Earticle

The purpose of this study was to investigate the effect of virtual reality-based exercise program using a video game on functional mobility, visual perceptual ability, and balance ability in students with cerebral palsy. Fourteen students with cerebral palsy participated as subjects in this study, and they were divided into exercise group(n=7) and control group(n=7). The exercise group participated in Wii fit program(Nintendo Inc., Japan) for six weeks(60 min, 2 day per week). After six weeks virtual reality-based exercise program, functional mobility significantly was improved. In case of visual perceptual ability, visual discrimination, visual memory, visual-spatial relationships, sequential memory, and visual figure-ground were significantly improved. In addition, Weight distribution index, stability index, and fall index related in balance ability were increased. In conclusion, these findings suggest that commercially available virtual reality-based exercise program can be used to improve the functional mobility, visual perceptual ability, and balance ability in students with cerebral palsy

본 연구는 가상현실 기반 운동프로그램이 뇌졸중 환자의 상지기능과 일상생활동작에 미치는 영향에 대해 알아보는데 그 목적이 있다. 총 30명의 뇌졸중 환자를 대상으로 상지재활치료만 받은 실험군과 가상현실 기반 운동프로그램을 추가한 실험군에 각각 15명씩 무선 할당하여 총 6주간 연구를 실시하였다. 중재 전․후의 상지기능을 알아보기 위하여 푸글-마이어 평가(Fugl-Meyer Assessment, FMA), 상지 운동기능검사(Action research Arm Test, ARAT), 한국판 울프 운동기능검사(K-Wolf Motor Function Test, K-WMFT)를 측정하였고, 일상생활동작의 변화를 알아보기 위하여 수정된 바텔지수(Modified Barthel Index, MBI)를 측정하였다. 6주 운동 중재 후 두 군 모두 실험 전보다 실험 후 상지기능 검사에서 FMA를 제외한 ARAT, K-WMFT 측정값이 유의하게 증가하였으며(p<.05), 군 간 비교에서 실험군이 대조군보다 실험 후 ARAT, K-WMFT값이 더 유의하게 증가한 것으로 나타났다(p<.05). 일상생활동작 검사에서는 가상현실 기반 운동군에서만 MBI값이 유의하게 증가하였으며, 군 간 비교에서는 실험군이 대조군보다 MBI값이 더 유의하게 증가한 것으로 나타났다(p<.05). 이러한 결과를 토대로 가상현실 기반 운동프로그램이 뇌졸중 환자의 상지기능과 일상생활동작의 회복에 효과가 있음을 알 수 있었다. 향후 가상현실 기반 운동프로그램을 이용한 효율적인 프로그램 개발과 적용에 대한 연구가 필요할 것으로 사료된다.

The purpose of this study was to investigate the effect of exercise on upper extremity function and activities of daily living(ADL) in stroke patients using a virtual reality-based exercise program. 30 stroke patients were divided into 2 groups. The control group had 15 patients and the experimental group another 15 patients. All patients received 30 minutes of upper extremity exercise 5 times a week, but the experimental group performed an additional 30 minutes of virtual reality-based exercise 3 times a week. Fugl-Meyer Assessment(FMA), Action research Arm Test(ARAT), K-Wolf Motor Function Test(K-WMFT) were measured initially to serve as baseline data for upper extremity function. To determine the impact on ADL, Modified Barthel Index(MBI) measurement was also done. Repeat measurements of FMA, ARAT, K-WMFT and MBI were done after 6 weeks. Independent t-test results showed significant increase in ARAT and K-WMFT for both groups while FMA and MBI results showed significant increase only in the experimental group. Dependent t-test results showed significant increase in the ARAT, K-WMFT and MBI of the experimental group. Based on these results, virtual reality exercise has a positive impact on the recovery of stroke patients’upper extremity function and in their activities of daily living.

노화로 인한 근력, 균형 및 보행능력의 감소가 노인의 신체활동 저하를 일으킨다. 가상현실운동은 노인의 기능적 균형과 움직임을 회복하는데 사용되고 있다. 본 연구의 목적은 비디오게임을 이용한 가상현실운동프로그램(VR)이 노인의 근력, 균형 및 보행능력에 미치는 영향을 알아보는 것이다. 48명의 노인을 대상으로 VR군(남자 11명, 여자 14명, 나이 68.4세)과 대조군(남자 10명, 여자 13명, 나이 67.6세)으로 무작위 추출하였다. VR군은 가상현실 운동을 8주 동안 주 2회 실시하였으며 대조군은 특별한 운동을 실시하지 않았다. 가상현실운동프로그램은 준비운동(10분), 가상현실프로그램(40분), 정리운동(10분)으로 구성되었으며 가상현실프로그램은 상하지의 움직임뿐만 아니라 시청각피드백을 제공하는 플레이스테이션 아이토이플레이로 수행되었다. 운동 전･후의 변화를 비교하기 위하여 하지의 근력, 힘판을 이용한 정적균형능력, 기능적 팔 뻗기와 일어나 걸어가기 검사로 구성된 동적균형능력과 10m 보행검사와 6분 보행검사로 이루어진 보행능력을 사전, 사후로 측정하였다. VR군은 하지 근력과 정적균형능력, 동적균형능력, 보행능력에서 모두 유의하게 향상되었다(p<.05). 결론적으로 가상현실운동프로그램이 노인의 근력, 균형 및 보행능력의 개선에 효과가 있는 것으로 나타났다.

Age related decrease of muscle strength, balance, and gait abilities bring about physical inactivity in the elderly. Virtual reality (VR) training has been used successfully to rehabilitate functional balance and mobility in elderly subjects. This study was aimed at determining the effect of VR-based exercise programs by using a video game on the muscle strength, balance, and gait abilities in the elderly. 48 old people were randomly divided into two groups; VR-group (men: 11, women: 14, age: 68.42yrs) and control group (men: 10, women: 13, age: 67.58yrs). VR-group performed an exercise program twice a week for 8 weeks and control group had no intervention. The VR-based exercise program was composed of warm up(10 mins), VR-program(40 mins), and cool down(10mins). It was performed by playstation eyetoy play that provided visual and auditory feedback as well as movements of the upper and lower extremities. Muscle strengths of the knee and ankle were measured using manual muscle tester. Static balance was estimated using computerized posturography. Dynamic balance was measured by Timed up and go test (TUG), Functional reach test (FRT). 10m walk test and 6-min walk test were used to assess gait abilities. After the completion of the VR-exercise program, muscle strength, balance, and gait abilities were improved significantly (p<0.05). In conclusion, the VR-based exercise program showed improvement on the muscle strength, balance, and gait ability in the elderly. This exercise program is both effective and interesting for this age group.