131 Impact of Virtual Reality Training in Patients After HIP Arthroplasty on Pressure Distribution in Standing and Walking

Abstract Introduction Patients after hip arthroplasty (THR) load the feet asymmetrically during standing or walking. Many reports indicate effectiveness of the Virtual Reality (VR) training in reeducation of postural stability, gait parameters and symmetry. The aim of this study was to assess if VR training programme based on non-walking exercises improve gait parameters or change foot pressure distribution. Materials and methods 56 patients after THR were randomly assigned to an experimental group (30 people) and a control group (26 people). The control group (CG) attended a standard post-operative rehabilitation programme, while 12 sessions of VR training were added to the standard programme in the experimental group (EG). Each patient performed standing with eyes opened and gait test on Zebris FDM-T treadmill. We calculated spatio-temporal parameters, foot pressure distribution and CoP displacement. The results were considered significant for p <0.05. Results In the static tests, the force on the forefoot and the rearfoot of the operated limb increased in EG (p<0.05). The force on the non-operated-side foot decreased and the force of the foot on the operated side increased in CG (p <0.05). No differences were found in the CoP movement in both groups. Most of the gait parameters improved significantly in both groups (p<0.05). However, EG obtained superior results in comparison to CG (p <0.05) after rehabilitation with regard to step time in the operated limb, stride time, cadence and maximum force in the midfoot area in the operated limb. Conclusions 1. The significantly better gait performance parameters obtained in the experimental group indicate a better movement capacity in these patients. This suggests that using VR in motor re-education in patients after THR may enhance the effects of rehabilitation. 2. Further studies are necessary to assess the influence of VR training on pressure distribution both in static and dynamic tests.

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130 Impact of Balance Training in Virtual Reality on Body Balance in Patients after Total HIP Replacement

Age and Ageing ◽

10.1093/ageing/afz164.130 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv28-iv33

Author(s):

Anna Hadamus ◽

Dariusz Białoszewski ◽

Aleksandra Justyna Kowalska ◽

Edyta Urbaniak ◽

Rafał Boratyński ◽

...

Keyword(s):

Virtual Reality ◽

Total Hip Replacement ◽

Hip Replacement ◽

Control Group ◽

Forward Movement ◽

Body Balance ◽

Total Hip ◽

Vr Training ◽

The Impact ◽

Experimental Group

Abstract Introduction Virtual Reality (VR) training is becoming an increasingly popular form of exercise aiding in re-education of body balance. Many reports have demonstrated its effectiveness, greater patient involvement in exercise and better outcomes compared to traditional rehabilitation [1]. The aim of this study was to assess the impact of the additional training in VR on body balance in patients after total hip replacement. Material and Methods 56 patients randomly assigned to an experimental group (30 people) and a control group (26 people) was included in the study. All patients had undergone THR within 2 to 12 weeks before the beginning of the study. The control group underwent standard post-operative rehabilitation, while a VR training programme was used in the experimental group as an additional rehabilitation tool. Balance was assessed with the VBC system and the AMTi AccuSway plate. The results were considered significant for p <0.05. Results CoP displacement in the frontal plane was reduced in both groups in tests with eyes closed (p<0.05). Other parameters in standing tests remain the same. The maximum forward deflection test has shown a significant increase in the range of forward movement in the experimental group (p <0.05). In the control group, the duration of the forward movement phase was reduced, but the range remained the same. The rhythmic sway test showed an increase in the average speed of movements in the experimental group (p <0.05). There were no changes in the control group. Conclusions 1. Postural stability training in VR primarily involves dynamic aspects of the maintenance of balance. 2. Improvement in functional tests may indicate a better clinical outcome of rehabilitation in patients who have additionally trained in VR. 3. The improvement obtained in static tests most probably results from improvement in muscle strength and static stability resulting from the rehabilitation.

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EFFECTS OF FULL IMMERSION VIRTUAL REALITY TRAINING ON BALANCE AND KNEE FUNCTION IN TOTAL KNEE REPLACEMENT PATIENTS: A RANDOMIZED CONTROLLED STUDY

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519420400072 ◽

2020 ◽

Vol 20 (09) ◽

pp. 2040007

Author(s):

SAMWON YOON ◽

HOHEE SON

Keyword(s):

Virtual Reality ◽

Total Knee Replacement ◽

Knee Replacement ◽

Knee Function ◽

Continuous Passive Motion ◽

Control Group ◽

Vr Training ◽

Total Knee ◽

Full Immersion ◽

Experimental Group

Background: Recently, new methods have emerged that encourage voluntary participation by allowing patients to perform tasks, including exercises or treatments, in a virtual reality (VR) environment. Aim: This study aimed to examine the effects of full immersion virtual reality training on balance and knee function in patients who had undergone total knee replacement. Design: Single blind randomized controlled trial. Setting: Department of Physical Therapy in a rehabilitation center. Population: A total of 30 elderly patients ([Formula: see text]65 years old) who had undergone total knee replacement. Methods: Participants were randomly allocated to an experimental group ([Formula: see text]) and a control group ([Formula: see text]). The experimental group received with a continuous passive motion machine, exercise therapy, and a full immersion VR training program; the control group received only with a continuous passive motion machine and exercise therapy. Biorescue was used to test static and dynamic balance ability, and the Timed Up and Go and Western Ontario and McMaster Universities tests were used to assess knee function. Paired [Formula: see text]-tests were used to examine differences by time in each group, and independent [Formula: see text]-tests were used to examine differences between the groups. Results: In terms of within-group differences by time, both the experimental group and the control group showed significant changes in the anterior, and posterior limits of stability in both sides; static balance; and knee function. In the between-groups comparison, among static balance tests, there was a significant difference in center of mass path length in the standing position with eyes open ([Formula: see text]); among dynamic balance tests, there were significant differences in left, right, anterior, and posterior limits of stability ([Formula: see text]). Conclusions: VR training produced better early balance ability and knee function than what was seen in the control group. We believe that VR training in initial post-operative rehabilitation of total knee replacement patients may increase the rate of recovery. Clinical Rehabilitation Impact: VR exercise programs are effective in early rehabilitation after total knee replacement, and have clinical value as inexpensive methods that can promote active participation.

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Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052654 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2654

Author(s):

Roxana Steliana Miclaus ◽

Nadinne Roman ◽

Ramona Henter ◽

Silviu Caloian

Keyword(s):

Virtual Reality ◽

Muscle Strength ◽

Lower Extremity ◽

Range Of Motion ◽

Control Group ◽

Mirror Therapy ◽

Cohen’S D ◽

Cohen's D ◽

Experimental Group ◽

Post Therapy

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

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Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-021-00030-2 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Shamekh Mohamed El-Shamy ◽

Ehab Mohamed Abd El Kafy

Keyword(s):

Cerebral Palsy ◽

Physical Therapy ◽

Muscle Tone ◽

Controlled Trial ◽

Gait Pattern ◽

Controlled Study ◽

Control Group ◽

Randomized Controlled ◽

Gait Parameters ◽

Experimental Group

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

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Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320981942 ◽

2021 ◽

Vol 35 (2) ◽

pp. 131-144

Author(s):

Maijke van Bloemendaal ◽

Sicco A. Bus ◽

Frans Nollet ◽

Alexander C. H. Geurts ◽

Anita Beelen

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Step Length ◽

Gait Training ◽

Control Group ◽

Significant Group ◽

Gait Symmetry ◽

Gait Parameters ◽

Walking Capacity ◽

Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

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MODIFICATION IN FOOT PRESSURE AND GAIT PATTERN AFTER ARTHROSCOPIC CARTILAGE REGENERATION FACILITATING PROCEDURES (ACRFP) IN PATIENTS WITH OSTEOARTHRITIS OF KNEE

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519419400268 ◽

2019 ◽

Vol 19 (02) ◽

pp. 1940026

Author(s):

TSUNG-CHIAO WU ◽

CHUAN-HSIN YEN ◽

SHAW-RUEY LYU ◽

SHUO-SUEI HUNG

Keyword(s):

Knee Injury ◽

Cartilage Regeneration ◽

Gait Pattern ◽

Knee Joints ◽

Knee Adduction Moment ◽

Control Group ◽

Lateral Side ◽

Foot Pressure ◽

Chronic Knee Pain ◽

Gait Parameters

Arthroscopic cartilage regeneration facilitating procedure (ACRFP) has been reported with satisfactory results, yet there is limited research on the biomechanics in these patients. The purpose of this study is to assess the change on the biomechanics after ACRFP, in terms of foot pressure and gait pattern. Patients with chronic knee pain due to osteoarthritis and received ACRFP were recruited, and the knee joints in each patient were divided into either study or control group according to radiographical or symptomatic severity. Assessments were done with Knee injury and Osteoarthritis Outcome Score (KOOS) and dynamic foot pressure at the time before surgery, three months and six months postoperatively. A total of 24 patients completed the study. Significant improvement was found of KOOS, at both three and six months postoperatively. No much change in the gait parameters was noted, but there was a significant decrease of foot pressure over lateral side of hindfoot at six months postoperatively. In conclusion, significant clinical improvements could be achieved with surgical results of ACRFP, and shifting of the foot pressure medially may be related to decrease in the knee adduction moment, which is more favorable for the knee joints.

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Development and Effects of a Nursing Education Program Using Virtual Reality for Enhancing Clinical Decision-Making Ability in Respiratory Disease Nursing Care

Journal of Korean Academy of Fundamentals of Nursing ◽

10.7739/jkafn.2021.28.4.458 ◽

2021 ◽

Vol 28 (4) ◽

pp. 458-469

Author(s):

Eun Ju Lee ◽

Min Jung Ryu

Keyword(s):

Decision Making ◽

Virtual Reality ◽

Nursing Education ◽

Respiratory Disease ◽

Nursing Care ◽

Clinical Decision Making ◽

Clinical Decision ◽

Control Group ◽

Simulation Education ◽

Experimental Group

Purpose: This study was conducted to develop and examine the effects of a nursing education program using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care by assessing students’ confidence in performance, clinical decision-making ability, practice flow, class evaluations, and simulation design evaluations.Methods: This study was developed based on the Jeffries simulation model and 5E learning cycle model, blending a virtual reality simulation and high-fidelity simulation. The participants were 41 third-year nursing students with no virtual reality and simulation education experience. The experimental group (n=21) received the virtual reality program, while the control group (n=20) received traditional simulation education. Data were collected from March 8 to May 28, 2021 and analyzed using SPSS version 27 for Windows.Results: Statistically significant differences were found between the experimental group and the control group post-intervention in confidence in performance (F=4.88, p=.33) and clinical decision-making ability (F=18.68, p＜.001). The experimental group showed significant increases in practice flow (t=2.34, p=.024) and class evaluations (t=2.99, p=.005) compared to the control group.Conclusion: Nursing education programs using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care can be an effective educational strategy in the clinical context.

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Effect of Brain-based Learning in Developing Spatial Ability of Ninth Grade Students with Low Achievement in Mathematics

Journal of Educational and Social Research ◽

10.36941/jesr-2021-0112 ◽

2021 ◽

Vol 11 (5) ◽

pp. 141

Author(s):

Ahmad Al-Tarawneh ◽

Awad Faek Altarawneh ◽

Wejdan Kh. Abd Al-Aziz Karaki

Keyword(s):

Spatial Ability ◽

Spatial Perception ◽

Training Programme ◽

Ninth Grade ◽

Control Group ◽

School Students ◽

Study Approach ◽

Brain Based Learning ◽

The Impact ◽

Experimental Group

This study aimed to investigate the impact of a brain-based learning training programme on improving the spatial abilities of a sample of ninth grade elementary school students in Karak Province, Jordan. The study approach is quasi-experimental, the research sample consisted of 60 students selected by the intentional method. After being divided into two groups, 30 students were in the control group and 30 students were in the experimental group. To achieve the objectives of the study, a training programme based on brain-based learning was developed. Seven tests which consisted of spatial perception, spatial visualisation, and spatial orientation were used to measure spatial capacity and its components. The results showed that the training programme improved spatial ability and its three components in the experimental group compared to the control group. Received: 29 March 2021 / Accepted: 5 July 2021 / Published: 5 September 2021

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The Effects of a Running Consistency Programme on Footfall Variability and Performance in the Long Jump

Polish Journal of Sport and Tourism ◽

10.1515/pjst-2016-0019 ◽

2016 ◽

Vol 23 (3) ◽

pp. 145-152

Author(s):

Marcin Starzak ◽

Hubert Makaruk ◽

Anna Starzak

Keyword(s):

Training Programme ◽

Control Group ◽

Education Students ◽

Acceleration Phase ◽

Physical Education Students ◽

Step Velocity ◽

Post Test ◽

Long Jump ◽

And Performance ◽

Experimental Group

Abstract Introduction. The main purpose of this study was to evaluate the effect of a training programme aimed to enhance toe-toboard consistency on footfall variability and performance in the long jump. Material and methods. The study involved 36 male physical education students. The experimental group participated in a 12-week training programme, whereas the control group was limited to taking part in the classes held at university. All participants performed 6 long jump trials during two testing sessions. The kinematic parameters were assessed using the Optojump Next device and were further analysed to determine the variability of footfall placement during the approach run. Results. The analysis revealed a significant (p < 0.01) decrease in footfall variability in the experimental group between the pre-test and post-test. After the completion of the training programme, the participants significantly (p < 0.05) improved their take-off accuracy. Additionally, they significantly (p < 0.05) increased their velocity in the last five steps before take-off and the effective distance of the jump (p < 0.001). Conclusions. The results of this study indicate that through specific training, it is possible to improve the consistency of the steps in the acceleration phase of the approach run in the long jump. Moreover, decreasing footfall variability helps achieve a more stable step pattern which may be beneficial for greater accuracy at the take-off board and makes it possible to increase step velocity at the final stage of the approach run.

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Dynamic Gait Parameters in Patients with Nonunion of the Tibia Following Treatment with the Ilizarov Method

Journal of Biomechanical Engineering ◽

10.1115/1.4051432 ◽

2021 ◽

Author(s):

Andzelika Pajchert Kozlowska ◽

Lukasz Pawik ◽

Lukasz Szelerski ◽

Slawomir Zarek ◽

Radoslaw Górski ◽

...

Keyword(s):

Maximum Force ◽

Control Group ◽

Ilizarov Method ◽

Dynamic Parameters ◽

Symmetrical Distribution ◽

Gait Parameters ◽

Tibial Nonunion ◽

Parameter Values ◽

Dynamic Gait ◽

Experimental Group

Abstract INTRODUCTION: The purpose of this study was a comprehensive assessment of the dynamic parameters of gait in patients who underwent Ilizarov treatment for nonunion of the tibia. MATERIALS AND METHODS: The experimental group consisted of24 individuals treated with the Ilizarov method for nonunion of the tibia.The control group comprised31healthy individuals,matched for BMI,sex,and age.The dynamic gait parameters in patients and in the control group were measured with a Zebris pedobarographic platform. RESULTS: The treatment group and the control group showed statistically significant differences in terms of the following gait parameters:Maximum force 1NOL(non-operated-limb),Time maximum force1OL(operated-limb),Time maximum force 1 NOL,Maximum force 2NOL,Time maximum force 2OL,and Maximum force forefoot OL.Most of the evaluated gait parameters were bilaterally similar in patients group.The only significant differences between the operated and non-operated limb were seen in terms of Time maximum force 2and Maximum force forefoot. CONCLUSIONS: The most pronounced abnormalities in dynamic gait parameters were observed in the forefoot.The patients treated with the Ilizarov method did not achieve a complete normalization of dynamic gait parameters,as their gait parameters did not equal those measured in the control group.The Ilizarov method for the treatment of tibial nonunion helps restore a symmetrical distribution of gait parameter values between the affected limb and the healthy limb.Patients with tibial nonunion treated with the Ilizarov method continue to show some abnormalities in their dynamic gait parameters after treatment.

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