• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.103-114
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• 2023

PURPOSE: This study compared the effects of computer-based and virtual reality-based cognitive rehabilitation programs on the cognitive function, upper limb function, activities of daily living, and their impact on the prefrontal cortex in convalescent stroke patients. METHODS: Ten recovering stroke patients were assessed for their cognitive function, upper limb function, and daily living activities using the Neurobehavioral Cognitive Status Examination, the Korean version of the Fugl-Meyer Assessment, and the Korean version of the Modified Barthel Index. The prefrontal cortex activity was measured with functional Near Infrared Spectroscopy. The virtual reality-based cognitive rehabilitation group utilized a program of daily living activities delivered via a laptop and Oculus Rift. The computer-based cognitive rehabilitation group performed various cognitive tasks on an all-in-one PC. Both groups underwent cognitive rehabilitation training for 30 minutes per day, three times a week, for six weeks, with identical conventional rehabilitation therapies in the hospital. RESULTS: Both programs positively impacted the cognitive and physical functions. On the other hand, the virtual reality-based cognitive rehabilitation program had a larger influence on improving the cognitive and physical functions of convalescing stroke patients. CONCLUSION: The virtual reality program suggests its potential to enhance cognitive and physical functions in convalescent stroke patients through increased engagement, focus, real-time feedback, and game elements, making it a promising rehabilitation approach.

• PNF and Movement
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• v.17 no.3
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• pp.369-378
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• 2019

Purpose: This study investigated the effects of virtual reality-based task training (VRBTT) using a smart glove on upper extremity function and activity of daily living in stroke patients. Methods: Twenty-nine patients with chronic stroke disease were randomly allocated to two groups: the VRBTT group (n=14) and the control group (n=15). All patients received 30 minutes of standard occupational therapy, 5 times a week, for 8 weeks. The VRBTT group performed an additional 30 minutes of virtual reality-based rehabilitation training, 5 times a week, for 8 weeks. Results: Both groups showed significant improvements in upper extremity function, yielding an increase in FMA and K-WMFT (p<0.05). There was a more significant increase in the VRBTT group before and after interventions (p<0.05). There was no significant difference in MAS for the control group (p>0.05); however, there was a significant increase for the VRBTT group (p<0.05). In the activities of daily living, there was a significant difference in the values for K-MBI (p<0.05). In addition, both groups showed a significant increase for K-MBI and K-RNLI (p<0.05). Conclusion: This study showed that VRBTT using smart gloves can have a more positive effect on upper extremity function and activities of daily living in stroke patients than conventional intervention methods. A variety of virtual reality-based contents and glove-shaped wearable devices will help stroke patients in rehabilitation clinics recover and return to society.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.67-75
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• 2019

Purpose: Patients with brain damage suffer from limitations in performing the activities of daily living (ADL) because of their motor function and visual perception impairment. The aim of this study was to help improve the motor function and visual perception ability of patients with brain damage by providing them with virtual reality-based contents. The usability results of the patients and specialists group were also evaluated. Methods: The ADL contents consisted of living room, kitchen, veranda, and convenience store, similar to a real home environment, and these were organized by a rehabilitation specialist (e.g., neurologist, physiotherapist, and occupational therapist). The contents consisted of tasks, such as turning on the living room lights, organizing the drawers, organizing the kitchen, watering the plants on the veranda, and buying products at convenience stores. To evaluate the usability of the virtual reality-based visual cognitive rehabilitation service, general elderly subjects (n=11), stroke patients (n=7), stroke patients with visual impairment (n=4), and rehabilitation specialists (n=11) were selected. The questionnaires were distributed to the subjects who were using the service, and the subjective satisfaction of individual users was obtained as data. The data were analyzed using SPSS 21.0 software. The general characteristics of the users and the evaluation scores of the experts were analyzed using descriptive statistics. Results: The usability test result of this study showed that the mean value of the questionnaire related to content understanding and difficulty was high, between 4-5 points. Conclusion: The virtual reality rehabilitation service of this study is an efficient service that can improve the function, interest, and motivation of stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.221-230
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• 2023

Purpose : This study was performed to evaluate the effects of virtual reality combined robot assist gait training (VRG) on improvement of balance and respiratory function in chronic stroke patients. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 35 chronic stroke patients. They were randomly allocated 2 groups; VRG group (n=18) and conservative treatment group (CG; n=17). The VRG group received 30 minutes robot assisted gait training combined virtual reality training, robot assisted gait training was conducted in parallel using a virtual reality device (2 sessions of 15 minutes in a 3D-recorded walking environment and 15 minutes in a downtown walking environment). In the conservative treatment group, neurodevelopmental therapy and exercise therapy were performed according to the function of stroke patients. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome balance and respiratory function were measured by a balance measurement system (BioRescue, Marseille, France), Berg balance scale, functional reach test for balance, Spirometry (Cosmed Micro Quark, Cosmed, Italy) for respiratory function Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximum expiratory volume (PEF) were measured according to the protocol. The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in balance and respiratory function during intervention period. VRG revealed significant differences in balance and respiratory function as compared to the CG groups (p<.05). Our results showed that VRG was more effective on balance and respiratory function in patients with chronic stroke. Conclusion : Our findings indicate that VRG can improve balance and respiratory function, highlight the benefits of VRG. This study will be able to be used as an intervention data for recovering balance and respiratory function in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.11-21
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• 2020

PURPOSE: This study examined the effects of posture improvement exercise using virtual reality programs on the posture and balance of patients with forward head postures. METHODS: Thirty men and women in their 20 s, who had a forward head posture, were divided randomly into a group with posture correction exercise and a group with posture correction exercise combined with virtual reality programs. The posture correction exercise was composed of squats, XCO training, and chin-tuck exercise. In contrast, exercise with virtual reality games involved the Hot Squat, Climbey, and Baskhead programs while wearing a headset. Both groups performed the exercises 15 min a day, three times per week, for four weeks. The balance ability, distance between the acromion and earlobe, and neck joint range of motion were assessed before and after the exercises. RESULTS: Both groups showed significant reductions in the distance between the acromion and the earlobe, along with significant improvements in the range of joint motion. The group that performed the virtual reality exercises showed a significant increase in the limit of stability. Both groups showed a significant decrease in the sway length. In contrast, the group given the virtual reality exercises showed a significant reduction in the sway speed while standing with their eyes closed. CONCLUSION: Exercise applying virtual reality programs can be used in clinical and home programs to correct the postures of individuals with a forward head posture because they can trigger interest in inducing active participation.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.1
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• pp.63-70
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• 2010

Purpose : The purpose of this study was to investigate the effects of virtual reality(VR) program on standing balance in stroke with sensory deficit. Methods : Subjects were assigned randomly to either VR group (n=28) or the control group (n=31) when study began. Both groups were conducted electricity therapy, exercise therapy 5 times per week during six weeks, and a group who have VR group 3 times per week during six weeks. Both groups assessed for standing balance before and after virtual reality program. Results : In standing balance, the virtual reality program which have sensory deficit in stroke group, open eyes from the center area of the body and center line significantly reduced the training period(p<.05). The virtual reality program to instantly move the weight through maximum voluntary safety limits to sensory deficit of virtual reality program(p<.05). Conclusion : Stroke patients with sensory deficit affects the recovery of the standing balance. In addition, virtual reality program was stroke patients with sensory deficit affects the recovery of standing balance.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.351-367
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• 2005

The purpose of this study was to identity effects of virtual reality(VR) program related to standing postural control on balance, gait and brain activation patterns in chronic hemiplegic stroke patients. Subjects were assigned randomly to either VR group (n=12) or the control group (n=12) when the study began. Both groups received conventional physical therapy for 2 to 3 times per week. In addition to conventional physical therapies, VR group trained 3 types of virtual reality programs using IREX for standing postural control during 4 weeks (4 times/week, 30 minutes/time). Subjects were assessed for static and dynamic balance parameters using BPM, functional balance using Berg Balance Scale related to movement of paretic lower limb before and after 4 weeks of virtual reality training. The results of this study were as follows. 1. Following VR training, VR group demonstrated the marked improvement on dynamic mean balance, anteroposterior limits of stability (AP angle) and mediolateral limits of stability (ML angle). 2. Following VR training, both groups scored higher on Berg Balance Scale. However, a comparison of mean change revealed differences between groups. In conclusion, these data suggest that the postural control training using VR programs improve dynamic and functional balance performance in chronic hemiplegic stroke patients.

• Journal of Institute of Control, Robotics and Systems
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• v.9 no.8
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• pp.577-584
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• 2003

Traditional ankle rehabilitation procedures are tedious, repetitive, and require therapist's help. Therefore, they do not provide patients with good motivation to actively participate in the rehabilitation exercises. In addition, objective diagnosis and evaluation of the treatment progress have been difficult because records of exercise history are made by passive instruments from time to time. The virtual reality technology can make these procedures more fun so that patients can perform everyday rehabilitation exercises more actively. Moreover, haptics technology can give active resistance to the patients ankle motion to improve strength of muscles as well as can record ankle's motion and force histories for objective diagnosis and evaluation. This paper summarizes development of a virtual environment fur reforming the conventional ankle rehabilitation procedures. First of all, conventional rehabilitation procedures have been summarized. Secondly, haptic design and control, user interface design, virtual environment contents design are described. Lastly, mutual cooperation among many developers including medical doctors and therapists and future works are commented.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.7-12
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• 2013

Purpose : The purpose of this study was to identify effects of virtual reality-based closed kinetic chain (CKC) exercise on lower extremity muscle activity in chronic stroke patients Methods : Subjects were assigned randomly either to VR+CKC exercise group (n=15) or the CKC exercise group (n=15). When the study began, both groups received conventional physical therapy five times per week. The VR+CKC exercise group received virtual reality programs and the CKC exercise group received close kinetic chain exercises. Each exercise program was performed for six weeks (5 times per weeks; 20 minutes per time). Participants were measured on lower extremity muscle activity using EMG. Results : There was a significant increase of muscle activity (%RVC) in vastus lateralis and vastus medialis. Conclusion : In this study, the virtual reality-based closed kinetic chain exercise program was an effective exercise for improving lower extremity muscle activity in chronic stroke patients.

• Journal of Digital Convergence
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• v.17 no.11
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• pp.349-355
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• 2019

The virtual reality training has been suggested as an intervention to improve physical function. But, the effects of virtual reality training focused on improving ADL in patients with acute stroke are unclear. Purpose of this study was to examine the effect of virtual reality training on hand function and activities of daily living (ADL) in patients with acute stroke. Sixteen patients with acute stroke were included in this study. The experimental group (VRA group) received 30 minutes of virtual reality training focused on ADL for each session, while the control group received 30 minutes of conventional virtual reality training. To examine the hand function and ADL of the subjects, the study used Jebsen-Tylor Hand Function Test (JTHFT) and Korean Modified Barthel Index (K-MBI), respectively. Both groups showed significant improvements in hand function of affected and unaffected sides, and in K-MBI total score before and after the intervention. The experimental group showed significantly greater improvements in the self-care domain of K-MBI after intervention than the control group. These findings suggest that the virtual reality training focused on ADL may have a better effect on self-care than conventional virtual reality training in patients with acute stroke.