• PNF and Movement
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• v.21 no.3
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• pp.345-356
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• 2023

Purpose: The aim of this study was to investigate the effects of physical therapy combined with a virtual reality (VR) game on pain, quality of life (QOL), engagement, and knee function in post-knee-surgery patients. Methods: Twenty-four patients who had undergone knee surgery four weeks or more before the study were recruited. Two withdrew from the study during the four-week experimental period, and a total of 22 patients were included in the final analysis. Routine physical therapy consisting of electrostimulation (10 min.) and therapeutic massage (10 min.) was the base intervention for all groups. The experimental group (n = 10) was additionally exposed to a VR game intervention, while the control group (n = 12) underwent an intervention involving similar motions as the experimental intervention but with no VR. The intervention for the experimental group used the game Rig Fit Adventure on Nintendo switch. Both groups underwent their respective interventions 3 times a week (35 min. per session) for 4 weeks. Pain was assessed using the numeric rating scale (NRS), and QOL was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L). Engagement was assessed using the Korea flow state scale (K-FSS). Finally, knee movement and function were assessed based on knee flexion and extension, range of motion (ROM), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results: After the four-week physical therapy, both groups showed significant reductions in pain (on the NRS), increased knee ROM (flexion), better WOMAC scores, and increased EQ-5D-5L scores (p < 0.05), with the experimental group showing significantly better improvements in EQ-5D-5L and K-FSS scores (p < 0.05). Conclusion: The results of this study confirm that a VR-game-integrated intervention is effective for improving pain, QOL, engagement, and knee function in post-knee surgery patients and that VR-game-integrated interventions could be therapeutic alternatives for patients bedridden for prolonged periods with little motivation for rehabilitation.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.131-139
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• 2020

Objective: The purpose of this study was to evaluate the effect of virtual reality (VR)-based core stabilization exercise on upper extremity function, postural control, and depression among persons with stroke with hemiplegia. Design: Randomized controlled trial. Methods: This study was conducted with the inclusion of 24 participants and were randomly assigned to either the VR-based trunk stability exercise group (n=12) or control group (n=12). The VR-based trunk stability exercise group performed core stabilization exercises in a VR environment for 30 minutes. Meanwhile, the control group conducted general core stabilization exercises for 30 minutes. The participants trained 3 times a week for 4 weeks. The manual functional test (MFT), Box and Block Test (BBT), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), the Geriatric Depression Scale (GDS) were used to assess all participants before and after the intervention. Results: The VR-based core stabilization exercise group had a significant improvement in upper extremity function (MFT, BBT) and postural control (BBS) compared with the control group (p<0.05). The VR-based core stabilization exercise showed a significant difference after intervention in the TIS and GDS scores (p<0.05), but they did not significantly differ between the two groups. Conclusions: The result showed that VR-based core stabilization exercise can be effective in improving upper extremity function and postural control among patients with stroke more than the sole application of general physical therapy.

• PNF and Movement
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• v.17 no.2
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• pp.199-206
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• 2019

Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.429-439
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• 2020

This study examined the effect size of virtual reality programs on the upper extremity function of stroke patients through a meta-analysis. Databases, such as the Research Information Sharing Service, the Korean Studies Information Service System, the National Library of Korea, the Korean Citation Index, and the National Digital Science Library, were used. Previous articles were surveyed for virtual reality programs between January 2010 and June 2019. A meta-analysis was performed by selecting the final 14 studies based on the PICO standard. The RoB and RoBANS tools were used as quality assessment tools for randomized and non-randomized control trials, respectively. The CMA 3.0 program was used to calculate the effect size of each study. Sub-group analysis, meta-regression analysis, and publication bias were performed. The total effect size of the virtual reality programs on the upper extremity function was Hedges's g=0.390 (95% CI: 0.192~0.587) (p<.05). The virtual reality program positively affects the upper extremity function of stroke patients. Therefore, the development of various virtual reality programs and industry-academia cooperation technology for stroke patients is required in accordance with the fourth industry. Randomized control trials and detailed upper extremity function studies for virtual reality programs will be needed in follow-up studies.

• Journal of Industrial Convergence
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• v.18 no.5
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• pp.42-53
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• 2020

This study approached the elderly in Korea with a systematic review to find out the effect of virtual reality program arbitration on balance, which the evidence for the virtual reality program is provided. Total of 94 papers were searched through the database Nuri Media (DBpia), Scholarship (earticle), Korean Studies Information (KISS), National Digital Science Library (NDSL), the Korea Educational Research and Information Service (RISS), Kyobo Book Scholar (RISS), and Hakjisa New Thesis on Literature Selection using PRISMA flow-chart from January 2005 to May 2020 based on the final literature selection process and analysis. The quality level of the literature was found to be three volumes (50.0%) of the base level I, one (16.7%) of the II, and two of the III (33.3%). The most common type of virtual reality program was Wii-fit balance of 4 (66.7%), and the effect of virtual reality program arbitration was significant overall through evaluation tools for balance and walking ability. This is expected to effectively apply the virtual reality program to the elderly. In addition, since clinical application basis has been provided, further studies applying various virtual reality program interventions need to be addressed.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.93-102
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• 2022

Purpose : The purpose of this study was to analyze the change in thickness of transvers abdominis, internal oblique, and external oblique when virtual reality based ring fit adventure is applied to young adults in order to investigate the effect of ring fit adventure on core stabilization. Methods : 30 subjects participated in the experiment. Subjects were randomly assigned to two groups. 15 subjects performed ring fit adventure core exercise (experimental group) and 15 subjects bridge and dead bug exercise (control group). The ring fit adventure core exercise program consists of 6 types, 1) bow pull, 2) overhead lunge twist, 3) pendulum bend, 4) seated ring raise, 5) plank, 6) warrior III pose. Each exercise was performed for 5 minutes, for a total of 30 minutes. The bridege and dead bug exercise were performed for 15 minutes each for a total of 30 minutes. All interventions were performed 3 times a week for 4 weeks. Thickness of the abdominal muscles was measured with a ultrasound. The paired t-test was used to compare the thickness of the transverse abdominis, internal oblique, and external oblique before and after intervention, and the comparison between groups was analyzed using the independent t-test. Results : As a result, in the experimental group, thickness of transverse abdominis and internal oblique increased significantly (p<.05), but external oblique decreased significantly (p<.05), and in the control group, thickness of transverse abdominis, internal oblique, and external oblique increased significantly (p<.05). There was a significant difference in external oblique in the difference between groups (p<.05). Conclusion : These study results showed that core exercise using ring fit adventure can reduce external oblique and increased selective muscle activity of transverse abdominis and internal oblique of the deep abdominal muscles, so it is meaningful as an effective intervention for core stabilization.

• Journal of Korean Physical Therapy Science
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• v.30 no.1
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• pp.62-71
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• 2023

Background: This study was performed to evaluate the effects of Thermal stimulation combined virtual reality training (TV) on improvement of upper extremity AROM and function in patient with chronic stroke. Design: Two groups pre-post randomized controlled design. Methods: A single-blind, randomized controlled trial was conducted with 30 chronic stroke patients. They were randomly allocated two groups; the TV group (n=15) and Virtual Reality training group (VT) (n=15). The TV group received treatment for 30 min - 15 min of Thermal stimulation, and 15 min of VR training. The VT group received 15 min of VR training. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome upper extremity AROM and function were measured by a active range of motion test, Manual Function Test (MFT) and Jebsen-Taylor hand function Test (JTT). The upper extremity active range of motion was evaluated using a digital dual inclinometer. MFT and JTT were used to evaluate the hand function. The measurement were performed before and after the 8 weeks intervention period. Results: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke. Conclusion: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke.

• Physical Therapy Korea
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• v.30 no.4
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• pp.306-313
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• 2023

Background: As social problems due to the acceleration of the aging era and the increase in the elderly population are becoming serious, virtual reality (VR)-based healthcare is emerging as an approach for preventing and managing health issues. Objects: This study used validity and reliability analyses to examine the clinical efficacy that is, the clinical value and usability of a novel VR cognitive evaluation system index that we developed. Methods: We developed a VR cognitive evaluation system based on motion recognition analysis evaluation for individuals aged 65 to 85. After conducting the Korean version of the Mini-Mental State Exam (K-MMSE) cognitive evaluation, the evaluation score was verified through correlation analysis in the VR cognitive evaluation system. To verify the construct validity of the two groups, the Global Deterioration Scale (GDS) grades were categorized into a normal cognitive group (GDS grade 1) and a cognitive impairment group (GDS grades 2 and 3). The data were measured twice to determine the reliability between the two measurements and assess the stability and clinical value of the evaluation system. Results: Our evaluation system had a high correlation of 0.85 with the widely used K-MMSE cognitive evaluation. The system had strong criterion-related validity at the 95% confidence interval. Compared to the average score of GDS grade 1 in the VR cognitive evaluation system, the average score of GDS grades 2 and 3 in the VR cognitive evaluation system was statistically significantly lower while also having strong construct validity at the 95% confidence interval. To measure the reliability of the VR cognitive evaluation system, tests-retests were conducted using the intraclass correlation coefficient (3,1), which equaled 0.923 and was statistically significant. Conclusion: The VR cognitive evaluation system we developed is a valid and reliable clinical tool to distinguish between normal cognitive status and mild cognitive impairment.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2002.11a
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• pp.187-192
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• 2002

Research has shown that many smokers experience an increase in the desire to smoke when exposed to smoking-related cues. Cue exposure treatment (CET) refers to the manualized, repeated exposure to smoking-related cues, aimed at the reducing cue reactivity by extinction. In this study, we constructed a virtual reality system for evoking a desire of nicotine, which was based on the results of a Questionnaire of Nicotine-craving. And we investigated the effectiveness of the virtual reality system as compared to classical device (pictures). As a result, we reached the conclusion that virtual reality elicits more craving symptoms than the classical devices.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.95-109
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• 2019

Purpose : This study was conducted to evaluate the effects of FES with abdominal muscle contraction before virtual reality training on balance and gait ability in patients of stroke patients. Methods : The subjects were 30 stroke patients who satisfied the selection criteria. They were randomly assigned to a group receiving functional electrical stimulation with a virtual reality training program (the experiment group, n=15) and placebo functional electrical stimulation with a virtual reality training program (the control group, n=15). The program consisted of three 30-min sessions per week for six weeks. The timed up and go test (TUG), the BT4, the G-WALK were used to estimate subjects' balance, gait before and after the program. For the experiment group, the functional electrical stimulation was applied to the external oblique and the rectus abdominis, For the control group, the same program and the placebo functional electrical stimulation were applied. Results : There were significant improvements in the subscales of the balance and gait ability test of those who participated in the functional electrical stimulation, while the control group showed no significant changes. Conclusion : Therefore, functional electrical stimulation with virtual reality effectively improved the balance and gait ability in patients with chronic stroke.