The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical Application of AR System in Early Rehabilitation Program After Stroke: 2 Case Study

  • An, Chang Man (Department of Physical Therapy, Chonbuk National University Hospital) ;
  • Kim, Dae Hyun (Department of Physical Therapy, Chonbuk National University Hospital)
  • Received : 2019.04.30
  • Accepted : 2019.06.29
  • Published : 2019.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To investigate the effect of an augmented reality (AR) system on muscle strength and function level of the paretic lower limb and the balance ability in the early rehabilitation program of acute stroke patients. Methods: The participants (30 or fewer days after stroke) were randomly assigned to receive intervention with an early rehabilitation program using an AR system (n=1) or an early rehabilitation program consisting of functional electrical stimulation and tilt table use (n=1). Patients in both subjects received interventions 4-5 times a week for 3 weeks. Results: In the paretic limb muscle strength, AR subject was increased from 15 to 39.6 Nm and Control subject was increased from 5 to 30.2 Nm. The paretic limb function of AR subject motor function was increased from 8 to 28 score and Control subject motor function was increased from 6 to 14 score. But sensory function was very little difference between the two subjects (AR subject: from 4 to 10 score, Control subject: from 3 to 10 score). In the balance ability, AR subject had more difference after intervention than control subject (AR subject: 33 score, Control subject: 22 score). Conclusion: The early rehabilitation program using the AR system showed a slightly higher improvement in the motor function of the paretic lower limb and balance ability measurement than the general early rehabilitation program. The AR system, which can provide more active, task-oriented, and motivational environment, may provide a meaningful environment for the initial rehabilitation process after stroke.

Keywords

References

  1. Tyson SF, Hanley M, Chillala J et al. Balance disability after stroke. Phys Ther. 2006;86(1):30-8. https://doi.org/10.1093/ptj/86.1.30
  2. Forster A, Young J. Incidence and consequences of falls due to stroke: a systematic inquiry. BMJ. 1995;311(6997):83-6. https://doi.org/10.1136/bmj.311.6997.83
  3. Solopova IA, Tihonova DY, Grishin AA et al. Assisted leg displacements and progressive loading by a tilt table combined with FES promote gait recovery in acute stroke. Neuro Rehabilitation. 2011;29(1):67-77.
  4. Puckree T, Naidoo P. Balance and stability-focused exercise program improves stability and balance in patients after acute stroke in a resource-poor setting. PM and R. 2014;6(12):1081-7. https://doi.org/10.1016/j.pmrj.2014.06.008
  5. Laver KE, George S, Thomas S et al. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2011;7(9).
  6. Holden MK. Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 2005;8:187-211. https://doi.org/10.1089/cpb.2005.8.187
  7. Thikey H, Grealy M, VanWijck F et al. Augmented visual feedback of movement performance to enhance walking recovery after stroke: study protocol for a pilot randomized controlled trial. Trials. 2012;11:13-163. https://doi.org/10.1186/1745-6215-11-13
  8. Merians AS, Poizner H, Boian R et al. Sensorimotor training in a virtual reality environment: does it improve functional recovery post stroke?. Neurorehabil Neural Repair. 2006;20(2):252-67. https://doi.org/10.1177/1545968306286914
  9. Eng K, Siekierka E, Pyk P et al. Interactive visuo-motor therapy system for stroke rehabilitation. Med Biol Eng Comput. 2007;45(9):901-7. https://doi.org/10.1007/s11517-007-0239-1
  10. Resquin F, Cuesta Gomez A, Gonzalez-Vargas J et al. Hybrid robotic systems for upper limb rehabilitation after stroke: a review. Med Eng Phys. 2016;38(11):1279-88. https://doi.org/10.1016/j.medengphy.2016.09.001
  11. Pereira S, Mehta S, McIntyre A et al. Functional electrical stimulation for improving gait in persons with chronic stroke. Top Stroke Rehabil. 2012; 19(6):491-8. https://doi.org/10.1310/tsr1906-491
  12. Roche A, Laighin G, Coote S. Surface-applied functional electrical stimulation for orthotic and therapeutic treatment of drop-foot after stroke: a systematic review. Physical Therapy Reviews. 2009;14(2):63-80. https://doi.org/10.1179/174328809X405946
  13. Robbins SM, Houghton PE, Woodbury MG et al. The therapeutic effect of functional and transcutaneous electric stimulation on improving gait speed in stroke patients: a meta-analysis. Arch Phys Med Rehabil. 2006; 87(6):853-9. https://doi.org/10.1016/j.apmr.2006.02.026
  14. Morris PE. Moving our critically ill patients: mobility barriers and benefits. Crit Care Clin. 2007; 23(1):1-20. https://doi.org/10.1016/j.ccc.2006.11.003
  15. Stinear C, Ackerley S, Byblow W. Rehabilitation is initiated early after stroke, but most motor rehabilitation trials are not: a systematic review. Stroke. 2013;44(7):2039-45. https://doi.org/10.1161/STROKEAHA.113.000968
  16. Czell D, Schreier R, Rupp R et al. Influence of passive leg movements on blood circulation on the tilt table in healthy adults. J Neuroeng Rehabil. 2004;25(1):4.
  17. Zheng X, Chen D, Yan T et al. A randomized clinical trial of a functional electrical stimulation mimic to gait promotes motor recovery and brain remodeling in acute stroke. Behav Neurol. 2018;2018:8923520. https://doi.org/10.1155/2018/8923520
  18. Nashner LM. Analysis of movement control in man using the movable platform. Adv Neurol. 1983;39:607-19.
  19. Baltz MJ, Lietz HL, Sausser IT et al. Tolerance of a standing tilt table protocol by patients an inpatient stroke unit setting: a pilot study. J Neurol Phys Ther. 2013;37(1):9-13. https://doi.org/10.1097/NPT.0b013e318282a1f0
  20. de Araujo Ribeiro Alvares JB, Rodrigues R, de Azevedo Franke R et al. Inter-machine reliability of the Biodex and Cybex isokinetic dynamometers for knee flexor/extensor isometric, concentric and eccentric tests. Phys Ther Sport. 2015;16(1):59-65. https://doi.org/10.1016/j.ptsp.2014.04.004
  21. Twitchell TE. The restoration of motor function following hemiplegia in man. Brain. 1951;74(4):443-80. https://doi.org/10.1093/brain/74.4.443
  22. Brunnstrom S. Movement therapy in hemiplegia. New York, Harper & Row. 1970.
  23. Fugl-Meyer AR, Jaasko L, Leyman I et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.
  24. Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair. 2002;16(3):232-40. https://doi.org/10.1177/154596802401105171
  25. Ganesan M, Pasha SA, Pal PK et al. Direction specific preserved limits of stability in early progressive supranuclear palsy: a dynamic posturographic study. Gait Posture. 2012;35(4):625-9. https://doi.org/10.1016/j.gaitpost.2011.12.012
  26. Cachupe WJC, Shifflett B, Kahanov L et al. Reliability of Biodex balance system measures. Meas Phys Educ Exerc Sci. 2001;5(2):97-108. https://doi.org/10.1207/S15327841MPEE0502_3
  27. Bank PJM, Cidota MA, Ouwehand PEW et al. Patient-tailored augmented reality games for assessing upper extremity motor impairments in Parkinson's disease and stroke. J Med Syst. 2018;3;42(12):246. https://doi.org/10.1007/s10916-018-1100-9
  28. Burke JW, McNeill MDJ, Charles DK et al. Augmented reality games for upper-limb stroke rehabilitation. Proc IEEE Int Conf Games Virtual Worlds Serious Appl. 2010;75-8.
  29. Liu J, Mei J, Zhang X et al. Augmented reality-based training system for hand rehabilitation. Multimedia Tools and Applications. 2017;76(13): 14847-67. https://doi.org/10.1007/s11042-016-4067-x
  30. Mousavi Hondori H, Khademi M, Dodakian L et al. Spatial augmented reality rehab system for post-stroke hand rehabilitation. Stud Health Technol Inform. 2013;184:279-85.
  31. Burke JW, McNeill MDJ, Charles DK et al. Optimising engagement for stroke rehabilitation using serious games. Vis Comput. 2009;25:1085-99. https://doi.org/10.1007/s00371-009-0387-4
  32. Wade DT, Wood VA, Hewer RL. Recovery after stroke the first 3 months. J Neurol Neurosurg Psychiatry. 1985;48(1):7-13. https://doi.org/10.1136/jnnp.48.1.7
  33. Burdea G. Review paper: Virtual rehabilitation benefits and challenges. Yearb Med Inform. 2003;(1):170-6.
  34. Rizzo A, Kim GJ. A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence. 2005;14(2):119-46. https://doi.org/10.1162/1054746053967094