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Yildirim Şahan T, Erbahçeci F. Effects of Virtual Reality on Transtibial Amputation Rehabilitation Outcomes: A Randomized Study. Games Health J 2023; 12:459-467. [PMID: 37934289 DOI: 10.1089/g4h.2023.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Purpose: Virtual reality is widely used in patients with chronic musculoskeletal problems. However, the short-term effects on individuals with transtibial (TT) amputation during this process remain unclear. This study aimed at investigating the effects of virtual reality on rehabilitation outcomes in TT amputees. Methods: The study included 20 TT amputees who were using TT prostheses. The participants were divided into two groups randomly as follows: physiotherapy (PT) and virtual reality (VR). Participants were treated 3 days a week, for 4 weeks, and evaluations were made before and after treatment; a 6-minute walk test was used for performance, a single-leg balance test for balance, Trinity Amputation Prosthesis Experience Scale for prosthesis satisfaction, a 10-meter walking test for gait speed, and a wearable smart t-shirt to determine cadence. Results: It was found that there was a statistically significant difference in performance, balance, prosthesis satisfaction, cadence, and gait speed before and after PT (P < 0.05). There were differences in terms of performance, prosthesis satisfaction, balance, cadence, and gait speed before and after VR (P < 0.05). There was no statistically significant difference between PT and VR (P > 0.05). Conclusion: The 4 weeks of VR training improved performance, prosthesis satisfaction, balance, cadence, and gait speed in TT amputation rehabilitation similar to physiotherapy methods. The addition of VR training to amputation rehabilitation will bring improvements since it is a fun and safe intervention. Clinical Trial Registration: The trial is registered at Clinical Trials.gov, Trial No: NCT03872193.
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Affiliation(s)
- Tezel Yildirim Şahan
- University of Health Science Turkey, Gulhane Faculty of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Fatih Erbahçeci
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Turkey
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Hao J, Chen Z, Remis A, He Z. Virtual Reality-Based Rehabilitation to Restore Motor Function in People With Amputation: A Systematic Literature Review. Am J Phys Med Rehabil 2023; 102:468-474. [PMID: 36730652 DOI: 10.1097/phm.0000000000002150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Virtual reality is an emerging technology with accumulating research and clinical evidence in the field of physical rehabilitation. This study aimed to systematically identify and examine the effects of virtual reality on motor function outcomes in patients with amputation to inform clinical decision making on amputation rehabilitation and inform further research endeavors. Five databases were searched, including PubMed, CINAHL, PsycINFO, Embase, and Scopus. After screening for 1052 records, 10 clinical studies were included in this review: four randomized controlled trials, three pre-post single-arm studies, and three case studies; all studies had fair to good methodological quality. Seven studies were for lower extremity amputation, and three were for upper extremity amputation. Results reveal the positive effects of virtual reality on improving motor function in prosthesis training, including balance, gait, and upper extremity outcomes. Participants also report enjoyment during virtual reality intervention as measured by subjective experience. However, it is unclear whether virtual reality can induce better therapeutic outcomes than conventional rehabilitation, given the limited number of controlled studies and conflicting results reported in the included studies. More properly designed randomized controlled trials with adequately powered sample sizes are warranted to elucidate the benefits of virtual reality-based rehabilitation in the amputation population.
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Affiliation(s)
- Jie Hao
- From the College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska (JH); School of Basic Medical Sciences, Capital Medical University, Beijing, China (ZC); Gate Parkway Primary Care Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida (AR); and Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (ZH)
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Cabrera IA, Pike TC, McKittrick JM, Meyers MA, Rao RR, Lin AY. Digital healthcare technologies: Modern tools to transform prosthetic care. Expert Rev Med Devices 2021; 18:129-144. [PMID: 34644232 DOI: 10.1080/17434440.2021.1991309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Digital healthcare technologies are transforming the face of prosthetic care. Millions of people with limb loss around the world do not have access to any form of rehabilitative healthcare. However, digital technologies provide a promising solution to augment the range and efficiency of prosthetists. AREAS COVERED The goal of this review is to introduce the digital technologies that have the potential to change clinical methods in prosthetic healthcare. Our target audience are researchers who are unfamiliar with the field of prostheses in general, especially with the newest technological developments. This review addresses technologies for: scanning of amputated limbs, limb-to-socket rectification, additive manufacturing of prosthetic sockets, and quantifying patient response to wearing sockets. This review does not address biomechatronic prostheses or biomechanical design practices. EXPERT OPINION Digital technologies will enable affordable prostheses to be built on a scale larger than with today's clinical practices. Large technological gaps need to be overcome to enable the mass production and distribution of prostheses digitally. However, recent advances in computational methods and CAD/CAM technologies are bridging this gap faster than ever before. We foresee that these technologies will return mobility and economic opportunity to amputees on a global scale in the near future.
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Affiliation(s)
- Isaac A Cabrera
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, United States
| | - Trinity C Pike
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, United States
| | - Joanna M McKittrick
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, United States
| | - Marc A Meyers
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, United States.,Department of Nanoengineering, University of California San Diego, La Jolla, United States
| | - Ramesh R Rao
- California Institute for Telecommunications and Information Technology (Calit2), La Jolla, United States
| | - Albert Y Lin
- California Institute for Telecommunications and Information Technology (Calit2), La Jolla, United States
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Hong S, Lee G. Effects of an Immersive Virtual Reality Environment on Muscle Strength, Proprioception, Balance, and Gait of a Middle-Aged Woman Who Had Total Knee Replacement: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1636-1642. [PMID: 31695020 PMCID: PMC6859930 DOI: 10.12659/ajcr.918521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The purpose of this case study was to apply a training program using virtual reality to a middle-aged woman who had total knee replacement surgery and to investigate its effects on her muscle strength, proprioception, balance, and gait ability. CASE REPORT The subject who participated in this study was a 62-year-old woman, who had been diagnosed with moderate osteoarthritis and had a total knee replacement. Post-operative treatment consisted of virtual reality training along with range of motion exercise of the knee joint, light quadriceps isometric exercise, and conventional physical therapy. This also included thermal and electric therapy for pain control conducted on 10 occasions (5 times a week for 2 weeks). Total treatment time, which included 30 min of conventional physical therapy, was 60 min. Measurement of the subject's lower extremity muscle strength after intervention decreased to 9.43 s, and the error in proprioception decreased to 1.5°. In addition, balance score increased to 56 points, and the time taken to measure gait ability decreased to 9.87 s. CONCLUSIONS The patient responded positively to rehabilitation using virtual reality, and her muscle strength, proprioception, balance, and gait ability improved. These results suggest that the application of rehabilitative training through virtual reality for total knee replacement patients warrants further study and consideration.
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Affiliation(s)
- Soungkyun Hong
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, South Korea
| | - GyuChang Lee
- Department of Physical Therapy, Kyungnam University, Changwon, South Korea
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Cho H, Sohng KY. The effect of a virtual reality exercise program on physical fitness, body composition, and fatigue in hemodialysis patients. J Phys Ther Sci 2014; 26:1661-5. [PMID: 25364137 PMCID: PMC4210422 DOI: 10.1589/jpts.26.1661] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 07/15/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to investigate the effects of a virtual
reality exercise program (VREP) on physical fitness, body composition, and fatigue in
hemodialysis (HD) patients with end-stage renal failure. [Subjects and Methods] A
nonequivalent control group pretest-posttest design was used. Forty-six HD patients were
divided into exercise (n=23) and control groups (n=23); while waiting for their dialyses,
the exercise group followed a VREP, and the control group received only their usual care.
The VREP was accomplished using Nintendo’s Wii Fit Plus for 40 minutes, 3 times a week for
8 weeks during the period of May 27 to July 19, 2013. Physical fitness (muscle strength,
balance, flexibility), body composition (skeletal muscle mass, body fat rate, arm and leg
muscle mass), and fatigue were measured at baseline and after the intervention. [Results]
After the VREP, physical fitness and body composition significantly increased, and the
level of fatigue significantly decreased in the exercise group. [Conclusion] These results
suggest that a VREP improves physical fitness, body composition, and fatigue in HD
patients. Based on the findings, VREPs should be used as a health promotion programs for
HD patients.
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Affiliation(s)
- Hyeyoung Cho
- Department of Emergency Medical Service, Daewon University, Republic of Korea
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Lee S, Shin S. Effectiveness of virtual reality using video gaming technology in elderly adults with diabetes mellitus. Diabetes Technol Ther 2013; 15:489-96. [PMID: 23560480 DOI: 10.1089/dia.2013.0050] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Diabetes in elderly adults is associated with an increased risk of fall. The aim of study was to determine whether a virtual reality exercise (VRE) program would improve balance, strength, gait, and falls efficacy in elderly adults with diabetes. SUBJECTS AND METHODS Fifty-five subjects with diabetes mellitus over 65 years of age were randomly assigned to a VRE group (VREG) (n=27) and a control group (CG) (n=28). The VREG received the VRE program and diabetes education, whereas the CG received only the diabetes education. The VRE program used video gaming (PlayStation(®) 2; Sony, Tokyo, Japan) and was conducted for 50 min twice a week for 10 weeks. Balance, muscle strength, gait, and falls efficacy were measured at baseline and after intervention. Measurements were taken using a clinical tests (the one-leg-standing test, the Berg Balance Scale, the functional reach test, the timed up-and-go test, and the sit-to-stand test), and gait analysis. A self-administered questionnaire was used to measure falls efficacy. RESULTS After training, the VREG showed significantly improved balance, decreased sit-to-stand times, and increased gait speed, cadence, and falls efficacy. CONCLUSIONS The VRE program was to maximize the effects of exercise by triggering players was to be fully immersed into the games and enhanced major influential factors on the falls of subject. This study suggests VRE programs are feasible and effective for reduced the risk of falls in elderly adults with type 2 diabetes.
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Affiliation(s)
- Sunwoo Lee
- Department of Nursing, Sahmyook Health University College, Seoul, Republic of Korea
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Imam B, Miller WC, McLaren L, Chapman P, Finlayson H. Feasibility of the Nintendo WiiFit™ for improving walking in individuals with a lower limb amputation. SAGE Open Med 2013; 1:2050312113497942. [PMID: 26770676 PMCID: PMC4687776 DOI: 10.1177/2050312113497942] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility of the Nintendo WiiFit™ as an adjunct to usual therapy in individuals with a lower limb amputation. METHODS The study was a Multiple Baseline (AB) Single Subject Research Design. Subjects were ≥19 years old, had their first unilateral transtibial or transfemoral amputation ≤12 months ago, and were participating in prosthetic training. WiiFit training was provided for 30 min, 5 times a week, for a minimum of 2 and a maximum of 6 weeks in addition to usual therapy. Feasibility indicators were safety, post-intervention fatigue and pain levels, adherence, and subject's acceptability of the program as measured by the Short Feedback Questionnaire-modified (SFQ-M). The primary clinical outcome was walking capacity assessed by the 2 Minute Walk Test (2MWT). The secondary clinical outcomes were the Short Physical Performance Battery, L-test, and Activities-Specific Balance Confidence. RESULTS Subjects (4 transtibial; 2 transfemoral) had a median age of 48.5 years (range = 45-59 years). No adverse events associated with the intervention occurred. Median pain and fatigue levels were 1.3 (range = 0.5-3.5) and 3.1 (range = 1.4-4.1), respectively. Median adherence was 80%. Subjects found the WiiFit enjoyable and acceptable (median SFQ-M = 35). Five subjects showed statistical improvement on the 2MWT and four on the secondary outcomes (p < 0.05). CONCLUSION The WiiFit intervention was found to be feasible in individuals with unilateral lower limb amputation. This research provides the foundation for future clinical research investigating the use of the WiiFit as a viable adjunctive therapy to improve outcomes in individuals with unilateral lower limb amputation who are participating in prosthetic training.
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Affiliation(s)
- Bita Imam
- Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada
| | - William C Miller
- Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Linda McLaren
- GF Strong Rehabilitation Centre, Vancouver, BC, Canada
| | | | - Heather Finlayson
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
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Lee SW, Song CH. Virtual Reality Exercise Improves Balance of Elderly Persons with Type 2 Diabetes: a Randomized Controlled Trial. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sun Woo Lee
- Department of Nursing, Sahmyook Health College
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