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Shin D, Hong S. A Study on the Effectiveness of VR Rehabilitation Training Content for Older Individuals with Total Knee Replacement: Pilot Study. Healthcare (Basel) 2024; 12:1500. [PMID: 39120203 PMCID: PMC11311570 DOI: 10.3390/healthcare12151500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/20/2024] [Accepted: 07/26/2024] [Indexed: 08/10/2024] Open
Abstract
There is a paucity of research applying fully immersive virtual reality (VR) training to older adults with degenerative joint disease. This study investigated the effects of a training program utilizing fully immersive VR games on proprioception and gait ability in older patients with degenerative arthritis who had undergone total knee arthroplasty. This randomized controlled trial enrolled patients aged ≥65 years who were diagnosed with knee joint arthritis and had undergone knee arthroplasty followed by physical therapy. Participants were randomly assigned to an experimental group (receiving training using fully immersive VR games along with regular physical therapy) and a control group (receiving only regular physical therapy). The intervention was conducted five times a week for four weeks. Knee joint proprioception was measured using Biodex before and after the intervention. Spatial-temporal gait variables were collected using OptoGait for gait assessment. There was a significant decrease in the absolute error values of proprioception after the intervention in the experimental group, compared to before (p < 0.05), indicating improvement in proprioception. Gait speed, step count, and stride length improved significantly (p < 0.05, p < 0.01), demonstrating an enhancement in gait ability. The experimental group showed significantly greater improvements in gait speed, step count, and stride length than the control group (p < 0.01). Training using a fully immersive VR exercise program may have potential benefits for improving proprioception and gait parameters in patients who have undergone total knee arthroplasty. Fully immersive VR game-based training can be utilized as an effective rehabilitation intervention for patients undergoing knee arthroplasty in the future.
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Affiliation(s)
- DooChul Shin
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul 01795, Republic of Korea;
| | - SoungKyun Hong
- Department of Physical Therapy, College of Health Science, Woosuk University, Wanju 55338, Republic of Korea
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Kim KH, Kim DH. Improved Balance, Gait, and Lower Limb Motor Function in a 58-Year-Old Man with Right Hemiplegic Traumatic Brain Injury Following Virtual Reality-Based Real-Time Feedback Physical Therapy. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e938803. [PMID: 36851837 PMCID: PMC9986857 DOI: 10.12659/ajcr.938803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND This report presents the case of a 58-year-old man with right hemiplegia who improved his gait and lower limb motor function following virtual reality (VR)-based physical therapy. The use of augmented reality or VR-based technology is being increasingly used to support physical therapy in patients with motor deficits and to improve gait, and can be used in small hospitals and outpatient departments. CASE REPORT A 58-year-old man was diagnosed with left hemiplegia due to traumatic brain injury (TBI). He received 20 minutes of VR-based real-time feedback gait training and 30 minutes of general physical therapy, 5 times a week for 8 weeks. BioRescue was used for measurement of balance, GAITRite was used for measurement of gait, and Fugl-Meyer assessment was used for lower extremity motor function measurement. These were measured before the intervention and at 2, 4, 6, and 8 weeks after the intervention. After the intervention, center of pressure and limits of stability also increased. The affected step length, stride length, affected single support, and cadence were significantly increased after VR-based real-time feedback. Additionally, his lower extremity motor function score increased from 18 to 23 points. CONCLUSIONS This case report supports recent studies that have shown the value of VR-based methods as part of a physical therapy program in patients with problems with gait and motor function, including patients with stroke. VR-based real-time feedback showed favorable effects on rehabilitation following a TBI.
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Affiliation(s)
- Kyung Hun Kim
- Department of Physical Therapy, Gimcheon University, Gimcheon, Gyeongsangbuk, South Korea
| | - Dong Hoon Kim
- Department of Physical Therapy, Gimcheon University, Gimcheon, Gyeongsangbuk, South Korea
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Özlü A, Ünver G, Tuna Hİ, Menekşeoğlu AK. The Effect of a Virtual Reality-Mediated Gamified Rehabilitation Program on Pain, Disability, Function, and Balance in Knee Osteoarthritis: A Prospective Randomized Controlled Study. Games Health J 2023; 12:118-124. [PMID: 36603100 DOI: 10.1089/g4h.2022.0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: This prospective randomized controlled study is the first study that evaluates the disease-specific gamification through virtual reality (VR) glasses on pain, disability, functionality, and balance in knee osteoarthritis (OA). Materials and Methods: The demographic data of the patients were recorded. A total of 73 patients were divided into two groups (35 in experimental group and 38 in control group). All patients were evaluated with pain (visual analog scale [VAS]), functionality (Lysholm functional knee score [LFKS], 6 minutes walking test [6MWT]), disability (Western Ontario and McMaster Universities Arthritis Index [WOMAC]), and balance (Berg Balance Scale [BBS]) before treatment, after treatment (3th weeks), and 4 weeks after treatment (7th weeks). In the experimental group, plus the conservative treatment, a total of 15 sessions of a disease-specific gamification through VR glasses were applied. Results: VAS and WOMAC scores of the experimental group were lower at the 3th and 7th weeks than those of the control group (P = 0.005, P = 0.000), (P = 0.000). LFKS of the experimental group was higher at the 3th and 7th weeks than that of the control group (P = 0.005, P = 0.013). No difference was found between the groups in terms of 6MWTs (P > 0.05). BBS score of the experimental group was higher in the 7th week than that of the control group (P = 0.021). Conclusion: In knee OA, the disease-specific gamification through VR glasses added to the conservative treatment has a positive effect on pain, functionality, and balance. Side effects such as mild nausea, headache that did not last long, require additional treatment. In light of this, disease-specific gamification through VR glasses is effective and safe in knee OA, more studies that reveal the long-term effect on structural healing must be planned.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Gamze Ünver
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey
| | | | - Ahmet Kıvanç Menekşeoğlu
- Department of Physical Medicine and Rehabilitation, Kanuni Sultan Süleyman Education and Training Hospital, Istanbul, Turkey
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Hadamus A, Błażkiewicz M, Wydra KT, Kowalska AJ, Łukowicz M, Białoszewski D, Marczyński W. Effectiveness of Early Rehabilitation with Exergaming in Virtual Reality on Gait in Patients after Total Knee Replacement. J Clin Med 2022; 11:jcm11174950. [PMID: 36078879 PMCID: PMC9456315 DOI: 10.3390/jcm11174950] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Total knee replacement (TKR) is the treatment of choice for advanced stages of osteoarthritis but it requires good postoperative rehabilitation. This study aimed to assess the effectiveness of exercises using virtual reality to improve gait parameters in patients after TKR. Fifty-nine patients 7−14 days after TKR surgery were divided into a study group (VRG, n = 38) and a control group (CG, n = 21). Both groups underwent the same 4-week rehabilitation protocol. The VRG group had 12 additional nonimmersive virtual reality game sessions on the Virtual Balance Clinic prototype system at 30 min each, focusing on gait and balance improvement. Spatiotemporal, force and foot plantar pressure parameters were collected on an instrumented treadmill during a 30 s walk. The most significant improvement was in the symmetry indices of forefoot force, maximum forefoot force, loading response time, and preswing time (p < 0.05) in both groups. Gait speed increased by 31.25% and 44% in the VRG and CG groups, respectively (p < 0.005). However, the extra exergaming sessions did not significantly improve rehabilitation outcomes. Therefore, additional VR training does not improve gait better than standard rehabilitation alone, but the improvement of gait, especially its symmetry, is significant within the first six weeks after surgery.
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Affiliation(s)
- Anna Hadamus
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Michalina Błażkiewicz
- Faculty of Rehabilitation, The Józef Piłsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland
| | - Kamil T. Wydra
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Aleksandra J. Kowalska
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Małgorzata Łukowicz
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Dariusz Białoszewski
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
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Schuermans J, Van Hootegem A, Van den Bossche M, Van Gendt M, Witvrouw E, Wezenbeek E. Extended reality in musculoskeletal rehabilitation and injury prevention - A systematic review. Phys Ther Sport 2022; 55:229-240. [DOI: 10.1016/j.ptsp.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
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Reynolds A, Hamidian Jahromi A. Improving Postoperative Care Through Mindfulness-Based Cognitive Therapy and Isometric Exercise Interventions: A Systematic Review (Preprint). JMIR Perioper Med 2021; 5:e34651. [PMID: 35687415 PMCID: PMC9233259 DOI: 10.2196/34651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/21/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes. Objective The aim of this review was to identify the impacts of mindfulness-based interventions (MBIs) and IET and, more specifically, their combination, which have not previously been assessed to our knowledge. Methods Studies were identified by searching the PubMed and Cochrane databases within the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm format and using relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria. Results In general, MBI was shown to positively impact both pain relief and physical functioning, while IET positively impacted physical functioning. Numerous other benefits, including improved quality of life and decreased postoperative opioid use, were also described from both interventions; however, further research is needed to confirm these findings as well as to determine other possible benefits. No studies were found that combined MBI and IET. Conclusions Despite many positive results from each individual intervention, there is a lack of information about how the combination of MBI and IET might impact postoperative care. The combination of these two interventions might prove to be more effective than each individual intervention alone, and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBI and IET in postoperative care routines as well as other possible combinations.
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Affiliation(s)
- Allie Reynolds
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, United States
| | - Alireza Hamidian Jahromi
- Department of Plastic and Reconstructive Surgery, Temple University Medical Center, Philadelphia, PA, United States
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Brady N, McVeigh JG, McCreesh K, Rio E, Dekkers T, Lewis JS. Exploring the effectiveness of immersive Virtual Reality interventions in the management of musculoskeletal pain: a state-of-the-art review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1903209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Niamh Brady
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
- Evolve Health, Physiotherapy and Rehabilitation Clinic, Cork, Ireland
| | - Joseph G. McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Karen McCreesh
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ebonie Rio
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Thomas Dekkers
- Evolve Health, Physiotherapy and Rehabilitation Clinic, Cork, Ireland
- Gaelic Sports Research Centre, Technological University Dublin, Dublin, Ireland
| | - Jeremy S. Lewis
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
- Therapy Department, Central London Community Healthcare National Health Service Trust, London, UK
- Department of Physical Therapy and Rehabilitation Science, Qatar University, Doha, Qatar
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Hadamus A, Białoszewski D, Błażkiewicz M, Kowalska AJ, Urbaniak E, Wydra KT, Wiaderna K, Boratyński R, Kobza A, Marczyński W. Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance. ENTROPY (BASEL, SWITZERLAND) 2021; 23:164. [PMID: 33573057 PMCID: PMC7911395 DOI: 10.3390/e23020164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 12/01/2022]
Abstract
Exercises in virtual reality (VR) have recently become a popular form of rehabilitation and are reported to be more effective than a standard rehabilitation protocol alone. The aim of this study was to assess the efficacy of adjunct VR training in improving postural control in patients after total knee replacement surgery (TKR). Forty-two patients within 7-14 days of TKR were enrolled and divided into a VR group and a control group (C). The C group underwent standard postoperative rehabilitation. The VR group additionally attended twelve 30-min exercise sessions using the Virtual Balance Clinic prototype system. Balance was assessed on the AMTI plate in bipedal standing with and without visual feedback before and after the four-week rehabilitation. Linear measures and sample entropy of CoP data were analyzed. After four weeks of rehabilitation, a significant reduction in parameters in the sagittal plane and ellipse area was noted while the eyes remained open. Regression analysis showed that sample entropy depended on sex, body weight, visual feedback and age. Based on the sample entropy results, it was concluded that the complexity of the body reaction had not improved. The standing-with-eyes-closed test activates automatic balance mechanisms and offers better possibilities as a diagnostic tool.
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Affiliation(s)
- Anna Hadamus
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Dariusz Białoszewski
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Michalina Błażkiewicz
- The Józef Piłsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland
| | - Aleksandra J. Kowalska
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Edyta Urbaniak
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Kamil T. Wydra
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Karolina Wiaderna
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Rafał Boratyński
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Agnieszka Kobza
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Wojciech Marczyński
- Medical Centre for Postgraduate Education, Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Orthopaedics Clinic, 05-400 Otwock, Poland;
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