Akut hemiplejili hastalarda yarı sürükleyici sanal gerçeklik uygulamasının mobilite, fonksiyonellik, denge, düşme korkusu üzerine etkisi

Year 2024, Volume: 4 Issue: 1, 51 - 63, 31.01.2024

Nuray Aytan Akca , Seçil Özkurt , Ayhan Köksal

https://doi.org/10.56723/dyad.1309756

Abstract

Akut hemiplejili hastalarda yarı sürükleyici sanal gerçeklik uygulamasının mobilite, fonksiyonellik, denge, düşme korkusu üzerine etkisi amaçlanarak, klinik çalışma gerçekleşti. Çalışmaya Başakşehir Çam ve Sakura Şehir Hastanesi’nde nöroloji servisinde yatan 19 hasta çalışma grubu ve 19 hasta kontrol grubu olmak üzere 38 akut hemiplejili hasta randomize olarak dahil edildi. Çalışma grubuna; sanal gözlükle 5 gün/2 hafta, günde 30 dakika ortalama 7.8 seans sanal gerçeklik uygulandı. Kontrol grubuna uygulama yapılmadı. Hastalar tedavi öncesi ve tedavi sonrasında; motor değerlendirmesi Brunnstrom hemipleji alt ve üst ekstremite motor evrelemesi, fonksiyonellik Fonksiyonel Bağımsızlık Ölçeği (FBÖ), denge Berg Denge Ölçeği (BDÖ), düşme korkusu Uluslararası Düşme Etkinliği Ölçeği (UDEÖ), mobilite Fonksiyonel Ambulasyon Sınıflaması (FAS) ile değerlendirildi. Tedavi sonrası çalışma ve kontrol grubu değerlendirildiğinde FAS, FBÖ, UDEÖ, BDÖ ölçeklerinde anlamlı farklılık bulunurken (p<0.05), Brunnstrom alt ve üst ekstremite motor evrelemesinde anlamlı farklılık (p>0.05) bulunmadı. Tedavi sonunda çalışma grubunun kontrol grubuna tüm değişkenlerde istatistiksel olarak üstünlüğü bulunmadı (p>0.05). Akut hemiplejili hastalarda hem yarı sürükleyici sanal gerçeklik uygulamasının hem kontrol grubunun mobilite, fonksiyonellik, denge ve düşme korkusu üzerine olumlu etkisi olduğu gözlendi. Her iki grupta Brunnstrom alt ve üst ekstremite motor değerlendirmesinde iyileşme gözlenmedi. Tedavi sonunda çalışma grubunun kontrol grubuna üstünlüğü bulunmamıştır.

Keywords

Akut hemipleji, ambulasyon, denge, düşme korkusu, fonksiyonellik, sanal gerçeklik

Supporting Institution

yok

Project Number

yok

Thanks

yok

The effects of semi-immersive virtual reality applications on mobility, functionality, balance, fear of falling in patients with acute hemiplegia

Abstract

It was investigated the effect of semi-immersive virtual reality application on mobility, functionality, balance and fear of falling in patients with acute hemiplegia. 19 patients in the study group and 19 patients as the control group on total 38 patients with acute hemiplegia hospitilized in the neurology services of Başakşehir Çam and Sakura City Hospital were included randomly in the study. Study group; 7.8 sessions of virtual reality video were applied with virtual glasses for 5 days/2 weeks, 30 minutes a day. No application was made to the control group. Motor evaluation of patients before and after treatment Brunnstrom hemiplegia lower and upper extremity motor staging, functional Functional Independence Scale (FIM), balance Berg Balance Scale (BDS), fear of falling International Fall Efficiency Scale (IFES), mobility Functional Ambulation Classification (FAS) evaluated with. When the study and control groups were evaluated after the treatment, there was a significant difference in the FAC, FIM, IFES and BDS (p<0.05), while no significant difference was found in Brunnstrom hemiplegia lower and upper extremity motor staging (p>0.05). At the end of the treatment, the study group was not statistically superior to the control group in all variables (p>0.05). It was observed that both semi-immersive virtual reality application and control group had a positive effect on mobility, functionality, balance, fear of falling in patients with acute hemiplegia. No improvement was observed in Brunnstrom lower and upper extremity motor assessment in either group. At the end of the treatment, the study group was not superior to the control group.

Keywords

Acute hemiplegia, ambulation, balance, fall, functionality, virtual reality

Project Number

yok

References

• [1] Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. “An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association”. Stroke, 44(7), 2064-2089, 2013.
• [2] Kim GY, Han MR, Lee HG. “Effect of dual-task rehabilitative training on cognitive and motor function of stroke patients”. J Phys Ther Sci, 26(1), 1-6, 2014.
• [3] Kamphuis JF, de Kam D, Geurts AC, Weerdesteyn V. “Is weight-bearing asymmetry associated with postural instability after stroke? A systematic review”. Stroke Res Treat, 2013, 692137, 2013.
• [4] Chen P, Hreha K, Kong Y, Barrett A. “Impact of spatial neglect on stroke rehabilitation: Evidence from the setting of an inpatient rehabilitation facility”. Archives of physical medicine and rehabilitation, 96(8), 1458-1466, 2015.
• [5] Beyaert C, Vasa R, Frykberg GE. “Gait post-stroke: pathophysiology and rehabilitation strategies”. Neurophysiol Clin, 45(4-5), 335-55, 2015.
• [6] Stein J, Harvey RL, Macko RF, Winstein CJ, Zorowitz RD. İnme İyileşmesi ve Rehabilitasyonu. Çeviri: Arasıl T, Öztürk EA. Ankara, Türkiye, Pelikan Yayıncılık, 2012.
• [7] Wade DT. “Measurement in neurological rehabilitation”. Curr Opin Neurol Neurosurg, 5(5), 682-686, 1992.
• [8] Taner D. Fonksiyonel Nöroanatomi. 15 baskı. Ankara, Türkiye, ODTÜ Yayıncılık, 2015.
• [9] Nelles G, Jentzen W, Jueptner M, Müller S, Diener H. “Arm training induced brain plasticity in stroke studied with serial positron emission tomography”. Neuroimage, 13(6), 1146-1154, 2001.
• [10] Chen JC, Liang CC, Shaw FZ. “Facilitation of sensory and motor recovery by thermal intervention for the hemiplegic upper limb in acute stroke patients: a single-blind randomized clinical trial”. Stroke, 36(12), 2665-2669, 2005.
• [11] Cirstea M, Levin MF. “Compensatory strategies for reaching in stroke”. Brain, 123(5), 940-953, 2000.
• [12] Chang WH, Kim YH. “Robot-assisted therapy in stroke rehabilitation”. Journal of Stroke, 15(3), 174, 2013.
• [13] Díaz I, Gil JJ, Sánchez E. “Lower-limb robotic rehabilitation: literature review and challenges”. Journal of Robotics, 2011, 759764, 2011.
• [14] Knecht S, Hesse S, Oster P. “Rehabilitation after stroke”. Deutsches Ärzteblatt International, 108(36), 600-606, 2011.
• [15] Langhorne P, Bernhardt J, Kwakkel G. “Stroke rehabilitation”. The Lancet, 377(9778), 1693-1702, 2011.
• [16] Levin HS, Grafman J. Cerebral Reorganization of Function After Brain Damage. New York, USA, Oxford University Press, 2000.
• [17] Bayona NA, Bitensky J, Salter K, Teasell R. “The role of task-specific training in rehabilitation therapies”. Topics in stroke rehabilitation, 12(3), 58-65, 2005.
• [18] Coleman ER, Moudgal R, Lang K, Hyacinth HI, Awosika OO, Kissela BM, et al. “Early rehabilitation after stroke: a narrative review”. Curr Atheroscler Rep, 19(12), 59, 2017.
• [19] Macclellan LR, Bradham DD, Whitall J, Volpe B, Wilson PD, Ohlhoff J, et al. “Robotic upperlimb neurorehabilitation in chronic stroke patients”. J Rehabil Res Dev, 42(6), 717-722, 2005.
• [20] Teasell RW, Kalra L. “What’s new in stroke rehabilitation: Back to basics”. Stroke, 36(2), 215-217, 2005.
• [21] Eriksson J, Mataric MJ, Winstein CJ. “Hands-off assistive robotics for post-stroke arm rehabilitation”. 9th International Conference on Rehabilitation Robotics, Chicago, USA, 28 June–1 July 2005.
• [22] Fasoli SE, Krebs HI, Stein J, Frontera WR., Hughes R, Hogan N. “Robotic therapy for chronic motor impairments after stroke: Follow-up results”. Archives of physical medicine and rehabilitation, 85(7), 1106-1111, 2004.
• [23] Frisoli A, Procopio C, Chisari C, Creatini I, Bonfiglio L, Bergamasco M, et al. “Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke”. Journal of neuroengineering and rehabilitation, 9(1), 1-16, 2012.
• [24] Kan P, Huq R, Hoey J, Goetschalckx R, Mihailidis A. “The development of an adaptive upper-limb stroke rehabilitation robotic system”. Journal of neuroengineering and rehabilitation, 8(1), 1-18, 2011.
• [25] Koritnik T, Bajd T, Munih M. Virtual Rehabilitation of Lower Extremities. 11th Mediterranean Conference on Medical and Biomedical Engineering and Computing, Ljubljana, Slovenia, 26–30 June 2007.
• [26] Sawner K, LaVigne JM, Brunnstrom S. Brunnstrom's Movement Therapy in Hemiplegia: A Neurophysiological Approach. 2. baskı. Philadelphia, USA, JB Lippincott Company, 1992.
• [27] Llobera J, Spanlang B, Ruffini G, Slater M. “Proxemics with Multiple Dynamic Characters in an Immersive Virtual Environment”. ACM Transactions on Applied Perception, 8(1), 1-12, 2010.
• [28] Hung Y, Vetivelu A, Hird MA, Yan M, Tam F, Graham SJ, et al. “Using fMRI virtual-reality technology to predict driving ability after brain damage: a preliminary report”. Neurosci Lett, 558, 41-46, 2014.
• [29] Arlı M, Nazik H. Bilimsel araştırmaya giriş. Ankara, Türkiye, Gazi Kitabevi, 2001.
• [30] Lee HC, Huang CL, Ho SH, Sung WH. “The Effect of a Virtual Reality Game Intervention on Balance for Patients with Stroke: A Randomized Controlled Trial”. Games for Health Journal, 6(5), 303-311, 2017.
• [31] Kucukdeveci AA, Kutlay S, Elhan AH, Tennant A. “Preliminary study to evaluate the validity of the mini-mental state examination in a normal population in Turkey”. Int J Rehabil Res, 28(1), 77-79, 2005.
• [32] Elhan AH, Kutlay S, Kucukdeveci AA, Cotuk C, Ozturk G, Tesio L, et al. “Psychometric properties of the Mini-Mental State Examination in patients with acquired brain injury in Turkey”. J Rehabil Med, 37(5), 306-311, 2005.
• [33] Kucukdeveci AA, Yavuzer G, Elhan AH, Sonel B, Tennant A. “Adaptation of the Functional Independence Measure for use in Turkey”. Clin Rehabil, 15(3), 311-319, 2001.
• [34] Young Y, Fan MY, Hebel JR, Boult C. “Concurrent Validity of Administering the Functional Independence Measure (FIM) Instrument by interview”. American journal of physical medicine & rehabilitation, 88(9), 766-770, 2009.
• [35] Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. “Clinical gait assessment in the neurologically impaired: reliability and meaningfulness”. Physical therapy, 64(1), 35-40, 1984.
• [36] Sahin F, Yilmaz F, Ozmaden A, Kotevoglu N, Sahin T, Kuran B. “Reliability and validity of the Turkish version of the Berg Balance Scale”. Journal of Geriatric Physical Therapy, 31(1), 32-37, 2008.
• [37] Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. “Development and initial validation of the Falls Efficacy Scale-International (FES-I)”. Age and ageing, 34(6), 614-619, 2005.
• [38] Rosamond WD, Folsom AR, Chambless LE, Wang CH, McGovern PG, Howard G, et al. “Stroke incidence and survival among middle-aged adults”. Stroke, 30(4), 736-743, 1999.
• [39] Alzahrani MA, Dean CM, Ada L, Dorsch S, Canning CG. “Mood and Balance are Associated with Free-Living Physical Activity of People after Stroke Residing in the community”. Stroke Research and Treatment, 2012, 470648, 2012.
• [40] Chen C, Kreidler T, Ochsenfahrt A. Rehago-A Home-Based Training App Using Virtual Reality to Improve Functional Performance of Stroke Patients with Mirror Therapy and Gamification Concept: A Pilot Study. Editörler: Bürkle T, Denecke K, Holm J, Sariyar M, Lehmann M. Healthcare of the Future 2022: Digital Health–From Vision to Best Practice!, Amsterdam, Netherlands, IOS Press, 2022.
• [41] Luque-Moreno C, Kiper P, Solís-Marcos I, Agostini M, Polli A, Turolla A, et al. “Virtual Reality and Physiotherapy in Post-Stroke Functional Re-Education of the Lower Extremity: A Controlled Clinical Trial on a New Approach”. Journal of Personalized Medicine, 11(11), 1210, 2021.
• [42] Afşar SI, Mirzayev I, Yemisci OU, Saracgil SNC. “Virtual Reality in Upper Extremity Rehabilitation of Stroke Patients: A Randomized Controlled Trial”. Journal of stroke & cerebrovascular diseases, 27(12), 3473-3478, 2018.
• [43] Santos FMK dos, Eichinger FLF, Domenech SC, Noveletto F, Engster MP, Aquino APM de, et al. “A Serious game for balance rehabilitation of hemiparetic stroke patients”. Research, society and development, 11(14), 1-10, 2022.
• [44] Fan T, Wang X, Song X, Zhao G, Zhang Z. “Research Status and Emerging Trends in Virtual Reality Rehabilitation: Bibliometric and Knowledge Graph Study”. JMIR Serious Games, 11, e41091, 2023.
• [45] Campo-Prieto P, Cancela J, Rodríguez-Fuentes G. “Immersive virtual reality as physical therapy in older adults: present or future (systematic review)”. Virtual Reality, 25, 801-817, 2021.
• [46] Porras DC, Siemonsma P, Inzelberg R, Zeilig G, Plotnik M. “Advantages of virtual reality in the rehabilitation of balance and gait Systematic review”. Neurology, 90(22), 1017-1025, 2018.
• [47] Akinladejo FO. Computer-Supported Rehabilitation Management A Case Study of Using Virtual Reality Technology in Ambulatory Training for Post-Acute Stroke Patients. PhD Thesis, Nova Southeastern University, Florida, USA, 2005.