The EFFECTIVENESS OF VIRTUAL REALITY BASED EXERCISES ON UPPER EXTREMITY FUNCTIONAL ABILITY AND COGNITIVE FUNCTION FOR PATIENTS WITH STROKE
Abstract
The objective of this study is to determine the effectiveness of Virtual Reality (VR) based exercises on upper extremity functional ability and cognitive functions in patients with stroke. This research is quasi-experiment using a pre–post test randomized control design. The treatment group I consisted of 8 people who were given conventional exercise, while in the treatment group II there were 8 people who were given VR-based exercises. This research was conducted at the Sri Mulyani Physiotherapy Clinic for 4 weeks from October to November 2022. The instrument for measuring upper extremity functional ability used the Wolf Motor Function Test (WMFT) and the instrument for measuring cognitive function used the Montreal Cognitive Assessment (MoCA-INA). The study showed that the upper extremity functional ability using WMFT showed that the results of the treatment group I showed an insignificant increase on upper extremity functional ability (p>0.05 or p=0.0520) and the results of the treatment group II showed an significant increase on upper extremity functional ability (p>0.05 or p=0.0003***). The measurement of cognitive function using the MoCA-INA showed that the results of treatment group I showed a slightly insignificant increase in cognitive function (p> 0.05 or p=0.4439) and treatment group II showed a significant increase in cognitive function (p>0.05 or p=0.0014**). The conclusions of this study indicate that conventional exercises and VR-based exercises can improve both upper extremity functional ability and cognitive function in post-stroke individuals. However, statistically, it appears that VR-based exercises are more effective.
Keywords : Stroke, Upper Extremitty Function Ability, Cognitive Function, Conventional Exercise, Virtual Reality Based Exercise
References
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28. Bo Ryun Kim, et al. (2011). Effect of Virtual Reality on Cognition in Stroke Patients. Ann Rehabil Med. 35: 450-459
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33. Stanton D, Foreman N, Wilson P, Duff y H, Parnell R. 2022. Use of virtual environments to acquire spatial under standing of real-world multi-level environments. Proceedings of the 4th International Conference on Disability, Virtual Reality and associated Technologies; Sep 18-20; Veszprem, Hungary. UK: University of Reading.
34. Llorens R, Noe E, Colomer C, Alcaniz M. (2015). Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 96:418-25
2. Kernan WN, Ovbiagele B, Black HR, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack : a guideline for healthcare professionals from the American Heart Association / American Stroke Association. Stroke. 45:2160-236.
3. Khedr EM, Hamed SA, El-Shereef HK, et al. (2009). Cognitive impairment after cerebrovascular stroke: relationship to vascular risk factors. Neuropsychiatr Dis Treat. 5:103-16.
4. Yu KH, Cho SJ, Oh MS, et al. (2013). Cognitive impairment evaluated with Vascular Cognitive Impairment Harmonization Standards in a multi center prospective stroke cohort in Korea. Stroke. 44:786-8.
5. Plautz EJ, Milliken GW, Nudo RJ. (2000). Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem. 74:27-55.
6. Kwakkel G. (2006). Impact of intensity of practice after stroke: issues for consideration. Disabil Rehabil. 28:823-30.
7. Platz T, van Kaick S, Mehrholz J, Leidner O, Eickhof C, Pohl M. (2009). Best conventional therapy versus modular impairment-oriented training for arm paresis after stroke: a single-blind, multicenter randomized controlled trial. Neurorehabil Neural Repair. 23:706-16.
8. Samuelkamaleshkumar S, Reethajanetsureka S, Pauljebaraj P, Benshamir B, Padankatti SM, David JA. (2014). Mirror therapy enhances motor performance in the paretic upper limb after stroke: a pilot randomized controlled trial. Arch Phys Med Rehabil. 95:2000-5.
9. Foley NC, Teasell RW, Bhogal SK, Doherty T, Speechley MR. (2003). The efficacy of stroke rehabilitation: a qualitative review. Top Stroke Rehabil . 10:1-18.
10. Langhorne P, Coupar F, Pollock A. (2009) Motor recovery after stroke: a systematic review. Lancet Neurol. 8:741-54.
11. Holden MK. (2005). Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 8:187-211. discussion 212-9.
12. Kwakkel G, Kollen BJ, Krebs HI. (2008). Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil Neural Repair. 22:111-21.
13. Kleim JA, Jones TA. (2008). Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 51:S225-39.
14. Doyon J, Benali H. (2005). Reorganization and plasticity in the adult brain during learning of motor skills. Curr Opin Neurobiol. 15:161-7.
15. Nudo RJ. (2003). Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury. J Rehabil Med. 7-10
16. Hallett M. (2005). Neuroplasticity and rehabilitation. J Rehabil Res Dev. 42. xvii-xxii.
17. Jang SH, You SH, Hallett M, et al. (2005). Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. Arch Phys Med Rehabil. 86:2218-23.
18. Kim B R, Min Ho Chun, M.D., Lee Suk Kim, M.D., Ji Young Park, M.D. (2011). Effect of Virtual Reality on Cognition in Stroke Patients. Ann Rehabil Med. 35: 450-459
19. Kwon JS, Park MJ, Yoon IJ, Park SH. (2012). Effects of virtual reality on upper extremity function and activities of daily living performance in acute stroke: a double-blind randomized clinical trial. Neuro Rehabilitation.31:379-85.
20. Brunner I, Skouen JS, Hofstad H, et al. (2016). Is upper limb virtual reality training more intensive than conventional training for patients in the subacute phase after stroke? An analysis of treatment intensity and content. BMC Neurol. 16:219.
21. Carregosa AA, Aguiar Dos Santos LR, Masruha MR, et al. (2018). Virtual rehabilitation through Nintendo Wii in poststroke patients: follow-up. J Stroke Cerebrovasc Dis. 27:494-8.
22. Lledo LD, Diez JA, Bertomeu-Motos A, et al. (2016). A comparative analysis of 2D and 3D tasks for virtual reality therapies based on robotic assisted neurorehabilitation for post-stroke patients. Front Aging Neurosci. 8:205.
23. Brunner I, Skouen JS, Hofstad H, Aßmus J, Becker F, Sanders A-M, et al. (2017). Virtual reality training for upper extremity in subacute stroke (VIRTUES): a multicenter RCT. Neurology. 89(24):2413–21
24. Soufi Ahmadi H, Hassani Mehraban A, Amini M, Sheikhi M. (2019). The Effects of Virtual Reality on Upper Limb Function in Chronic Stroke Patients: A Clinical Trial. Iranian Rehabilitation Journal. 17 (1) :81-89
25. Calabrò RS, Naro A, Russo M, Leo A, De Luca R, Balletta T, et al. (2017). The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial. J Neuroeng Rehabil. 14(1):1–16.
26. Kiper P, Piron L, Turolla A, Stożek J, Tonin P. (2011). The efectiveness of reinforced feedback in virtual environment in the first 12 months after stroke. Neurol Neurochir Pol. 45(5):436–44
27. Shin J-H, Kim M-Y, Lee J-Y, Jeon Y-J, Kim S, Lee S, et al. (2016). Efects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: a single-blinded, randomized controlled trial. J Neuroeng Rehabil. 13(1):1–10.
28. Bo Ryun Kim, et al. (2011). Effect of Virtual Reality on Cognition in Stroke Patients. Ann Rehabil Med. 35: 450-459
29. Ben-Yishay Y, Piasetsky EB, Rattock J. 1987. A systematic method for ameliorating disorders in basic attention. In : Meier MJ, Benton AL, Diller L, Editors. Neuro-psychological rehabilitation, 1st ed. New York : Chur-chill Livingstone, 165-181.
30. Rose FD, Brooks BM, Attree EA, Parslow DM, Lead- better AG, McNaill JE, Jayawardena S, Greenwood R, Potter J. (1999). A preliminary investigation into the use of virtual environments in memory retraining after vascular brain injury: indications for future strategy? Disabil Rehabil. 21: 548-554
31. Kim YH, Shin SH, Park SH, Ko MH. (2001). Cognitive assessment for patient with brain injury by computerized neuropsychological test. J Korean Acad Rehab Med. 25: 209-216.
32. Wilson PN, Foreman N, Tlauka M. (1996). Transfer of spatial information from a virtual to a real environment in physically disabled children. Disabil Rehabil. 18: 633-637.
33. Stanton D, Foreman N, Wilson P, Duff y H, Parnell R. 2022. Use of virtual environments to acquire spatial under standing of real-world multi-level environments. Proceedings of the 4th International Conference on Disability, Virtual Reality and associated Technologies; Sep 18-20; Veszprem, Hungary. UK: University of Reading.
34. Llorens R, Noe E, Colomer C, Alcaniz M. (2015). Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 96:418-25
Published
2022-12-30
How to Cite
Fatria, I. (2022). The EFFECTIVENESS OF VIRTUAL REALITY BASED EXERCISES ON UPPER EXTREMITY FUNCTIONAL ABILITY AND COGNITIVE FUNCTION FOR PATIENTS WITH STROKE. Jurnal Inovasi Pendidikan Dan Sains, 3(3), 152-158. https://doi.org/10.51673/jips.v3i3.1273
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