• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.103-113
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• 2019

PURPOSE: The purpose of this study was to determine if virtual reality-based exercise was effective in balance, gait, and falls efficacy in patients with Parkinson's disease (PD). METHODS: Thirty patients with PD were assigned randomly to the experimental (n=15) or control groups (n=15). The experimental group performed virtual reality-based exercise and the control group underwent conventional physical therapy for 30minutes, five times per week for four weeks. A force platform system, the Korean version of the Berg Balance Scale (K-BBS), the six-minute walking test (6MWT), and the Korean Version of the Falls Efficacy Scale (K-FES) were used to evaluate balance, gait, and falls efficacy. Wilcoxon signed-rank test and Mann-Whitney U test were used to examine the within- and between-group differences after training, respectively. RESULTS: Changes in the K-BBS score (p<.001) and fall efficacy (p<.01), following the intervention were significantly greater in the experimental group than in the control group whereas significant group difference were not observed for the anterior-posterior and mediolateral postural sway lengths. The change in the ground reaction force (p<.001) and 6MWT values (p<.05) were significantly greater after intervention in patients in the experimental group than in the control group, whereas a significant group difference was not observed for the step and stride lengths. CONCLUSION: This study indicates that virtual reality-based exercise is an effective intervention for improving balance, gait, and fall efficacy in patients with PD.

• 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 the Korea Convergence Society
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• v.11 no.8
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• pp.63-70
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• 2020

This study was designed to test the convergence effectiveness of virtual reality programs for patients with stroke by using meta-analysis. Based on the PICOS criteria, we searched domestic literature and selected the final 9 studies in relation to 'stroke' and 'virtual reality programs'. Evaluation of the risk of bias in individual studies was conducted using evaluation tools according to the design of each study. The effect size of the meta-analysis was calculated using CMA program. The mediating effect analysis was conducted by sub-group analysis and meta-regression analysis. The overall effect size of the virtual reality program on the activities of daily living ability was Hedges's g=0.302(95% CI: 0.064~0.540), Therefore, virtual reality programs can increase the activities of daily living in stroke patients and have a positive impact on the medical industry that the convergence of virtual reality industry and healthcare industry.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.50-56
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• 2015

Purpose: To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Materials and Methods: Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. Results: The median level I and II axillary volume coverage percentages at the $V_{D95%}$ line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. Conclusion: The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.403-412
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• 2022

Background: Most pain management techniques for challenging procedures are still performed under the guidance of the C-arm fluoroscope although it is sometimes difficult for even experienced clinicians to understand the modified three-dimensional anatomy as a two-dimensional X-ray image. To overcome these difficulties, the development of a virtual simulator may be helpful. Therefore, in this study, the authors developed a virtual simulator and presented its clinical application cases. Methods: We developed a computer program to simulate the actual environment of the procedure. Computed tomography (CT) Digital Imaging and Communications in Medicine (DICOM) data were used for the simulations. Virtual needle placement was simulated at the most appropriate position for a successful block. Using a virtual C-arm, the authors searched for the position of the C-arm at which the needle was visualized as a point. The positional relationships between the anatomy of the patient and the needle were identified. Results: For the simulations, the CT DICOM data of patients who visited the outpatient clinic was used. When the patients revisited the clinic, images similar to the simulated images were obtained by manipulating the C-arm. Transforaminal epidural injection, which was difficult to perform due to severe spinal deformity, and the challenging procedures of the superior hypogastric plexus block and Gasserian ganglion block, were successfully performed with the help of the simulation. Conclusions: We created a pre-procedural virtual simulation and demonstrated its successful application in patients who are expected to undergo challenging procedures.

• Cartoon and Animation Studies
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• s.22
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• pp.81-97
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• 2011

The technology of 'Virtual Reality' has placed in advanced tools for human beings' joy and anger together with sorrow and pleasure in our generation. It has recently tried in a variety ways to use as an implication for treatment in the field of Cognitive Psychology. Especially, it widely approaches to human in terms of that a sense of reality in a virtual world through the five senses should reinterpret the meaning of cognition in the real world. Based on this paradigm shift, it allows for new treatment using the technology of virtual reality. A typical example is a field of Therapy in order to overcome panic disorder. It has advantages that in particular development of flexible interaction technologies in a virtual space can lead patients to experience psychological environments rather than physical one. the interaction technology provides environments in which users' five senses can be actively stimulated, it is very useful that information from the experiences in the virtual world allows people to learn through real experiences by renewing potential energies, advantages of Virtual Reality Therapy can be customized treatment by depending on symptoms in patients with panic disorder and are capable of differentiate application for the cure at each stage. It is to treat by leading patients to get accustomed to environments and situations in real world through care process with each symptom and stage. It is helpful that based on A Human-Sensibility Ergonomics, technologies like immersive virtual reality equipment, force-relative feedback and stereophonic sound, and like stimulating the sense of smell make people to induce experiences by stimulating human's five senses. There are many advantages of immersion in virtual world in that the phenomenon such as challenge, interaction, reality, illusion, and cooperation is expanded. As an application for therapy by growing such augmented reality, virtual space and sharing of data through the Internet and also inexpensive its availability have recently expanded the base. There are other benefits of Virtual Reality Therapy offering active interaction environments for cognitive experience which can provide appropriately adjusted environments for patients who are hard to overcome the real situation because of phobia. In addition to that it is safe and economical and patients' confidentiality is assured. Moreover, due to the principles of applying real-time navigation the Virtual Reality Therapy makes modification and supplementation easier and also it can reduce cybersickness because of the supply of Lenticular allowing people to see stereoscopy without eyeglasses, which makes sense of presence clearer. On top of that due to the development of interactive technologies, it is becoming close to sense of reality similar to real world by leading users to navigate by themselves and to operate objects in a virtual space. This paper will therefore examine, although it is of limited, characteristics of application of virtual reality technology based on A Human-Sensibility Ergonomics used for treatment for a disorder. this paper will analyse a range of its application and problems and it will suggest the future possibilities.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.227-238
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• 2011

Objectives : This study was to investigate the effects on using Virtual reality exercise program($Wii-Fit^{TM}$) for dynamic balance and walking ability in patients with stroke. Methods : The 22 subjects were randomly selected from the patients of the S hospital who met the study conditions. They were divided into a $Wii-Fit^{TM}$ balance game group of 12 patients and a conventional physical therapy group of 10 patients. The $Wii-Fit^{TM}$ balance game group received $Wii-Fit^{TM}$ balance game group general physiotherapy for 5 days a weeks, 30 minutes a day, for a 4 weeks and the conventional physical therapy group received general physiotherapy for the same period. The subjects were measured and compared for Brunel balance assessment, functional gait assessment, 6 minute walk test, GAITRite system before and after the program. Results : The experimental group tend to improve more than control group in shifting the weight to the affected side(p=0.040) and tap test(p<0.001). The experimental group tend to improve more than control group in FGA(p=0.016). The experimental group improved significantly more than control group in 6MWT(p=0.008). The experimental group improved significantly more than control group in gait speed, cadence, stride length. Conclusions : Virtual Reality program($Wii-Fit^{TM}$) with conventional physical therapy shows the benefits on dynamic balance and gait parameters in patients with stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.69-76
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• 2019

Purpose : This study examined the effects of a virtual reality rehabilitation program on stroke patients' upper extremity functions and activities of daily living (ADL). Methods : The subjects were equally and randomly divided into an experimental group (n=16) to whom a virtual reality rehabilitation program was applied and a control group (n=16) who received traditional occupational therapy. The intervention was applied five times per week, 30 minutes per each time, for six weeks. Jebsen-Taylor hand function test was conducted and the subjects' Manual Function Test was measured to examine their upper extremity functions before and after the treatment intervention, and a Korean version of modified Barthel index was calculated to look at their activities of daily living. Results : After the intervention, the upper extremity functions and activities of daily living of the participants in both groups significantly improved (p<.05). However, the improvements in these parameters among the participants in the virtual reality rehabilitation program were significantly greater than those in the control group (p>.05). Conclusion : The virtual reality rehabilitation program is a stable and reliable intervention method for enhancing the upper limb functions and activities of daily living of stroke patients.

• The Journal of the Korea Contents Association
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• v.12 no.8
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• pp.274-282
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• 2012

This study conducted the following experiment to examine change of physicopsychological function on lumbar stabilization exercise(LSE) and virtual reality game training(Nintendo Wii Sport-NWS) to stroke patients subject for fall prevention. Psychological function was measured by falls efficacy with stroke patients and physical function was measured by static and dynamic balance on comparative analysis of pre, post exercise and each groups in 30 stroke patient subject. Static balance was measured by BBS, FRT, dynamic were measured by TUG, 10m walking test and falls efficacy with stroke patients was measured index of falls efficacy. These result lead us to the conclusion that each group were statistically improved at all physicopsychological test, but BBS, FRT, 10m walking test were more statistically improved at LSE group and falls efficacy with stroke patients were more improved at virtual reality game training group. Consequently, virtual reality game training would be lead to positive increment of physicopsychological function on stroke patient.