The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effects of Virtual Reality-based Continuous Slow Exercise on Factors for Falls in the Elderly

가상현실에서 연속적 느린 운동이 노인의 낙상 요인에 미치는 영향

  • Kim, Jung-Jin (Department of Physical Therapy, College of Health Science, Korea University) ;
  • Gu, Seul (Department of Physical Therapy, College of Health Science, Korea University) ;
  • Lee, Jin-Ju (Department of Physical Therapy, College of Health Science, Korea University) ;
  • Kim, Yu-Shin (Department of Physical Therapy, College of Health Science, Korea University) ;
  • Yoon, Bum-Chul (Department of Physical Therapy, College of Health Science, Korea University)
  • 김정진 (고려대학교 보건과학대학 물리치료학과) ;
  • 구슬 (고려대학교 보건과학대학 물리치료학과) ;
  • 이진주 (고려대학교 보건과학대학 물리치료학과) ;
  • 김유신 (고려대학교 보건과학대학 물리치료학과) ;
  • 윤범철 (고려대학교 보건과학대학 물리치료학과)
  • Received : 2012.03.15
  • Accepted : 2012.04.12
  • Published : 2012.04.25
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Abstract

Purpose: The purpose of this study was to assess the effects of virtual reality-based continuous slow exercise on muscle strength and dynamic balance capacity, in older adults over 65 years of age. Methods: Twenty-six volunteers were randomly divided into two groups; a Virtual Reality (VR) exercise-group ($67.8{\pm}4.1$ yrs) and a Control group ($65.5{\pm}5.2$ yrs). The VR group participated in eight weeks of virtual reality exercise, utilizing modified Tai-Chi provided by a motion capture system, and the Control group had no intervention. The hip muscle strength and dynamic balance of the members of both the VR group and the Control group were measured at pre- and post-intervention, using a multimodal dynamometer, and backward stepping test, respectively. Results: 1. After the 8-week VR-based exercise, the VR group showed significant improvement of hip strength, compared to the control group: hip extension (p=0.00), flexion (p=0.00), abduction (p=0.00), and adduction (p=0.00). 2. After the 8-week VR-based exercise, the VR group showed significant improvement of dynamic balance capacity as ground reaction force, compared to the control group. Eyes opened backward stepping test: Fx (+) (p=0.00), Fy (-) (p=0.02), Ver (+) (p=0.02) direction. Eyes closed backward stepping test: Fx (+) (p=0.04), Fy (-) (p=0.04), Ver (+) (p=0.03) direction. Conclusion: The VR group showed improvement of their hip muscle strength, and dynamic balance capacity. Therefore VR-based continuous slow exercise would contribute to reducing the risk of falls in the elderly.

Keywords

References

  1. Kim HD. Effect of a pnf training program on functional assessment measures and gait parameters in healthy older adults. J Kor Soc Phys Ther. 2010;22(1):39-45.
  2. Lee YW, Choi SJ, Song CH. The effect of a balance training program to improve the balance of aged patients with diabetes mellitus. J Kor Soc Phys Ther. 2010;22(3):23-30.
  3. Moller J. Projected costs of fall related injury to older persons due to demographic change in australia. Canberra, Commonwealth of Australia, 2004.
  4. Oakley A, Dawson MF, Holland J et al. Preventing falls and subsequent injury in older people. Quality and Safety in Health Care. 1996;5(4):243-9. https://doi.org/10.1136/qshc.5.4.243
  5. Son HH, Oh JL, Park RJ. The effect of an exercise program on activities of daily living (ADL), balance and cognition in elderly individuals with Alzheimer's disease and vascular demendia. J Kor Soc Phys Ther. 2010;22(1):43-60. https://doi.org/10.1589/jpts.22.43
  6. Kim JH. Reliability and validity of gait assessment tools for elderly person. J Kor Soc Phys Ther. 2009;21(1):41-8.
  7. Rubenstein LZ, Joesephson KR, Trueblood PR et al. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. Journal of Gerontology. 2000;55(6):M317-21.
  8. Cress ME, Buchner DM, Questad KA et al. Exercise: effects on physical functional performance in independent older adults. J Gerontol. 1999;54(5):M242-8. https://doi.org/10.1093/gerona/54.5.M242
  9. Hong Y, Li JX, Robinson PD. Balance control, flexibility, and cardiorespiratory fitness among older Tai Chi practitioners. Br J Sports Med. 2000;34:29-34. https://doi.org/10.1136/bjsm.34.1.29
  10. Wolf SL, Barnhart HX, Ellision GL et al. The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Phys Ther. 1997;77(4):371-84.
  11. Li JX, Hong Y, Chan KM. Tai chi: physiological characteristics and beneficial effects on health. Br J Sports Med. 2001;35:148-56. https://doi.org/10.1136/bjsm.35.3.148
  12. Tsang WWN, Hui-chan CWY. Effects of Tai Chi on joint proprioception and stability Limits in elderly subjects. Med Sci Sports Exerc. 2003;35(12):1962-71. https://doi.org/10.1249/01.MSS.0000099110.17311.A2
  13. Schuler T, Brutsch K, Muller R et al. Virtual realities as motivational tools for robotic assisted gait training in children: a surface electromyography study. Neuro Rehabilitation. 2011;28(4):401-11.
  14. Steuer J. Defining virtual reality: dimensions determining telepresence. J Commun. 1992;42(4):73-93. https://doi.org/10.1111/j.1460-2466.1992.tb00812.x
  15. Bruin ED, Schoene D, Pichierri G et al. Use of virtual reality technique for the training of motor control in the elderly. Zeitschrift fur Gerontologie und Geriatrie. 2010;43(4):229-34. https://doi.org/10.1007/s00391-010-0124-7
  16. Flynn S, Palma P, Bender A. Feasibility of using the Sony PlayStation 2 gaming platform for an individual poststroke: a case report. J Neurol Phys Ther. 2007;31(4):180. https://doi.org/10.1097/NPT.0b013e31815d00d5
  17. Cunningham D, Krishack M. Virtual reality promotes visual and cognitive function in rehabilitation. Cyberpsychol Behav. 1999;2:19-23. https://doi.org/10.1089/cpb.1999.2.19
  18. Hoffman HG, Patterson DR, Carrougher GJ. Use of virtual reality therapy for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain. 2000;16(3):244-50. https://doi.org/10.1097/00002508-200009000-00010
  19. Kollock RO, Onate JA, Van Lunen B. Assessing muscular strength at the hip joint. Athl Ther Today. 2008;13(2):18-24.
  20. Takeuchi Y, Tanaka Y, Shimomura Y et al. The rffect of aging on the backward stepping reaction as estimated from the velocity of center of foot pressure and muscular strength. J Physiol Anthropol. 2007;26(2):185-9. https://doi.org/10.2114/jpa2.26.185
  21. Kim JD, Kuno S, Soma R et al. Relationship between reduction of hip joint and thigh muscles and walking ability in elderly people. Jpn J Phys Fitness Sports Med. 2000;49:589-96.
  22. Daubney ME, Culham EG. 1. Lower-extremity muscle force and balance performance in adults aged 65 years and older. Phys Ther. 1999;79(12):1177-85.
  23. Lan C, Lai J-S, Chen S-Y et al. 12-month Tai Chi training in the elderly: its effect on health fitness. Med Sci Sports Exerc. 1998;30(3):345-51. https://doi.org/10.1097/00005768-199803000-00003
  24. Xu D, Hong Y, Li J et al. Effect of tai chi exercise on proprioception of ankle and knee joints in old people. Br J Sports Med. 2004;38:50-4. https://doi.org/10.1136/bjsm.2002.003335
  25. Lan C, Lai J-S, Chen S-Y et al. Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil. 2000;81(5):604-7. https://doi.org/10.1016/S0003-9993(00)90042-X
  26. Hsiao ET, Robinovitch SN. Biomechanical influences on balance recovery by stepping. J Biomech. 1999;32:1099-106. https://doi.org/10.1016/S0021-9290(99)00104-9
  27. Mille M-L, Johnson ME, Martinez KM et al. Age-dependent differences in lateral balance recovery through protective stepping. Clin Biomech. 2005;20(6):607-16. https://doi.org/10.1016/j.clinbiomech.2005.03.004
  28. Mathiyakom W, McNitt-Gray JL. Regulation of angular impulse during fall recovery. J Rehabil Res Dev. 2008;45(8):1237-8. https://doi.org/10.1682/JRRD.2008.02.0033
  29. Sveistrup H, McComas J, Thornton M et al. Experimental studies of virtual reality-delivered compared to conventional exercise programs for rehabilitation. Cyberpsychol Behav. 2003;6(3):245-9. https://doi.org/10.1089/109493103322011524
  30. Brien M, Sveistrup H. An Intensive virtual reality program improves functional balance and mobility of adolescents with cerebral palsy. Pediatr Phys Ther. 2011;23(3):258-66. https://doi.org/10.1097/PEP.0b013e318227ca0f
  31. Skinner HB, Barrack RL, Cook SD. Age related decline in proprioception. Clin Orthop Relat Res. 1984;184:208-11.
  32. Perrin PP, Jeandel C, Perrin CA et al. Influence of visual control, conduction, and central integration on static and dynamic balance in healthy older adults. Gerontology. 1997;43(4):223-31. https://doi.org/10.1159/000213854
  33. Yen CY, Lin KH, Hu MH et al. Effects of Virtual Reality-augmented balance training on sensory organization and attentional demand for postural control in people with parkinson disease: a randomized controlled trial. Phys Ther. 2011;91:862-74. https://doi.org/10.2522/ptj.20100050
  34. Bisson E, Contant B, Sveistrup H et al. Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training. Cyberpsychol Behav. 2007;10(1):16-23. https://doi.org/10.1089/cpb.2006.9997
  35. Saposnik G, Teasell R, Mamdani M et al. Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke. 2010;41(7):1477-84. https://doi.org/10.1161/STROKEAHA.110.584979
  36. Mirelman A, Patritti BL, Bonato P et al. Effects of virtual reality training on gait biomechanics of individuals post-stroke. Gait & Posture. 2010;31(4):433-7. https://doi.org/10.1016/j.gaitpost.2010.01.016
  37. Bart O, Agam T, Weiss PL et al. Using video-capture virtual reality for children with acquired brain injury. Disabil Rehabil. 2011;33(17-18):1579-86. https://doi.org/10.3109/09638288.2010.540291