Purpose: We developed virtual reality-based tangible training system (Joystim®) that is training tool for activity of daily living linked with virtual reality contents. Patients carry out physical activities of daily living with affected upper extremity using tangible tools according to the method presented in the screen. The aim of this study is to evaluate the effect of the newly developed virtual reality-based tangible upper extremity training and cognitive rehabilitation system (Joystim®) in chronic stroke patients.
Methods: Ten stable chronic stroke out-patients attended in the virtual reality-based tangible upper extremity training and cognitive rehabilitation program with Joystim® for 6 weeks (30 minutes per day, 3 days per week). Upper extremity function (Fugl-Meyer assessment, hand coordination test), strength (manual muscle test, hand grip), spasticity (Modified Asthworth Scale) of affected upper limb and cognitive function (Mini-Mental State Evaluation) were evaluated.
Results: After the training, the total upper Fugl-Meyer assessment improved significantly from 33.50 to 40.50 (p=0.005), and their proximal and distal sub-scores also improved significantly from 23.90 to 28.40 (p=0.007) and from 4.70 to 6.00 (p=0.024) respectively. In a view point of hand function, grip strength and Box and block score were significantly enhanced from 11.70 kg to 13.88 kg (p=0.018), from 16.50 to 20.05 (p=0.027) respectively. Moreover, MMSE was improved from 26.80 to 28.40 (p=0.010) after Joystim® training. But there was no improvement in spasticity and 9-hole pegboard test.
Conclusion: On the basis of the results, the function of the affected upper extremity, hand functions and cognition could be improved after 6-week Joystim® training in the chronic stroke patients. We suggest that the newly developed Joystim® can be a useful therapeutic tool for stroke patients. To prove the effect of this system, large scale randomized controlled study should be done. (This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI15C1529))
|
