸중 환자의 상지기능, 인지와 일상생활활동도 효과가 있다는 것을 확인할 수 있다.

The purpose of this study was to investigate the effects of a virtual reality rehabilitation program on upper limb function, cognition, and activities of daily living in stroke patients. Among the 25 participants in the program, it was randomly classified 13 experimental group and 12 control group. Rehabilitation training was applied 3 times a week and general occupational therapy 2 times a week using virtual reality rehabilitation training equipment in the experimental group, and general occupational therapy was performed 5 times a week, 30 minutes per session in the control group. As a result of the virtual reality rehabilitation program, cognitive function increased by 3.39 points in the experiment group, The control group who received only general occupational therapy increased by 1.5 points. As for the upper limb function, the average of the experimental group subjected to the virtual reality rehabilitation program increased by 4.84 points The control group who received only general occupational therapy increased by 1.34 points. As for activities of daily living, the average of the experimental group that conducted the virtual reality rehabilitation program increased by 20.38 points, The control group who received only general occupational therapy increased by 7.61 points. This result show that the virtual reality program has an effect on upper limb function, cognition, and activities of daily living of stroke patients.

키워드

참고문헌

  1. Dijkerman, H. C., Ietswaart, M., Johnston, M., & MacWalter, R. S. (2004). Does motor imagery training improve hand function in chronic stroke patients? A pilot study. Clinical Rehabilitation, 18(5), 538-549. https://doi.org/10.1191/0269215504cr769oa
  2. Hochstenbach, J., Prigatano, G., & Mulder, T. (2005). Patients' and relatives' reports of disturbances 9 months after stroke: Subjective changes in physical functioning, cognition, emotion, and behavior. Archives of Physical Medicine and Rehabilitation, 86(8), 1587-1593. https://doi.org/10.1016/j.apmr.2004.11.050
  3. Joo, M. C., Park, H. I., Noh, S. E., Kim, J. H., Kim, H, J., & Jang, C. H. (2014). Effects of robot-assisted arm training in patients with subacute stroke. Brain & NeuroRehabilitation, 7(2), 111-117. https://doi.org/10.12786/bn.2014.7.2.111
  4. Meadmore, K. L., Exell, T. A., Hallewell, E., Hughes, A. M., Freeman, C. T., Kutlu, M., ... Burridge, J. H. (2014). The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: A feasibility study. Journal of Neuroengineering and Rehabilitation, 11(1), 1-11. https://doi.org/10.1186/1743-0003-11-1
  5. Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., ... Bergquist, T. (2011). Evidence-based cognitive rehabilitation: Updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92 (4), 519-530. https://doi.org/10.1016/j.apmr.2010.11.015
  6. H. M. Kim. (2015). A study on the development of a force sensor and finger rehabilitation robot for stroke patients, Doctoral dissertation, Gyeong sang University, Jinju.
  7. H. K. Shin. (2008). The recovery of hand function induced by EMG-triggered electrical stimulation in hemiplegic finger extensor. J Korean Soc Occup Ther, 16, 61-69.
  8. P. S. Buyn & M. Y. Chon. (2012). The effects of rehabilitation training using video game on improvement range of motion for upper-extremity, shoulder pain and stress in stroke patients with hemiplegia. Journal of muscle and joint health, 19(1), 46-56. https://doi.org/10.5953/JMJH.2012.19.1.046
  9. V. Sirtori, D. Corbetta, L. Moja & R. Gatti. (2009). Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database Syst Rev, 4(4).
  10. C. R. Senesac, S. Davis & L. Richards. (2010). Generalization of a modified form of repetitive rhythmic bilateral training in stroke. Human movement science, 29(1), 137-148. https://doi.org/10.1016/j.humov.2009.05.004
  11. A. A. Rizzo, J. G. Buckwalter & U. Neumann. (1997). Virtual reality and cognitive rehabilitation: A brief review of the future. The Journal of Head Trauma Rehabilitation
  12. Turolla, A., Dam, M., Ventura, L., Tonin, P., Agostini, M., Zucconi, C., Piron, L. (2013). Virtual reality for the rehabilitation of the upper limb motor function after stroke: A prospective controlled trial. Journal of Neuroengineering and Rehabilitation, 10(1), 1-9. https://doi.org/10.1186/1743-0003-10-1
  13. Faria, A. L., Andrade, A., Soares, L., & Badia, S. B. (2016). Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: A randomized controlled trial with stroke patients. Journal of Neuro Engineering and Rehabilitation, 13 (1), 1-12 https://doi.org/10.1186/s12984-015-0109-2
  14. S. A. Park & H. Y. Kim. (2019). Effects of virtual reality program on recovery of functional in individuals stroke: a systematic review and meta analysis. Journal of Digital Convergence, 17(5), 235-247. https://doi.org/10.14400/JDC.2019.17.5.235
  15. Folstein, M.F., Folsein, S.E, Mchugh, P.R.(1975). Mini-Mental State : A practica; method for grading the congnotive state of pateinets for the clician. J psychiatr Res 12:189-198. https://doi.org/10.1016/0022-3956(75)90026-6
  16. Kwon, Y. C. (1989). Korean version of MiniMental State Examination (MMSE-K). Journal of theKorean Neuropsychiatric Association, 1,123-135.
  17. Nakamura, R., & Moriyama, S. (2000). Manual Function Test (MFT) and functional occupational therapy for stroke patients. Tokorozawa, JP: National Rehabilitation Center for the Disabled
  18. Shah, S., Vanclay, F., & Cooper, B. (1989). Improving the sensitivity of the barthel index for stroke rehabilitation. Journal of Clinical Epidemiology, 42(8), 703-709.
  19. Jung, H. Y., Park, B. K., Shin, H. S., Kang, Y. K., Pyun, S. B., Paik, N. J. Han, T. R. (2007). Development of the Korean version of Modified Barthel Index (K-MBI): Multi-center study for subjects with stroke. Annals of Rehabilitation Medicine, 31(3), 283-297
  20. A. L. Aramaki, R. F. Sampaio, A. C. S. Reis, A. Cavalcanti, F. C. M. S. E. Dutra(2019). "Virtual reality in the rehabilitation of patients with stroke: an integrative review", Arquivos de Neuro-Psiquiatria, 77(4), 268-278, https://doi.org/10.1590/0004-282x20190025