The effects of virtual reality-based physical therapy in stroke patients

Kim, Charyong,Min, Won-Kyu korean Academy of Physical Therapy Rehabilitation 2013 Physical therapy rehabilitation science Vol.2 No.1

Objective: Final goal of nerve advancement therapy is to provide maximum ability to function independently in life to patients. This paper appraises and describes basic concepts of the virtual reality (VR) based exercise program to improve functional movement for neurologically impaired patients. Design: Review article. Methods: Stroke patients from the physical therapy department while wearing comfortable clothing receive therapy and also VR based motion therapy administered by the therapist in charge. After evaluation of stroke patients, therapy includes an exercise program that is suitable for use with stroke patients; stroke patients wear head-mounted display while in front of the computer, where the camera is located; they follow the action on the screen and the computer perceives the operation of the stroke patients according to subject accomplishment. Results: According to obstacle condition of stroke patients using the method, which is various environments after setting, in stroke patients, there is a possibility of presenting suitable therapeutic environments. The display presentation of the method, which is identical, causes difficulty for all stroke patients. According to subject accomplishment; stroke patients result in execution of repetition training and deepening study, which leads to mobility. Conclusions: The VR based rehabilitation training programs is a difference of the existing video training program, is immediate feedback and compensation method. It will provide rehabilitation training services for the family of the patient whose condition could be improved with rehabilitative therapy where it is a continuous circumstance as a matter of the social welfare facility therapy.

Balance trainer training with transcutaneous electrical nerve stimulation improves spasticity and balance in persons with chronic stroke

Yang, Youjin,Lee, Jungeun,Choi, Wonjae,Joo, Younglan,Lee, Seungwon korean Academy of Physical Therapy Rehabilitation 2020 Physical therapy rehabilitation science Vol.9 No.2

Objective: The purpose of this study was determine the effect of Balance Trainer training with Transcutaneous Electrical Nerve Stimulation (TENS) on spasticity and balance in persons with chronic stroke. Design: Randomized controlled trial. Methods: A total of 30 subjects with hemiparetic stroke were recruited and randomly divided into the Balance Trainer training with TENS group (n=15) and Balance Trainer training with placebo TENS group (n=15). The Balance Trainer training with TENS group practiced additional Balance Trainer training with TENS for 30 minutes a day, 5 days per a week during 4 weeks and the Balance Trainer training with placebo TENS group practiced additional Balance Trainer training with placebo TENS for the same period. Spasticity and balance were assessed by ability (static balance, dynamic balance) and were measured before and after the 4-week programs. Results: The result of spasticity and dynamic balance were improved significantly in both groups (p<0.05). The Balance Trainer training with TENS group showed significantly greater improvement in spasticity of the gastrocnemius & dynamic balance, compared to the Balance Trainer training with placebo TENS group (p<0.05). The Balance trainer training with TENS group showed a significant improvement in static balance, especially during the eye-closed condition (p<0.05). Conclusions: The Balance Trainer training with TENS was effective in improving spasticity and balance in subjects with chronic stroke. Based on these results, it is suggested that Balance Trainer training with TENS could clinically be used more actively in conjunction with conventional physical therapy.

Comparison of the effects of muscle stretching exercises and cupping therapy on pain thresholds, cervical range of motion and angle: a cross-over study

Yim, Jongeun,Park, Junhyuck,Kim, Hongseop,Woo, Juyeon,Joo, Soyeong,Lee, Sumin,Song, Jewon korean Academy of Physical Therapy Rehabilitation 2017 Physical therapy rehabilitation science Vol.1 No.1

Objective: Computers and smartphones have become a necessity for modern people, and the use of these things in an inappropriate position has increased the number of people who complain about neck problems. The purpose of this study was to compare the changes of cervical angle, range of motion (ROM) and pain threshold according to the McKenzie stretching and dry cupping therapy. Design: Cross-over design. Methods: We included 12 male and 6 female college students in their twenties, and conducted a pre- and post-test to evaluate the changes of each variable after the application of the McKenzie stretching and dry cupping therapy. Results: Neither the cervical spine angle nor the turtle neck angle showed any change in both the McKenzie stretching and the dry cupping treatment. In the McKenzie stretching, the pain threshold decreased, and the ROM of the cervical spine increased in all directions but there was no significant difference. The pain threshold was increased in the dry cupping treatment, and the ROM of the cervical spine was significantly increased in all directions (p<0.05). Comparisons of the McKenzie stretching and cupping treatment showed that the cupping treatment produced significantly greater pain thresholds and improvements in ROM of the cervical spine than the McKenzie stretching technique (p<0.05). Conclusions: Cupping treatment is more effective in improving ROM of the cervical spine and pain thresholds than the McKenzie stretching technique. In the future, cupping treatment will be one of the treatment options for pain and ROM impairments of the cervical spine.

The effects of an additional weight aquatic exercise program on balance and lower extremity strength in persons with stroke: randomized controlled study

Park, Jaeho,Chung, Yijung korean Academy of Physical Therapy Rehabilitation 2018 Physical therapy rehabilitation science Vol.7 No.1

Objective: The purpose of this study was to investigate the effects of an additional weight aquatic exercise program on the balance and lower extremity strength on aquatic environment in persons with stroke. Design: Randomized controlled trial. Methods: All subjects were randomly divided into three groups where thirteen subjects were in the additional weight aquatic exercise group, twelve subjects in the aquatic exercise group, and fifteen subjects in the control group. Subjects received a graded aquatic exercise program for 30 minutes, with 3 sessions per week for 6 weeks, and subjects in all groups received conventional physical therapy. All subjects were assessed with the Medical Research Council (MRC), the Berg Balance scale (BBS), Timed Up and Go test (TUG), and 10-meter walk test (10MWT) pre and post intervention. Results: The MRC, BBS, TUG, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas post-treatment (p<0.05). In addition, it has been confirmed that the additional weight aquatic exercise group had significantly improved in MRC, BBS, and TUG scores compared with the aquatic exercise and control group (p<0.05). Conclusions: The findings of this study suggested that the additional weight aquatic exercise program improves lower extremity and balance in persons with stroke.

Pressure pain threshold and visual analogue scale changes in the high and low energy extracorporeal shock wave

Yang, You-Jin,Lee, Seung-Joon,Choi, Matthew korean Academy of Physical Therapy Rehabilitation 2014 Physical therapy rehabilitation science Vol.3 No.2

Objective: This study aims to investigate high energy and low energy extracorporeal shockwave therapy (ESWT) and which one is more effective for shoulder pain. Design: Single blind randomized controlled trial. Methods: Fifty two subjects with upper trapezius (UT) trigger point (TrP) participated in this study. They were allocated to high energy (n=26) and low energy group (n=26). This study applies ESWT and investigates the changes of pressure pain threshold (PPT) and visual analogue scale (VAS). The high and low energy groups received focused piezo electric type ESWT 4 Hz, 1,000 pulses and 0.351 and $0.092mJ/mm^2$ respectively. Outcome measures of PPT and pain was measured by algometer and pain VAS. These measurements were performed before and after treatment. Results: The PPT value was significantly increased in both groups after treatment (p<0.05) and VAS scores were significantly decreased after treatment in both groups (p<0.05). However, there were no significant differences between groups. Conclusions: ESWT is an effective treatment for the application of the UT TrP. Although there were significant effects of extracorporeal shock wave therapy on PPT and VAS scores, there were no signficant differences between high and low energy extracorporeal shock wave therapy.

The validity and reliability of the Healthy Lifestyle Screening Tool

Kim, Cheong Hoon,Kang, Kyung-Ah korean Academy of Physical Therapy Rehabilitation 2019 Physical therapy rehabilitation science Vol.8 No.2

Objective: The aim of the present study was to develop a valid and reliable scale that measures the healthy life styles among young adults. Design: A methodological study design was employed to develop and validate the Healthy Lifestyle Screening Tool (HLST). Methods: The validity and reliability of the HLST were established in accordance with DeVellis' 8 steps guideline for tool development. The question items were generated based on literature reviews and interviews, which were then classified into 12 categories. The HLST was administered to 272 students attending a Korean university. The reliability was tested using Cronbach's alpha. The validity of the scale was examined with the mean inter-item correlations (MIIC) and factor analysis, and was also examined for content validity by experts. Results: The reliability of the HLST was found to be acceptable, as indicated by a Cronbach's alpha of 0.71. In the validity test, items with less than 80% "agreement" ratings on the content validity index by experts were revised. The MIIC values were greater than 0.25. A factor analysis of 36 items extracted 9 factors (i.e., four items per factor), which together explained 50.4% of the variance. The HLST consists of 36 items that measure 9 factors based on a 4-point Likert rating scale, with 4 items per factor, as follows: sunlight, water, air, rest, exercise, nutrition, temperance, trust, and general physical condition. High scores on the HLST are indicative of a healthy lifestyle (HL). Conclusions: The HLST is a valid and reliable scale that can be used to measure HL among young adults. Identification of HL by using the HLST can provide guidance to integrated therapeutic approaches along with conventional physical therapy.

Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: a pilot randomized controlled trial

Kang, Hyungkyu,Chung, Yijung korean Academy of Physical Therapy Rehabilitation 2012 Physical therapy rehabilitation science Vol.1 No.1

Objective: The objective of this study is to investigate the effect of treadmill training with real optic flow scene on functional recovery of balance and balance self-efficacy in stroke patients. Design: Single blind, Randomized controlled trial. Methods: Nine patients following stroke were divided randomly into the treadmill with optic flow group (n=3), treadmill with virtual reality group (n=3), and control group (n=3). Subjects in the treadmill with optic flow group wore a head-mounted display in order to receive a speed modulated real optic flow scene during treadmill training for 30 minutes, while those in the treadmill with virtual reality group and control group received treadmill training with virtual reality and regular therapy for the same amount of time, five times per week for a period of three weeks. Timed up and go test (TUG) and activities-specific balance confidence scale (ABC scale) were evaluated before and after the intervention. Results: TUG in the treadmill training with optic flow group showed significantly greater improvement, compared with the treadmill training with virtual reality group and control group (p<0.05). Significantly greater improvement in the ABC scale was observed in the treadmill training with optic flow group and the tread mill training with virtual reality group, compared with the control group (p<0.05). Conclusions: Findings of this study demonstrate that treadmill training with real optic flow scene can be helpful in improving balance and balance self-efficacy of patients with chronic stroke and may be used as a practical adjunct to routine rehabilitation therapy.

Comparison of vertical ground reaction forces between female elderly and young adults during sit-to-stand and gait using the Nintendo Wii Balance Board

Lim, Ji Young,Yi, Yoonsil,Jung, Sang Woo,Park, Dae-Sung korean Academy of Physical Therapy Rehabilitation 2018 Physical therapy rehabilitation science Vol.7 No.4

Objective: The purpose of this study was to analyze and compare vertical ground reaction forces during sit to stand (STS) and gait between female elderly and young individuals using the Wii Balance Board (WBB). Design: Cross-sectional study. Methods: Fifty-one female elderly people (age: $75.18{\pm}4.60years$), and 13 young people (age: $29.85{\pm}3.69years$) performed the five times STS test and gait respectively on the WBB. We analyzed time (s), vertical peak (%), integral summation (Int_SUM, %), and counter variables (%) in STS and 1st peak (body weight, BW%), 2nd peak (BW%), peak minimum (BW%), time (second), center of pressure (COP) path length (mm), and Int_SUM (BW%) in gait. The independent t-test was used to assess for differences in STS, gait ability, and general characteristics between the female elderly group and young adults group. With the first and last trials excluded, the mean value was obtained from the middle three of the five trials. Results: During STS, Int_SUM and time of young adults were significantly less than of the female elderly subjects. There were no significant differences in peak and counter variables. In gait, all variables (1st peak, 2nd peak, min, time, COP_path, and Int_SUM) showed significant differences between groups (p<0.05). This study demonstrated that the validity of vertical ground reaction forces occurring during STS and gait was significant in female elderly and young adults. Conclusions: Based on the measurement of vertical ground reaction forces in STS and gait using the WBB, it is possible to clinically improve the quality of geriatric physical therapy. Further studies are necessary to examine concurrent validity of elderly patients who have undergone total hip or knee replacement.

The effects of water-based exercise on postural control in children with spastic cerebral palsy

Kim, Kyung Ho,Shin, Hwa Kyung korean Academy of Physical Therapy Rehabilitation 2017 Physical therapy rehabilitation science Vol.1 No.1

Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

Minimal Clinically Important Difference of Berg Balance Scale scores in people with acute stroke

Song, Min-Jeong,Lee, Jae-Hyoung,Shin, Won-Seob korean Academy of Physical Therapy Rehabilitation 2018 Physical therapy rehabilitation science Vol.7 No.3

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.