• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.155-164
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• 2021

Purpose : The purpose of this study is to investigate the effects of transcranial direct current stimulation and virtual reality program application on cognition and depression of patients with mild cognitive impairment, and to find an intervention method that can enhance active participation of patients with mild cognitive impairment. Methods : In this study, 50 mild cognitive impairment patients were divided into a treatment group (25 patients) and a control group (25 patients). The treatment group was applied with a transcranial direct current stimulation and a virtual reality program, while the control group received a placebo transcranial direct current stimulation and a virtual reality program. Both groups received five 50-minute sessions per week (one session per day) for six weeks (total of 30 sessions). NCSE was used to evaluate the cognitive functions of the patients before and after treatment intervention. Moreover, K-BDI was conducted to examine the depression of the patients. Results : As a result of the transcranial direct current stimulation and a virtual reality program intervention, the cognitive function of both treatment and control group significantly (p<.05) improved, and the depression of both treatment and control group significantly (p<.05) decreased. Moreover, the changes in cognitive functions and depression were significant between the two groups¸ treatment and control group (p<.05). Conclusion : The results of the study showed that the application of the transcranial direct current stimulation and virtual reality program significantly improved the cognitive function of mild cognitive impairment patients and decreased the depression of them. Therefore, it could be concluded that the transcranial direct current stimulation and virtual reality program was an intervention method which positively affects the cognitive function and depression of mild cognitive impairment patients.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.115-125
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• 2016

PURPOSE: The purpose of this study was to compare the effects of task-oriented training and virtual reality training on upper extremity function, balance ability, depression in stroke patients. METHODS: Forty stroke patients were randomly allocated into a task oriented training group (TTG, n = 20), a virtual reality training group (VRG, n = 20). Both groups received the usual physical therapy. In addition, TTG patients underwent task training such as sweeping the table, cup stacking, carrying wood block. VRG patients underwent virtual reality training using X-box kinect. Both groups received 30 minutes of training per day, five times per week, for twelve weeks. RESULTS: After intervention, both groups showed significant improvement on upper extremity function, balance ability, and depression. VRG showed more improvement on upper extremity function, balance ability, and depression than TTG. CONCLUSION: According to the results of this study, task-oriented training and virtual reality training are feasible and suitable for stroke patients. And virtual reality training is more effective method than task oriented training.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.96-102
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• 2013

Purpose: The purpose of the study was to investigate the effect of a training program using virtual reality on the balance and lower muscular strength of Parkinson's disease patients. Methods: The study included 22 patients with Parkinson's disease who were arbitrarily classified into 2 groups: 11 patients in the experimental group and 11 patients in the control group. Balance was measured with the Berg balance scale (BBS), the functional reach test (FRT), one-leg stance test (OLST), and the timed up and go test (TUG); whereas, lower muscular strength was measured with the sit-to-stand test (STS). Ping-Pong, bowling, and tennis were selected for virtual reality training for the experimental group, and were performed for 30 minutes 3 times a week for 8 weeks. The control group did not undergo any of the virtual reality training programs. Results: A significant difference was observed in the BBS, FRT, OLST, TUG, and STS results within the experimental group that underwent the virtual reality training program. On the other hand, no significant difference was observed in the BBS, FRT, OLST, TUG, and STS values within the control groups. Conclusion: In conclusion, the virtual reality training program positively affects the balance and lower muscular strength in Parkinson's disease patients. This result indicates the possibility of application of the virtual reality training program to the management for Parkinson's disease patients, and highlights the need for the development and application of more efficient virtual reality training programs in the future.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.355-363
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• 2016

Purpose: In this study, we investigated the effectiveness of a 12-week virtual reality exercise program using the Nintendo Wii console (Wii) in improving balance, emotion, and quality of life among patients with cognitive decline. Methods: The study included 30 patients with cognitive decline (12 female, 18 male) who were randomly assigned to an experimental (n=15) and control groups (n=15). All subjects performed a traditional cognitive rehabilitation program and the experimental group performed additional three 40-minute virtual reality based video game (Wii) sessions per week for 12 weeks. The berg balance scale (BBS) was used to assess balance abilities. The short form geriatric depression scale-Korean (GDS-K) and the Korean version of quality of life-Alzheimer's disease (KQOL-AD) scale were both used to assess life quality in patients. Statistical significance was tested within and between groups before and after treatment, using Wilcoxon signed rank and Mann-Whitney u-tests. Results: After 36 training sessions, there were significant beneficial effects of the virtual reality game exercise on balance (BBS), GDS-K, and KQOL-AD in the experimental group when compared to the control group. No significant difference was observed within the control group. Conclusion: These findings demonstrate that a virtual reality-training program could improve the outcomes in terms of balance, depression, and quality of life in patients with cognitive decline. Long-term follow-ups and further studies of more efficient virtual reality training programs are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.3
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• pp.11-19
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• 2017

Purpose : This study examined the effects of balance training using virtual reality program on sitting balance ability and activities of daily living (ADL) in stroke patients. Method : In the study, 20 patients with hemiplegia were divided into two groups: experiment group (EG) of 10 patients and control group(CG) of 10 patients. The two groups received general occupational therapy for 30 minutes, per day, at a rate of 5 times per week for 6 weeks. The EG was additionally conducted which was performed virtual reality balance training and the CG was conducted general occupational therapy balance training for 30-minutes, once a day, 3 times a week for 6 weeks. Result : The evaluations of this study included: limit of stability(LOS), modified Functional Reach Test(mFRT), and modified Barthel Index(MBI). The patients were evaluated before and after their six week training programs. Significant differences in the LOS, mFRT, MBI were found between pretest and posttest scores in both the EG and CG groups(p<.05). Also, LOS, mFRT, MBI were significant different between the groups at post-test(p<.05). Conclusion : The study findings suggest that virtual reality balance training can improve sitting balance and ADL ability in stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.3
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• pp.1-9
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• 2017

Purpose: The purpose of this study was to investigate the effects of an immersive, virtual reality-based exercise program on range of motion and dexterity in the upper extremities of stroke patients. Methods: Fifteen patients with hemiparesis after stroke participated in this study. The participants participated in Rapael Semart GloveTM, an immersive, virtual reality-based exercise program, performed for 30 minutes-, 3 times per week for 4 weeks. The Rapael Smart GloveTM program and a Box and Block Test (BBT) were used to measure range of motion and to assess dexterity, respectively, pre-and post-intervention. Results: Range of motion in pronation and supination of the forearm and flexion, extension, and ulnar deviation of the wrist improved after the intervention. Dexterity measured by BBT also improved. However, range of motion in flexion and extension of the fingers and radial deviation of the wrist did not improve. Conclusion: This study presents the effects of an immersive, virtual reality-based exercise program on hand function. In the future, a study comparing an immersive, virtual reality- based exercise program to other upper-extremity interventions for stroke patients should be conducted. A study about the effects of an immersive virtual reality program on activities of daily living is also needed.

• 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.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.360-365
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• 2013

Purpose: The purpose of study was to investigate effects of dance sports in virtual reality on balance, depression, and activities of daily living (ADL) in stroke patients. Methods: Subjects of the research consisted of 18 stroke patients who were randomly divided into the experimental and control groups, with nine patients each. All subjects underwent 30 minutes of Neurodevelopmental treatment (NDT) and 15 minutes of Functional electrical stimulation (FES) five days per week for a period of six weeks. Subjects in the experimental group performed an extra 30 minutes of dance sports in virtual reality each day. Balance, depression, and ADL of patients before and after the experiment were measured using Berg's balance scale (BBS), Beck depression inventory (BDI), and Modified Barthel index (MBI), respectively. For comparisone of the state before and after the experiment, wilcoxon signed ranks test was applied and for comparison of the difference between the groups, mannn-whitney U test was applied. Results: Results of this study, showed significant difference in balance, depression, and ADL between the experimental and control groups(p<0.05). As a control of the two groups, the experimental group, which performed extra dance sports in virtual reality, showed a significant difference in balance, depression, and ADL(p<0.05). Conclusion: Depending on the result, a dance sport in virtual reality was verified to enhance balance, depression, and ADL in stroke patients. Therefore, from now on, need for effective program development and application using dance sports in virtual reality will arise.

• Journal of Korean Physical Therapy Science
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• v.24 no.3
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to investigate the effects of virtual reality based treadmill training on muscle architecture of gastrocnemius in chronic stroke patients. Methods: Thirty chronic stroke patients were randomly assigned to either the virtual reality based treadmill training (VRTT) group (n=15) or treadmill training (TT) group (n=15). Both groups participated in a standard rehabilitation program; in addition, the VRTT group participated in virtual reality based treadmill training for 30 minutes per day, three times per week, for 6 weeks, and TT group participated in treadmill walking training for 30 minutes per day, three times per week, for 6 weeks. Ultrasound image was used for measurement of pennation angle and muscle thickness of the medial gastrocnemius muscle at rest and during maximum voluntary contraction. Results: In the paretic side medial gastrocnemius muscle, greater improvement on the pennation angle and muscle thickness while resting and maximal voluntary contraction were observed in the VRTT group compared with the TT group. Conclusion: Findings of this study demonstrated that the virtual reality based treadmill training has an effect on muscle architecture of medial gastrocnemius in chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.27 no.1
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• pp.61-67
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• 2015

Purpose: This study was conducted in order to investigate the effectiveness of an 8-week virtual reality exercise program designed around the Nintendo Wii (Wii), in improving balance among patients with Multiple Sclerosis (MS). Methods: The study included 16 patients with MS (10 female, 6 male) who were assigned randomly to experimental (n=8) or control group (n=8). Experimental group performed three 40-minute Wii balance-training sessions per week, for 8 weeks. The control group did not perform any of the training programs. A computerized dynamic posturography (Sensory Organizing Test, SOT) was used to evaluate all patients at baseline and at the end of the treatment protocol. Statistical significance was tested in between the patients before and after treatment by t-test. Results: After 24 training sessions, SOT showed significant difference on condition 5, 6, and vestibular ratios within the experimental group from baseline to post-intervention. By contrast, no significant difference was observed within the control groups. Conclusion: These findings demonstrated that the virtual reality training program could improve the outcomes in terms of balance in the MS population. Long term follow ups and the development of more efficient virtual reality training programs are needed.