GyuChang Lee

Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia.

ObjectiveThe aim of this study was to investigate the effects of additional virtual reality training using Xbox Kinect on upper extremity function, including range of motion, motor function, and gross manual dexterity, in stroke survivors with hemiplegia. DesignThis study is a randomized controlled trial. Forty participants were randomly allocated to either the experimental or control groups; the experimental group (n = 20) underwent virtual reality training using Xbox Kinect and conventional occupational therapy, and the control group (n = 20) underwent conventional occupational therapy alone. The mean time since the onset of stroke was 7.22 mos in the experimental group and 8.47 mos in the control group. At baseline and after 6 wks of intervention, range of motion of the upper extremity was measured, and the Fugl-Meyer Assessment and the Box and Block Test were performed. ResultsAfter intervention, significant improvements from baseline values in range of motion of the upper extremity, Fugl-Meyer Assessment scores, and Box and Block Test scores were observed in the experimental and control groups (P < 0.05). At follow-up, there were significant differences between the two groups in range of motion (except for the wrist), Fugl-Meyer Assessment scores, and Box and Block Test scores (P < 0.05). ConclusionsThe hemiplegic stroke survivors who received additional virtual reality training using Xbox Kinect showed significantly improved function of the upper extremity. However, the effects of the virtual reality training using Xbox Kinect may have been a result of the greater total intervention time in the training group compared with the control group. Thus, the potential efficacy of Xbox Kinect in the rehabilitation of post-stroke survivors needs to be investigated in greater depth.

Effects of Training Using Video Games on the Muscle Strength, Muscle Tone, and Activities of Daily Living of Chronic Stroke Patients

[Purpose] The purpose of this study was to investigate the effects of training using video games played on the Xbox Kinect on the muscle strength, muscle tone, and activities of daily living of post-stroke patients. [Subjects] Fourteen stroke patients were recruited. They were randomly allocated into two groups; the experimental group (n=7) and the control group (n=7). [Methods] The experimental group performed training using video games played on the Xbox Kinect together with conventional occupational therapy for 6 weeks (1 hour/day, 3 days/week), and the control group received conventional occupational therapy only for 6 weeks (30 min/day, 3 days/week). Before and after the intervention, the participants were measured for muscle strength, muscle tone, and performance of activities of daily living. [Results] There were significant differences pre- and post-test in muscle strength of the upper extremities, except the wrist, and performance of activities of daily living in the experimental group. There were no significant differences between the two groups at post-test. [Conclusion] The training using video games played on the Xbox Kinect had a positive effect on the motor function and performance of activities of daily living. This study showed that training using video games played on the Xbox Kinect may be an effective intervention for the rehabilitation of stroke patients.

Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation

BackgroundA balance test provides important information such as the standard to judge an individual’s functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform.MethodsTwenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM).ResultsThe inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity.ConclusionThe balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment.

Effect of Eccentric Strengthening on Pain, Muscle Strength, Endurance, and Functional Fitness Factors in Male Patients with Achilles Tendinopathy

Objective The aim of this study was to investigate the effect of eccentric strengthening on pain, muscle strength, endurance, and functional fitness factors in Achilles tendinopathy patients. Design Thirty-two male patients with Achilles tendinopathy were assigned to either the experimental group that performed eccentric strengthening or the control group that performed concentric strengthening (n = 16, both groups) for 8 wks (50 mins per day, three times per week). A visual analog scale, an isokinetic muscle testing equipment, the side-step test, and the Sargent jump test were used to assess pain, muscle strength, endurance, and functional fitness factors before and after the intervention. Results In comparison with the control group, the experimental group showed significant improvement in pain, ankle dorsiflexion endurance, total balance index, and agility after the intervention (P < 0.05). However, there was no significant difference in dexterity between the two groups. Conclusions Eccentric strengthening was more effective than concentric strengthening in reducing pain and improving function in patients with Achilles tendinopathy; therefore, regular eccentric strengthening is important for patients in a clinical setting.

Effect of whole body vibration exercise in the horizontal direction on balance and fear of falling in elderly people: a pilot study

[Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies.

Does whole-body vibration training in the horizontal direction have effects on motor function and balance of chronic stroke survivors? A preliminary study

[Purpose] The objective of this study was to investigate the effects of whole-body vibration (WBV) in the horizontal direction on the motor function and balance of chronic stroke survivors. [Subjects and Methods] This study was a randomized controlled trial. Twenty-one individuals with chronic stroke from an inpatient rehabilitation center participated in the study. The participants were allocated to either the WBV training group or the control group. The WBV training group (n = 12) received whole-body vibration delivered in the horizontal direction (15 min/day, 3 times/week, 6 wks) followed by conventional rehabilitation (30 min/day, 5 times/week, 6 wks); the control group (n = 9) received conventional rehabilitation only (30 min/day, 5 times/week, 6 wks). Motor function was measured by using the Fugl-Meyer assessment, and balance was measured by using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test before and after the interventions. [Results] After the interventions, all variables improved significantly compared with the baseline values in the WBV training group. In the control group, no significant improvements in any variables were noted. In addition, the BBS score in the WBV training group increased significantly compared with that in the control group. [Conclusion] WBV training with whole-body vibration delivered in the horizontal direction may be a potential intervention for improvement of motor function and balance in patients who previously experienced a stroke.

Effect of the cognitive-motor dual-task using auditory cue on balance of surviviors with chronic stroke: a pilot study:

Objective: To investigate the effect of a cognitive-motor dual-task using auditory cues on the balance of patients with chronic stroke. Design: Randomized controlled trial. Setting: Inpatient rehabilitation center. Subjects: Thirty-seven individuals with chronic stroke. Interventions: The participants were randomly allocated to the dual-task group (n=19) and the single-task group (n=18). The dual-task group performed a cognitive-motor dual-task in which they carried a circular ring from side to side according to a random auditory cue during treadmill walking. The single-task group walked on a treadmill only. All subjects completed 15 min per session, three times per week, for four weeks with conventional rehabilitation five times per week over the four weeks. Main measures: Before and after intervention, both static and dynamic balance were measured with a force platform and using the Timed Up and Go (TUG) test. Results: The dual-task group showed significant improvement in all variables compared to the single-task group, except for anteroposterior (AP) sway velocity with eyes open and TUG at follow-up: mediolateral (ML) sway velocity with eye open (dual-task group vs. single-task group: 2.11 mm/s vs. 0.38 mm/s), ML sway velocity with eye close (2.91 mm/s vs. 1.35 mm/s), AP sway velocity with eye close (4.84 mm/s vs. 3.12 mm/s). After intervention, all variables showed significant improvement in the dual-task group compared to baseline. Conclusion: The study results suggest that the performance of a cognitive-motor dual-task using auditory cues may influence balance improvements in chronic stroke patients.

Mirror Therapy with Neuromuscular Electrical Stimulation for improving motor function of stroke survivors: A pilot randomized clinical study

OBJECTIVE This study was to investigate the effects of Mirror Therapy (MT) combined with Neuromuscular Electrical Stimulation (NMES) on muscle strength and tone, motor function, balance, and gait ability in stroke survivors with hemiplegia. METHODS This study was a randomized controlled trial. Twenty-seven hemiplegic stroke survivors from a rehabilitation center participated in the study. The participants were randomly assigned to either an experimental or a control group. The experimental group (n = 14) underwent MT combined with NMES and conventional physical therapy, and the control group (n = 13) underwent conventional physical therapy alone. Muscle strength and tone, balance, and gait ability were examined at baseline and after 4 weeks of intervention. A hand-held dynamometer was used to assess muscle strength, the Modified Ashworth Scale (MAS) was used to assess muscle tone, the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) were used to ascertain balance, and the 6-m Walk Test (6mWT) was used to examine gait ability. RESULTS After the intervention, compared to baseline values, there were significant improvements in muscle strength and MAS, BBS, TUG, and 6mWT values in the experimental group (P< 0.05). In addition, at post-intervention, there were significant differences between the two groups in muscle strength and BBS (P< 0.05). CONCLUSION MT combined with NMES may effectively improve muscle strength and balance in hemiplegic stroke survivors. However, further studies are necessary to demonstrate brain reorganization after MT combined with NMES.

Effect of core stability training using pilates on lower extremity muscle strength and postural stability in healthy subjects

This study investigated the effect of core stability training using pilates for 8 weeks on lower extremity muscle strength and postural stability. Participants included 40 healthy people who were randomly allocated to 1 of 2 groups: a core stability training group (CST) (n = 20) and a control group (n = 20). The CST group received three 60-minute pilates training sessions per week for 8 weeks, whereas the control group did not undergo any training. We measured pre- and post-training lower extremity muscle strength using isokinetic equipment and postural stability using a balance device. Significant posttest increments in lower extremity muscle strength and postural stability were observed in the CST group (P < 0.05). However, neither of these parameters was significantly improved in the control group. Significant differences in lower extremity muscle strength and postural stability were found between the CST group and the control group after 8 weeks (P < 0.05). These results indicate that pilates core stability training enhances motor performance skills by increasing lower extremity muscle strength and improving postural stability and can prevent musculoskeletal disorders and improve quality of life. Further studies should focus on creating a program combining other trainings for achieving improved core stability and investigating duration of training effect.

Influence of light touch using the fingertips on postural stability of poststroke patients.

[Purpose] The purpose of this study was to investigate the influence of fingertip light touch on the postural control in poststroke patients. [Subjects] In the study, the subjects were recruited through a rehabilitation hospital, and 21 patients were screened from among 30 volunteers. [Methods] The subjects participated in an experiment that measured postural sway during the static standing posture without light touch and postural sway during the static standing posture with light touch as follows: visual information not blocked without light touch, visual information blocked without light touch, visual information blocked with light touch using fingertips, and visual information not blocked with light touch using fingertips. The measurements were performed using a force platform. The variables measured by the force platform included sway velocities of the COP in the anterior and posterior directions and, medial and lateral directions and sway velocity moments. [Results] In the results of the study, there were significant differences between the state without light touch and state with light touch in terms of the postural sway velocity and velocity moment under all conditions. The rate of decease of the sway velocity and moment velocity under the eyes closed condition were higher compared with those under the eyes open condition. [Conclusion] Through this study, we confirmed the influence of fingertip light touch on the decrease in postural sway. The results show that active light touch may be supplemental means of improving postural sway in stroke patients.