DOI QR코드

DOI QR Code

The Effect of Multimodal Intervention through Virtual Reality-Based Immersion Program on Cognitive Function and Brain activity in Patients with Mild Cognitive Impairment

가상현실 기반 몰입형 복합중재프로그램이 경도인지장애 환자의 인지기능 및 두뇌 활성에 미치는 영향

  • Ye-Rim Im (Center of Rehabilitation Therapy, Shinseage Geriatric Hospital) ;
  • Sun-Min Lee (Department of Occupational Therapy, College of Rehabilitation Sciences, Daegu University)
  • 임예림 (신세계요양병원) ;
  • 이선민 (대구대학교 재활과학대학 작업치료학과)
  • Received : 2023.02.03
  • Accepted : 2023.02.08
  • Published : 2023.02.28

Abstract

PURPOSE: The purpose of this study was to investigate the effect of multimodal intervention through VR (virtual reality)-based immersion program on the cognitive function and brain activity of patients with mild cognitive impairment. METHODS: The subjects of the study were 10 people in the experimental group who applied a complex intervention that performed cognitive tasks using the movement of the upper extremities through the VR program, and 10 people in the control group who received traditional occupational therapy. After the study intervention was applied 5 times a week, 30 minutes a day for a total of 8 weeks, LOTCA-G(Lowenstein Occupational Therapy Cognitive Assessment for Geriatric Population) and NIRSIT LITE were used to compare. RESULTS: Significant differences in cognitive function and brain activity were noted between the pre- test and post-test in the experimental group. Brain activity showed statistically significant differences in four channels of the working memory domain and one channel of the metacognitive domain (p < . 05). Comparative analysis of the difference between the two groups revealed statistically significant differences in cognitive function and brain activity. The brain activity showed statistically significant differences in three channels of the working memory domain and one channel of the metacognitive domain (p < .05). CONCLUSION: Through the results of this study, it was found that the complex intervention of performing cognitive tasks using upper extremity movements through the VR program had a positive effect on the cognitive function of patients with mild cognitive.

Keywords

Acknowledgement

본 논문은 2018년도 대구대학교 교내 학술연구비 지원을 받아 수행된 연구임(No. 2018-0457).

References

  1. Statistcs Korea. 2022 Statistics on the elderly; 2022. https://kostat.go.kr/portal/korea/kor_nw/1/1/index.board ?bmode=read&aSeq=420896
  2. Seo EH, Kim HW, Lee KH, et al. Altered executive function in pre-mild cognitive impairment. J Alzheimers Dis. 2016;54(3):933-40. https://doi.org/10.3233/JAD-160052
  3. Oh ES, Lee AY. Mild cognitive impairment. J Korean Neurol Assoc. 2016;34(3):167-75. https://doi.org/10.17340/jkna.2016.3.1
  4. Jo MB. A study on cognitive-based intervention for the improvement of cognitive function of the elderly with mild cognitive impairment. Korean Journal of Academic Convergence with Health and Welfare. 2017; 9(1):3-22.
  5. National Institute of Dementia. 2021 Korean Dementia observatory; 2021. https://www.nid.or.kr/info/dataroom_view.aspx?bid=243
  6. Park GS. A case study on user experience valuation of the instrumental activities of daily living training contents for the elderly with mild cognitive disabilities based on virtual reality. Master's Degree. Soonchunyang University. 2020.
  7. American Occupational Therapy Association (AOTA). Cognition, cognitive rehabilitation, and occupational performance, Am J Occup Ther. 2013;67(6):9-31. https://doi.org/10.5014/ajot.2013.67S9
  8. Hoffmann T, Bennett S, koh C, et al. The cochrane review of occupational therapy for cognitive impairment in stroke patients. Eur J Phys Rehabil Med. 2011;47(3):513-9.
  9. Kwon MH, Lee JS. The effect of nonpharmacologic interventions on behavioral and psychological symptoms of dementia: a meta-analysis. Jour. of KoCon. a. 2017;17(6):540-50.
  10. Shin YJ. A case study on reminiscence-based small group art therapy to improve cognitive function in the elderly with mild neurocognitive disorder. Master's Degree. Daegu University. 2021
  11. Mun HJ, Chun SY. The effect of group art therapy on the emotions and cognition of the elderly with mild cognitive impairment using book art. Korean Journal of Art Therapy. 2021;28(1):31-54. https://doi.org/10.35594/KATA.2021.28.1.002
  12. Heo SJ, Cho YN, Jeong JH. The effect of a working memory training program on the cognitive function of mild cognitive impairment patients. The Journal of Korean Society of Cognitive Rehabilitation. 2016;5(1): 63-76.
  13. Kim YG. The effect of the virtual reality rehabilitation system on activities of daily living, cognitive function, self-esteem in stroke. Journal of the Korea Academia-Industrial Cooperation Society. 2015;16(80):5476-84. https://doi.org/10.5762/KAIS.2015.16.8.5476
  14. Kim KU. Effect of virtual reality rehabilitation program with rapael smart glove on stroke patient's upper extremity functions and activities of daily living. Journal of The Korean Society of Integrative Medicine. 2019;7(2):69-76. https://doi.org/10.15268/KSIM.2019.7.2.069
  15. Hwang HS, Yoo DH, Kim H, et al. Effects of virtual reality-based upper limb rehabilitation training on upper limb function, muscle activation, activities of daily living, and quality of life in stroke patients. Korean Journal of Occupational Therapy. 2020; 28(2):115-29. https://doi.org/10.14519/kjot.2020.28.2.09
  16. Ko KB, Moon SH. The effects of virtual reality-based task training using a smart glove on upper extremity function and activity of daily living in stroke patients. PNF and Movement (PNF & Mov). 2019;17(3):369-78.
  17. Jang YS, Baik JY, Jeong GU, et al. Clinical effectiveness of body function on virtual reality training for post stroke hemiplegia: literature research. Journal of Special Education & Rehabilitation Science. 2013;52(3):419-36. 
  18. Shin JH, Kim MY, Lee JY, et al. Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: a singleblinded, randomized controlled trial. J Neuroeng Rehabil. 2016;13(17):1-10 https://doi.org/10.1186/s12984-015-0109-2
  19. Santos GD, Nunes PV, Stella F, et al. Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer's disease and cognitive impairment without dementia. Arch. Clin. Psychiatry. 2015;42(6):153-6. https://doi.org/10.1590/0101-60830000000066
  20. Yuk JS, Kwon JS, Byun MM. A guide to cognitive rehabilitation at home: koonja publishing Inc. Seoul. 2006.
  21. Shuvra LT, Islam SMR, Zaman N, et al. Analysis of hemodynamic response function using fnirs. 2018 international conference on innovation in engineering and technology (ICIET), Dhaka, Bangladesh, 2018, pp.1-6.
  22. Hong S, Lee J, Heo J, et al. The estimation of activated prefrontal brain area due to the execution mental tasks using fNIRS. Jounal of Biomedical Enginering Research. 2015;36(5):177-82. https://doi.org/10.9718/JBER.2015.36.5.177
  23. Bae JH. Analysis of the reader's f-NIRS brainwave characteristics in the context of informational and literary text reading. The Journal of Learner-Centered Curriculum and Instruction, 2020;20(9):425-47. https://doi.org/10.22251/jlcci.2020.20.9.425
  24. Trakoolwilaiwan T, Kim KS, Choi JW. The feasibility of using wearable functional near-infrared spectroscopy (fnirs) to study hemodynamic response during mental arithmetic task. Information and Communication Engineering. 2016;59(1):641-2.
  25. Katz N, Itzkovich M, Averbuch S, et al. Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery for brain-injured patients: reliability and validity. Am J Occup Ther. 1989;43(3):184-92. https://doi.org/10.5014/ajot.43.3.184
  26. Katz N, Elazar B, Itzkovich, M. Construct validity of a geriatric version of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery. Phys Occup Ther Geriatr. 1995;13(3):31-46. https://doi.org/10.1080/J148v13n03_03
  27. Lee JW, Park YM. EEG analysis on reading of expository text for main idea comprehension. Journal of Reading Research. 2015;37:9-36 https://doi.org/10.17095/JRR.2015.37.1
  28. Hwang JH, Park MS. Effect of a dual-task virtual reality program for seniors with mild cognitive impairment. Korean J Clin Lab Sci. 2018;50(4):492-500. https://doi.org/10.15324/kjcls.2018.50.4.492
  29. Choy YS, Kim KS, Kim YJ, et al. The effectiveness of cognitive rehabilitation program using virtual reality content on cognition, activities of daily living, and upper extremity functions in cerebrovascular disease. Journal of Korea Academia- Industrial cooperation Society. 2020;21(8):537-45 https://doi.org/10.5762/KAIS.2020.21.8.537
  30. Kang HJ, Kim SR, Kim JH, et al. Effect of the virtual reality cognitive rehabilitation program on cognition ability and activities of daily living in patients with mild cognitive impairment. Journal of the Korean Society of Physical Medicine. 2020;15(4):155-61. https://doi.org/10.13066/kspm.2020.15.4.155
  31. Kim CS, Kwon YH. Therapeutic virtual reality program in chronic stroke patients recovery of upper extremity and neuronal reorganization. Journal of Special Education & Rehabilitation Science. 2005; 44(1):87-106.
  32. Park JH. Effects of spatial cognitive training based on virtual reality on prefrontal cortex of older adults with mild cognitive impairment: single subject design. The Journal of Korean Society of Cognitive Rehabilitation. 2019;8(2):23-41.  https://doi.org/10.24226/jvr.2019.8.29.2.23