Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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Effects of Computer Based Virtual Reality Program on Clinical Rehabilitation in Korea: A Meta-analysis

컴퓨터 기반 가상현실 프로그램의 국내 임상재활 적용 효과: 메타분석

  • Kwon, Jae-Sung (Department of Occupational Therapy, College of Health Science, Cheongju University)
  • 권재성 (청주대학교 보건의료대학 작업치료학과)
  • Received : 2015.05.15
  • Accepted : 2015.07.20
  • Published : 2015.07.28
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Abstract

Meta-analysis was conducted to examine effects of computer based virtual reality on clinical rehabilitation in Korea. The data were analyzed as the ICF categorizations. The papers used in this study were located through domestic data search engines. The fifteen studies were selected among the studies published between 1995 and 2014. The PEDro score was used for qualitative assessment. The sample size and the average and standard deviations of pre and post tests were analyzed through a meta-analysis. The PEDro scores of the selected studies were 6 points higher and 338 participants were involved. The effect size of combined data was 1.030, activities and participation 1.120, sensory function 1.199 as indicated by a "large effect size" and the effect size of mental function was 0.557 as indicated by a "medium effect size." As a result, virtual reality program as a adjunctive therapeutic methods has proven the effect. In particular, the effects were demonstrated in activities and participation, sensory function. However there was no evidence of the effectiveness of mental function.

본 연구에서는 국내 임상재활 현장에서 적용된 컴퓨터 기반 가상현실 프로그램의 효과를 알아보기 위하여 ICF 분류 기준을 근거하여 메타분석을 실시하였다. 국내 논문 데이터베이스에서 1995년~2014년까지 게재된 연구들 중 15편을 선정하였다. 연구의 질적 평가는 PEDro score를 사용하였고 대상 논문들의 표본수와 사전-사후 평균, 표준편차를 사용하여 메타분석을 실시하였다. 연구결과 선정된 연구는 PEDro score 6점 이상이었고 연구 대상자는 338명이었다. 효과크기 분석 결과 분석대상의 통합된 효과크기는 1.030, ICF 분류의 활동과 참여 1.120, 감각기능 1.199로 큰 효과크기를 보였고 정신기능의 효과크기는 0.557로 중간효과크기를 나타내었다. 본 연구의 결과로 임상재활 현장에서 가상현실 프로그램이 전통적인 재활 치료에 대한 대체 또는 보조적 치료 프로그램으로서의 효과가 입증되었다. 특히 ICF 분류의 활동과 참여, 신체기능의 감각기능에 대한 효과가 입증되었고 신체기능의 정신기능에 대한 효과는 통계적 근거가 미흡하였다.

Keywords

References

  1. G. Saposnik, & M. Levin, Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians. Stroke; a journal of cerebral circulation, Vol. 42, No. 5, pp. 1380-1386, 2011. https://doi.org/10.1161/STROKEAHA.110.605451
  2. S. H. Kim, H. G. Kim, & J. H. Lee, Effect of Virtual Reality Based Exercise Program on the Upper Extremity Function and Activities of Daily Living in Stroke Patients. Journal of Rehabilitation Research, Vol. 17, No. 2, pp. 373-391, 2013.
  3. M. J. Kim, Research Trends in Rehabilitation Program for disabled applying Virtual Reality Technology in Korea. Journal of Digital Convergence, Vol. 13, No. 2, pp. 381-391, 2015. https://doi.org/10.14400/JDC.2015.13.2.381
  4. K. R. Lohse, C. G. Hilderman, K. L. Cheung, S. Tatla, & H. F. Van der Loos, Virtual reality therapy for adults post-stroke: a systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PloS one, Vol. 9, No. 3, pp. e93318, 2014. https://doi.org/10.1371/journal.pone.0093318
  5. S. H. You, S. H. Jang, Y. H. Kim, M. Hallett, S. H. Ahn, Y. H. Kwon, et al., Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke; a journal of cerebral circulation, Vol. 36, No. 6, pp. 1166-1171, 2005. https://doi.org/10.1161/01.STR.0000162715.43417.91
  6. S. H. Jang, S. H. You, M. Hallett, Y. W. Cho, C. M. Park, S. H. Cho, et al., Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. Archives of physical medicine and rehabilitation, Vol. 86, No. 11, pp. 2218-2223, 2005. https://doi.org/10.1016/j.apmr.2005.04.015
  7. M. K. Holden, Virtual environments for motor rehabilitation: review. Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society, Vol. 8, No. 3, pp. 187-211; discussion 212-219, 2005. https://doi.org/10.1089/cpb.2005.8.187
  8. H. A. Oh, The effects of virtual reality leisure activity on leisure satisfaction, self-efficacy and disability acceptance in a sample of spinal cord injury patients. Master dissertation, Yonsei University, 2009.
  9. J. Y. Park, J. H. Ku, S. W. Cho, Y. C. Jung, & J. J. Kim, A Study on the Application of Coping Skill Training Using Virtual Reality for Alcoholics. Mental Health & Social Work, Vol. 34, No. 4, pp. 56-90, 2010.
  10. K. E. Shin, Effect of Virtual Reality Game on Old Patient's Depression, Relationship and Life Satisfaction. Master dissertation, DongShin University, 2013.
  11. J. S. Kwon, M. J. Park, I. J. Yoon, & S. H. Park, Effects of virtual reality on upper extremity function and activities of daily living performance in acute stroke: a double-blind randomized clinical trial. NeuroRehabilitation, Vol. 31, No. 4, pp. 379-385, 2012.
  12. M. S. Song, T. W. Kang, H. J. Noh, & D. H. Bang, Effects of Robot-Assist Training Using Virtual Reality Program on Gait Ability in Patient with Acute Spinal Cord Injury. Journal of Special Education & Rehabilitation Science, Vol. 51, No. 3, pp. 347-362, 2012.
  13. G. Yavuzer, A. Senel, M. B. Atay, & H. J. Stam, "Playstation eyetoy games" improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. European journal of physical and rehabilitation medicine, Vol. 44, No. 3, pp. 237-244, 2008.
  14. L. F. Lucca, Virtual reality and motor rehabilitation of the upper limb after stroke: a generation of progress? Journal of rehabilitation medicine, Vol. 41, No. 12, pp. 1003-1010, 2009. https://doi.org/10.2340/16501977-0405
  15. S. S. Oh, Meta-analysis: Theory and practive. Seoul: Konkuk University Press, 2002.
  16. World Health Organization, International Classification of Functioning, Disability and Health(ICF). Geneva: WHO, 2001.
  17. A. M. Moseley, R. D. Herbert, C. Sherrington, & C. G. Maher, Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). The Australian journal of physiotherapy, Vol. 48, No. 1, pp. 43-49, 2002. https://doi.org/10.1016/S0004-9514(14)60281-6
  18. R. Rosenthal, & D. B. Rubin, Comparing Effect Size of Independent Studies. Psychological Bulletin, Vol. 92, No. 2, pp. 500-504, 1982. https://doi.org/10.1037/0033-2909.92.2.500
  19. M. Borenstein, L. V. Hedges, J. P. Higgins, & H. R. Rothstein, Introduction to Meta-Analysis. New York, NY: Wiley, 2011.
  20. J. Cohen, Statistical Power for the Social Sciences. Hillsdale, NJ: Laurence Erlbaum and Associates, 1988.
  21. J. A. Sterne, & M. Egger, Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. Journal of clinical epidemiology, Vol. 54, No. 10, pp. 1046-1055, 2001. https://doi.org/10.1016/S0895-4356(01)00377-8
  22. R. Rosenthal, Combining Probabilities and the File Drawer Problem Evaluation in Education, Vol. 4, pp. 18-21, 1980.
  23. Y. S. Kang, Influence of Virtual Reality-Based Exercise Program on Functional Mobility, Visual Perceptual Ability, and Balance Ability in Students with Cerebral Palsy Journal of Exercise Rehabilitation, Vol. 7, No. 4, pp. 79-89, 2011.
  24. D. S. Ko, D. I. Jung, & S. H. Lee, Physical Functions of Industrial Workers with Chronic Low Back Pain and Changes in Health-related Quality of Life according to Virtual Reality Exercise Program. Journal of the Korea Academia-Industrial Cooperation Society, Vol. 13, No. 10, pp. 4564-4571, 2012. https://doi.org/10.5762/KAIS.2012.13.10.4564
  25. M. Y. Kim, The Effect of Cognitive Training Based on Virtual Reality (VR) Program for the Elderly. Ph.D. dissertation, Yonsei University, 2002.
  26. S. J. Kim, The Effect of Virtual Reality Training Using Nintendo Wii Fit on Balance and Walking Ability of the Stroke Patient. Master dissertation, Korea National Sport University, 2013.
  27. E. K. Kim, J. H. Kang, & H. M. Lee, Effects of Virtual Reality Based Game on Balance and Upper Extremity Function in Chronic Stroke Patients. Journal of Special Education & Rehabilitation Science, Vol. 49, No. 3, pp. 131-149, 2010.
  28. J. H. Kim, M. H. Oh, J. S. Lee, & h. S. Ahn, The Effects of Training Using Virtual Reality Games on Stroke Patient's Functional Recovery. The Journal of Korean Society of Occupational Therapy, Vol. 19, No. 3, pp. 101-114, 2011.
  29. J. H. Kim, Effects of Virtual Reality Program on Balance, Gait and Brain Activation Patterns in Stroke Patient. Ph.D. dissertation, Daegu University, 2005.
  30. W. S. Shin, & S. M. Lee, Effects of Rehabilitation Exercise Using Virtual Reality on Functional Recovery in the Persons with Stroke. Journal of Special Education & Rehabilitation Science, Vol. 48, No. 3, pp. 49-64, 2009.
  31. D. k. Lee, The Effects of Virtual Reality Training Using Xbox Kinect on Balance, Gait and Function Recovery in Stroke Patient. Master dissertation, Sahmyook University, 2014.
  32. M. J. Lee, Effects of Virtual Reality Applied Therapy Which is Based on Kinect Base System to Visual Perception Development Disabled School Age Children. Master dissertation, Daegu University, 2012.
  33. J. H. Lee, Influence of Virtual Reality Games on Cognition, Balance and Function in Dementia Patients. Master dissertation, Nambu University, 2011.
  34. S. J. Tack, The Effect of Virtual Reality Training Using a Video Game for Sitting Balance with Spinal Cord Injury Patient. Master dissertation, Sahmyook University, 2011.
  35. J. H. Han, & J. Y. Ko, Evaluation of Balance and Activities of Daily Living in Children with Spastic Cerebral Palsy using Virtual Reality Program with Electronic Games. Journal of the Korea Contents Association, Vol. 10, No. 6, pp. 480-488, 2010. https://doi.org/10.5392/JKCA.2010.10.6.480

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