- Volume 13 Issue 7
DOI QR Code
Effects of Home-based Virtual Reality on Upper Extremity Motor Function for Stroke - An Experimenter Blind Case Study
가정-중심 가상현실이 만성뇌졸중환자의 팔 운동기능에 미치는 영향 - 실험자 맹검 단일실험연구
- Lee, Jung-Ah (Department of Motor and Cognitive Rehabilitation, Korea National Rehabilitation Center Research Institute) ;
- Hwang, Su-Jin (Department of Physical Therapy, Nambu University) ;
- Song, Chiang-Soon (Department of Occupational Therapy, Chunnam-Techno College)
- Received : 2012.02.29
- Accepted : 2012.07.12
- Published : 2012.07.31
The purpose of this study was to investigate the effect of the home-based virtual reality (VR) on upper extremity motor function in hemiparetic stroke patients. Two matched subjects with left hemiplegia were volunteered to participate in this study. One subject received the home-based VR whereas the other subject recovered a modified home-based constraint-induced movement therapy (CIMT). Both interventions were given for 4 hours x 5 times a week for 4 weeks. Outcome measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Wolf Motor Function Test (WMFT). The VR-trained subject showed considerable improvement in all the tested motor functions when compared with the home-based CIMT. Specifically, the FMA measure demonstrated that the VR subject showed 17% enhancement whereas the CIMT subject showed 5% increase. Similarly, Amount of Use (AOU) and Quality of Movement (QOM) of the MAL scores of the VR subject showed 40% and 20% increase whereas the CIMT subject showed 0% and 20% increase, respectively. The WMFT scores of the VR subject and CIMT subject showed 20% increase. Our home-based VR was effective in upper extremity motor recovery of chronic hemiparetic patients even when compared with the well-established CIMT approach in stroke victims.
Arm motor function;Stroke;Virtual reality
- A. S. Merians, D. Jack, R. Boian, et al, Virtual reality-augmented rehabilitation for patients following stroke. Phys Ther, 82, 898-915, 2002.
- S. J. Page, S. A. Sisto, & P. Levine, Modified constraint-induced therapy in chronic stroke. American J Physl Med Rehab, 81, 870-875, 2002. https://doi.org/10.1097/00002060-200211000-00013
- S. C. Deluca, K. Echols, S. L. Raney, & E. Taub, Pediatric costraint-induced movement therapy for a young child with cerebral palsy: Two episodes of care. Phys Ther, 83(11), 1003-1013, 2003.
- S. H. You, S. H. Jang, SH,. Y. H. Kim, et al, Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke. Stroke, 36, 1166-1171, 2005. https://doi.org/10.1161/01.STR.0000162715.43417.91
- J. M. Andre, J. P. Didier, J. Paysant, Functional motor amnesia instroke and learned non-use phenomenon. J Rehabil Med, 36, 138-140, 2004. https://doi.org/10.1080/16501970410026107
- S. Lennon, & A. Ashburn, The Bobath concept in stroke rehabilitation: A focus group study of the experienced physiotherapist's perspective. Disabil Rehab, 22(15), 665-674, 2000. https://doi.org/10.1080/096382800445461
- J. S. Knutson, T. Z. Hisel, M, Y, Harley, et al, A novel functional electrical stimulation treatment for recovery of hand function in hemiplegia: 12-week pilot study. Neurorehabil Neural Repair, 23(1), 17-25, 2009. https://doi.org/10.1177/1545968308317577
- F. Eser, G. Yavuzer, D. Karakus, et al, The effect of balance training on motor recovery and ambulation after stroke: A randomized controlled trial. European J Phys Rehab Med, 44(1), 19-25, 2008.
- S. J. Page, S. A. Sisto, R. Levine, R. E. McGrath, Efficacy of modified constraint-induced movement therapy in chronic stroke: A single-blinded randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 85, 14-18, 2004. https://doi.org/10.1016/S0003-9993(03)00481-7
- E. Taub, G. Uswatte, R. Pidikiti, Constraint-induced movement therapy: A new family of techniques with broad application to physical rehabilitation. J Rehab Resear Develop, 36(3), 237-251, 1999.
- H. J. Freund, M. Jeannerod, M. Hallett, & R Leiguarda. Higher-order motor disorders: from neuroanatory and neurobiology to clinical neurology. Chapter 25: Cortical plasticity and motor disorders, pp. 455-473, New York, MD: Oxford University Press Inc, 2005.
- J Broeren, L. Claesson, D. Goude, et al. Virtual rehabilitation in an activity centre for community dwelling persons with stroke: The possibilities of 3-dimensional computer games. Cerebrovasc Dis, 26(3), 289-296, 2008. https://doi.org/10.1159/000149576
- A. Henderson, N. Korner-Bitensky, & M. Levin, Virtual reality in stroke rehabilitation: A systematic review of its effectiveness for upper limb motor recovery. Top Stroke Rehabil, 14(2), 52-61, 2007. https://doi.org/10.1310/tsr1402-52
- S. Subramaniam, L. A. Knaut, C. Beaudoin, et al, Virtual reality environments for post stroke arm rehabilitation, J Neuroeng Rehabil, 22(4), 20, 2007.
- J. H. Van Der Lee, H. Beckerman, G. J. Lankhorst, L. M. Bouter, The responsiveness of the action research arm test and the Fugl-Meyer assessment scale in chronic stroke patients. J Rehabil Med, 33, 110-113. 2001. https://doi.org/10.1080/165019701750165916
- A. R. Fugl-Meyer, L. Jääskö, Leyman et al. The post-stroke hemiplegic patient. II. Incidence, mortality, and vocational return in Goteborg, Sweden with a review of the literature, Scand J Rehabil Med, 7, 13-31, 1975.
- A. Shumway-Cook, M. H. Woollacott, Motor Control: Translating research into clinical practice 3rd ed. pp. 175-230, Philadelphia, Lippincott Williams & Wilkins, 2007.
- G. Uswatte, E. Taub, D. Morris, et al, The motor activity log-28: Assessing daily use of the hemiparetic arm after stroke. Neurology, 67, 1189-1194, 2006. https://doi.org/10.1212/01.wnl.0000238164.90657.c2
- E. Taub, N. E. Miller, T. A. Novack, et al, Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil, 174(4), 347-354, 1993.
- S. L. Wolf, D. E. Lecraw, L. A. Barton, et al, Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol, 104(2), 125-132, 1989. https://doi.org/10.1016/S0014-4886(89)80005-6
- M. K. Holden, T. A. Dyar L. Dayan-Cimadoro, Telerehabilitation using a virtual environment improves upper extremity function in patients with stroke. IEEE Trans Neural Syst Rehabil Eng, 15(1), 36-42, 2007. https://doi.org/10.1109/TNSRE.2007.891388
- M. Rydmark, J. Broeren, R. Pascher, Stroke rehabilitation at home using virtual reality haptics and telemedicine. Stud Health Technol Inform, 85, 434-437, 2002.
- J. L. Alberts, A. J. Butler, S. L. Wolf, The effects of constraint-induced therapy on precision grip: a preliminary study, Neurorehabil Neural Repair, 18(4), 250-258, 2004. https://doi.org/10.1177/1545968304271370
- E. Taub, G. Uswatte, V. W. Mark, et al. The learned nonuse phenomenon: Implications for rehabilitation. Eura Medicpphys. 42(3), 241-256, 2006.
- Rehabilitation robotics for the upper extremity: review with new directions for orthopaedic disorders vol.12, pp.8, 2017, https://doi.org/10.1080/17483107.2016.1269211