가상현실훈련과 위팔 기능적 전기자극이 만성 뇌졸중 환자의 위팔 근력, 능동관절운동과 기능에 미치는 효과 = The Effects of Virtual Reality Training with Upper Limb Functional Electrical Stimulation to Improve on Muscle Strength, AROM, and Function of Upper Limb Joints in Patient with Chronic Stroke

다국어 초록 (Multilingual Abstract)

Purpose : The purpose of the present study is to examine the effects of VR training with FES on improving the muscle strength, AROM, and function of the upper limb joints in patients with chronic stroke.
Methods : The present study makes use of a pre-post control group design. Thirty patients with chronic stroke were randomly assigned to two groups according to treatment method – the VRFES group and the control group. The VRFES group received 15 minutes of VR training and 15 minutes of FES treatment. The control group received 15 minutes of conservative physical therapy and 15 minutes of VR training. All subjects received 30 minutes of treatment, three times a week, for eight weeks, which amounted to 24 sessions of training. The muscle strength, AROM, and function of the upper extremities were measured before the training and eight weeks after. Upper limb muscle strength was tested using the Digital Manual Muscle Tester while AROM was measured using the Digital Dual Inclinometer. The clinical assessment tools for upper extremity function included the use of the Manual Function Test and the Jebsen-Taylor Hand Function Test.
Result : Both groups exhibited great improvements in muscle strength and upper extremity function during the intervention period. The VRFES group exhibited a significant difference in muscle strength, AROM, and function of the upper extremities in comparison with the control group(p<.05). Our results reveal that VRFES is more effective for the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke.
Conclusion : VRFES treatment will be used as an important intervention for improving the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke and achieving the functional recovery of the upper extremities.

참고문헌 (Reference)

1 주민철, "아급성기 뇌졸중 환자에서의 상지 재활 로봇 치료의 효과" 대한뇌신경재활학회 7 (7): 111-117, 2014

2 양종은, "가상현실을 기반으로 한 손 움직임 훈련이 뇌졸중 환자의 상지 및 손 기능에 미치는 영향" 대한신경치료학회 23 (23): 45-50, 2019

3 Tieri G, "Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies" 15 (15): 107-117, 2018

4 Broeren J, "Virtual reality and haptics as a training device for movement rehabilitation after stroke : a single-case study" 85 (85): 1247-1250, 2004

5 Holden MK, "Virtual environment training : a new tool for neurorehabilitation?" 26 (26): 62-71, 2002

6 Carregosa AA, "Virtual Rehabilitation through Nintendo Wii in Poststroke Patients : Follow-Up" 27 (27): 494-498, 2018

7 Maggio MG, "Virtual Reality and Cognitive Rehabilitation in People With Stroke : An Overview" 51 (51): 101-105, 2019

8 Scibek JS, "Validation of a new method for assessing scapular anterior-posterior tilt" 9 (9): 644-656, 2014

9 American Stroke Association, "Understand stroke. What is stroke"

10 Liepert J, "Treatment-induced cortical reorganization after stroke in humans" 31 (31): 1210-1216, 2000

11 Kim DH, "The effects of virtual reality training with upper limb sensory exercise stimulation on the arm of upper limb joints, function, and concentration on chronic stroke patients" 2019

12 Braun SM, "The effects of mental practice in stroke rehabilitation : a systematic review" 87 (87): 842-852, 2006

13 Hara Y, "The effect of electromyography-controlled functional electrical stimulation on upper extremity function and cortical perfusion in stroke patients" 124 (124): 2008-2015, 2013

14 Meadmore KL, "The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study" 11 (11): 2014

15 Gi Jeong Yun, "The Synergic Effects of Mirror Th erapy and Neuromuscular Electrical Stimulation for Hand Function in Stroke Patients" 대한재활의학회 35 (35): 316-321, 2011

16 Christiansen C, "Task performance in virtual environments used for cognitive rehabilitation after traumatic injury" 79 (79): 888-892, 1998

17 Carr JH, "Stroke rehabilitation: guidelines for exercise and training to optimize motor skill" Butterworth-Heinemann 426-, 2003

18 Rizzolatti G, "Resonance behaviors and mirror neurons" 137 (137): 85-100, 1999

19 Artilheiro MC, "Reliability, validity and description of timed performance of the Jebsen–Taylor Test in patients with muscular dystrophies" 22 (22): 190-197, 2018

20 Koblbauer IF, "Reliability of maximal isometric knee strength testing with modified hand-held dynamometry in patients awaiting total knee arthroplasty: useful in research and individual patient settings? A reliability study" 12 : 2011

21 Miyamoto S, "Reliability and validity of the Manual Function Test in patients with stroke" 88 (88): 247-255, 2009

22 Kiper P, "Proprioceptive based training for stroke recovery. Proposal of new treatment modality for rehabilitation of upper limb in neurological diseases" 5 (5): 6-, 2015

23 Shumway-Cook A, "Motor control" Lippincott Williams & Wilkins 612-, 2007

24 Thieme H, "Mirror therapy for improving motor function after stroke" 44 (44): 1-2, 2013

25 Kim JH, "Mirror therapy combined with biofeedback functional electrical stimulation for motor recovery of upper extremities after stroke : a pilot randomized controlled trial" 22 (22): 51-60, 2015

26 Perez-Marcos, D, "Increasing upper limb training intensity in chronic stroke using embodied virtual reality: a pilot study" 14 (14): 2017

27 Thomas CK, "Incidence of F waves in single human thenar motor units" 25 (25): 77-82, 2002

28 Dos Santos-Fontes RL, "Home-based nerve stimulation to enhance effects of motor training in patients in the chronic phase after stroke : a proof-of-principle study" 27 (27): 483-490, 2013

29 Benjamin EJ, "Heart disease and stroke statistics—2017 update : a report from the American Heart Association" 135 (135): 146-603, 2017

30 Massimiliano G, "Hand passive mobilization performed with robotic assistance: acute effects on upper limb perfusion and spasticity in stroke survivors" 2017 : 2017

31 Kapadia NM, "Functional electrical stimulation therapy for recovery of reaching and grasping in severe chronic pediatric stroke patient" 29 (29): 493-499, 2014

32 Kesar TM, "Functional electrical stimulation of ankle plantar flexor and dorsiflexor muscles : effects on post stroke gait" 40 (40): 3821-3827, 2009

33 Kojima K, "Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients : a randomized crossover trial" 34 (34): 235-244, 2014

34 Jung HT, "Feasibility of using the RAPAEL Smart Glove in upper limb physical therapy for patients after stroke: A randomized controlled trial" 2017 : 3856-3859, 2017

35 Boggio PS, "Enhancement of non-dominant hand motor function by anodal transcranial direct current stimulation" 404 (404): 232-236, 2006

36 Powell J, "Electrical stimulation of wrist extensors in post stroke hemiplegia" 30 (30): 1384-1389, 1999

37 Combs SA, "Effects of a repetitive gaming intervention on upper extremity impairments and function in persons with chronic stroke : a preliminary study" 34 (34): 1291-1298, 2012

38 Ring H, "Contralled study of neuroprosthetic functional electrical stimulation in sub-acute post-stroke rehabilitation" 37 (37): 32-36, 2005

39 Saito K, "Combined effect of motor imagery and peripheral nerve electrical stimulation on the motor cortex" 227 (227): 333-342, 2013

40 Thompson AJ, "Clinical management of spasticity" 76 (76): 459-463, 2005

41 Cauraugh J, "Chronic motor dysfunction after stroke : recovering wrist and finger extension by electromyography-trigered neuromuscular stimulation" 31 (31): 1360-1364, 2000

42 Summers JJ, "Bilateral an unilateral movement training on upper limb function in chronic stroke patients: a TMS study" 252 (252): 76-82, 2007

43 Nanji LS, "Analysis of the cochrane review: Interventions for improving upper limb function after stroke" 28 (28): 551-553, 2015

44 Chae J, "A critical review of neuromuscular electrical stimulation for treatment of motor dysfunction in hemiplegia" 12 (12): 33-49, 2000

45 Teasell RW, "A blueprint for transforming stroke rehabilitation care in canada: the case for change" 89 (89): 575-578, 2008