• Title/Summary/Keyword: 가상 모의 환자

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CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

Virtual Reality-based Training Program Using Computer-human Interface for Recovery of Upper Extremity Use in Stroke Patients (뇌졸중 환자에서 상지 회복을 위해 컴퓨터-인간 연동을 이용한 가상현실 기반 훈련 프로그램)

  • Lee, Kyoung-Hee;Hwang, Ki-Chul
    • Journal of Digital Convergence
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    • v.14 no.1
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    • pp.285-290
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    • 2016
  • To identify virtual reality (VR) interventions used for upper extremity rehabilitation in stroke patients. The Medline database was searched up to February 11, 2015. Randomized controlled and clinical trials that included a VR intervention for upper extremity rehabilitation in stroke patients were included. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the included studies. In total, 8 studies were included. PEDro scores varied from 5 to 8/10. All studies showed significant improvement in outcomes in favor of the VR group. This review suggests that VR applications used for upper extremity rehabilitation in stroke patients predominantly mediate learning through providing task-oriented and graduated learning with variable and unpredictable practice.

A Preliminary Study of the Effects of Monitor-Based Virtual Reality Games on the Cognition & Activities of Daily Living for Acute Stroke : A Double-blind Randomized Controled Trial (모니터기반 가상현실게임을 이용한 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대한 사전연구: 이중 맹검 무작위 대조 시험 연구)

  • Choi, Bong-Geun;Kwon, Jae-Sung
    • The Journal of the Korea Contents Association
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    • v.20 no.9
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    • pp.531-540
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    • 2020
  • Objectives: This study aimed to investigate the effects of a 4-weeks intervention using a monitor-based virtual reality game intervention(VRI) on the cognitive function and activities of daily living of individuals with acute stroke. Methods: For this study, 19 individuals with acute stroke were recruited. To compare the effectiveness of the VRI and the computer based cognitive intervention(CBCI), Each of the two groups were provided different interventions a 30 minutes a day, 5 times per week for 4 weeks, and to measure the effects of the intervention, the TMT A&B, DST, RKMT and K-MBI were performed before and after interventions. Results: Both the VRI and the CBCI were found to have significantly improved the cognitive function and activities of daily living, and the difference in change compared between groups showed that the effectiveness of the VRI was significantly higher. Conclusion: Based on the findings of this study, the monitor-based VRI is anticipated to prove useful as an effective intervention for the cognitive function and activities of daily living of stroke patients. Furthermore, the utility of monitor-based VRI is likely to be high in clinical occupational therapy.

Effects of Virtual Reality Based Video game and Rehabilitation Exercise on the Balance and Activities of Daily Living of Chronic Stroke Patients (가상현실기반 비디오게임과 재활운동이 만성기 뇌졸중 환자의 균형 및 일상생활동작에 미치는 영향)

  • Lee, Hyun-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.2
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    • pp.201-207
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    • 2013
  • 연구목적: 닌텐도 위를 이용한 가상현실기반 비디오게임 프로그램을 만성기 뇌졸중 환자에게 적용하여 균형능력 및 일상생활동작에 어떠한 영향을 미치는지 알아보고, 뇌졸중 환자의 재활프로그램으로서 적용 가능성이 있는지 알아보고자 한다. 연구방법: 만성기 뇌졸중 환자를 무작위로 가상현실기반 비디오게임 프로그램을 적용한 실험군(n=7)과 적용하지 않은 대조군(n=10)으로 구분하여 연구를 진행하였다. 연구에 참여한 모든 대상자에게 30분의 Bobath therapy와 15분간의 FES 치료를 기본적으로 실시하였다. 이에 더하여 실험군은 가상현실기반 비디오게임 프로그램을 1일 30분이내, 주 5회, 3주간 실시하였다. 대조군은 자전거 운동과 보행훈련으로 30분간 시행하였다. 실험 전 후 눈뜨고 외발서기(OLST; open leg standing test), Timed Up and Go(TUG) 검사, 10m 걷기 검사, Functional Independence Measure(FIM)를 측정하였다. 실험 전과 실험 후 측정값의 차이를 비교하기 위해 Wilcoxon Signed Ranks Test를 실시하였다. 그리고 각 측정값의 변화량에 대한 실험군과 대조군 사이의 차이를 알아보기 위해 Mann-Whitney U Test를 실시하였다. 연구결과: 실험결과는 다음과 같다. 1) 실험군에서는 FIM의 유의한 증가와 TUG, 10m 걷기 검사의 유의한 감소를(p<.05) 보였다. 대조군에서는 OLST의 증가와 TUG, 10m walking test의 감소가 나타났지만 통계적으로 유의하지 않았다. 오직 FIM에서만 유의한 증가가 나타났다(p<.05). 2) 실험 전 후의 실험군과 대조군의 각 측정값들의 평균차를 비교한 결과 실험군은 대조군보다 실험 전 후 OLST, TUG, 10m walking test 차이의 평균은 컸지만 통계적으로 유의하지 않았다. 결론: 이상의 결과로부터 가상현실기반 비디오게임이 만성기 뇌졸중 환자의 동적균형능력 및 일상생활동작 향상에 효과가 있음을 알 수 있었다.

The Effects of Virtual Reality-based Exercise on Energy Expenditure during Gait in Chronic Stroke Patients (가상현실을 이용한 재활운동이 뇌졸중 환자의 보행시 에너지 소모에 미치는 효과)

  • Lee, Dong-Yeop;Shin, Won-Seob
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3826-3832
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    • 2010
  • This study was aimed at determining the effect of virtual reality(VR) based exercise programs on energy expenditure during gait in chronic stroke patients. Thirty-two stroke patients were participated for this study. They underwent stroke for more than 6 months and were assigned to a VR-exercise group (n=16) or a control group (n=16). The VR-exercise group executed a rehabilitation exercise three times a week during 6 weeks. The VR-exercise was performed by PS2 for one hour. Control group maintained their usual life without application of exercise. Energy expenditure index(EEI) during gait was calculated from heart rate and gait velocity. After the completion of the VR-exercise, the EEI was decreased significantly (p<0.05). These results showed that the rehabilitation exercise using a virtual reality is effective in the improvement of energy efficiency during gait in chronic stroke patients.

The Effect of Trunk Control Training Using Virtual Reality Game-based Training Program on Balance and Upper Extremity Function of Subacute Stroke Patients (가상현실 게임기반 훈련프로그램을 이용한 체간조절훈련이 아급성기 뇌졸중 환자의 균형 및 상지기능에 미치는 영향)

  • Park, Sam-Ho;Kim, Byeong-Soo;Lee, Myung-Mo
    • Journal of Convergence for Information Technology
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    • v.9 no.5
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    • pp.172-179
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    • 2019
  • The purpose of this study was to investigate the effects of virtual reality game based training on balance and upper limb function in subacute stroke patients. Thirty patients with subacute stroke were randomly assigned to experimental groups(n=15) and control groups(n=15) applying virtual reality game-based training programs. Intervention is applied three times a week for 6 weeks, 30 minutes for 1 time. In the study group, there was a significant improvement in balance ability, upper extremity function, and trunk impairment scale(p<.05), and the difference between the two groups was significant in the BBS, TUG, TIS(p<.05). Based on these results, the virtual reality game based training program is clinically useful exercise program for subacute stroke patients.

Development of virtual reality vestibular rehabilitation contents using HMD (HMD를 활용한 가상현실 전정재활 콘텐츠 개발)

  • Lee, Sungjin;Sung, Nak-Jun;Hong, Min
    • Proceedings of the Korea Information Processing Society Conference
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    • 2019.05a
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    • pp.678-681
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    • 2019
  • 어지럼증은 모든 사람들이 일상생활에서 겪는 가장 흔한 질병 중 하나이다. 이러한 어지럼증은 주로 전정 기관의 약화 및 충격으로 인한 다양한 원인에 의해 유발되며 전정 재활을 통해 회복 될 수 있다. 전정 재활은 다양한 형태로 존재하지만 모든 사람을 위해 수행 할 수 있는 보편적 인 방법으로 훈련의 목적은 눈, 머리 및 균형 운동을 통해 전정 기관을 반복적으로 운동하는 것이다. 그러나 이러한 재활은 지루하고 흥미가 없으므로 환자가 계속 훈련을 하고 제대로 수행하고 있는지 확인하는 것이 어렵다. 이러한 문제점을 해결하기 위해 본 연구에서는 Unity3D 및 FOVE HMD를 사용하여 재미있고 평가 가능한 가상 현실 전정 재활의 내용을 구현했다.

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;Hwang, Su-Jin;Song, Chiang-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3023-3029
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    • 2012
  • 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.

A Study on Dose Distribution using Virtual Wedge in Breast Cancer (유방암 환자에서 가상 쐐기모양 보상체의 선량분포 특성에 대한 연구)

  • Yun, Sang-Mo;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.7-12
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    • 2007
  • In the radiation therapy for breast cancer patients, wedge shaped compensators are essentially used to achieve appropriate dose distribution because of thickness difference according to breast shapes. Tangential Irradiation technique has usually been applied to radiation therapy for breast cancer patients treated with breast conservative surgery. When a primary beam is incident on wedge shaped compensators from medial direction In tangential irradiation technique, low energy scattered radiation is generated and gives additional dose to the breast surface. As a method to reduced additional dose to breast surface, the use of virtual wedge shaped compensator is possible. Eclipse radiation treatment planning (RTP) systems Installed at our institution have virtual wedge shaped compensator for radiation therapy treatment planning. The dose distributions of 15, 30, 45, 60 degree physical wedges and virtual wedges were measured and compared. Results showed that there was no significant differences In symmetry of $10{\times}10$ field among various wedge angles. When the transmission factor was compared, transmission factor Increased linearly as the wedge angle Increased. These results Indicates that the appilcation of virtual wedge in clinical use is appropriate.

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Effect of Virtual Reality Training Focus on ADL on Upper Extremity Function and Activities of Daily Living in Stroke Patients (일상생활에 중점을 둔 가상현실 훈련이 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 효과)

  • Park, In-Hye
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.321-329
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    • 2019
  • This study aimed to investigate the effect of virtual reality training focus on ADL on upper extremity function and activities of daily living in stroke patients. 20 patients with chronic stroke were included in this study. The participants were divided into the experimental (n=10) or control (n=10) groups. Both groups received conventional rehabilitation therapy for 30 min a day, 5 times per week for 4 weeks. The experimental group also performed virtual reality training focus on ADL for 30 min a day, and the control group performed general virtual reality training for 30 min a day. The Fugl-Meyer Assessment (FMA) and Functional Independence Measure (FIM) scores were evaluated before and after the intervention, and both groups showed significant improvement (p<.05). Compared to the control group, the experimental group showed significant improvement in the FMA wrist score and the FIM total, self-care, and sphincter control scores (p<.05). These findings suggest that virtual reality training focus on ADL may have a positive effect on wrist function and overall ADLs compared to that using general virtual reality training in stroke patients.