OBJECTIVE: To compare the clinical efficacy between Jiao's scalp acupuncture combined with virtual reality (VR) rehabilitation training and VR rehabilitation training alone for motor dysfunction in patients with Parkinson's disease (PD). METHODS: A total of 52 patients with PD were randomly divided into an observation group and a control group, 26 cases in each group. The patients in both groups were treated with routine basic treatment, and the patients in the control group were treated with VR rehabilitation training. The patients in the observation group were treated with Jiao's scalp acupuncture on the basis of the control group. The scalp points included the movement area, balance area and dance tremor control area. Both groups were treated once a day, 5 times a week for a total of 8 weeks. Before treatment and 4 and 8 weeks into treatment, the gait parameters (step distance, step width, step speed and step frequency), timed "up and go" test (TUGT) time and unified Parkinson's disease rating scale part Ⅲ (UPDRS-Ⅲ) score were compared between the two groups, and the clinical efficacy was evaluated. RESULTS: Four weeks into treatment, except for the step width in the control group, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01, P<0.05); the step distance in the observation group was better than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05). Eight weeks into treatment, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01); the step distance and step speed in the observation group were better than those in the control group, the TUGT time in the observation group was shorter than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05, P<0.01). The total effective rate was 92.3% (24/26) in the observation group, which was higher than 69.2% (18/26) in the control group (P<0.05). CONCLUSION Jiao's scalp acupuncture combined with VR rehabilitation training could improve the gait parameters, walking ability and motor function in patients with PD. The clinical effect is better than VR rehabilitation training alone.
Acupuncture Therapy/adverse effects* ; Gait ; Humans ; Parkinson Disease/therapy* ; Scalp ; Virtual Reality

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.
Assertiveness ; Community Mental Health Centers ; Humans ; Reality Therapy ; Schizophrenia ; Self Concept ; Social Stigma

OBJECTIVE: To investigate the effects of using motor imagery (MI) in combination with a virtual reality (VR) program on healthy volunteers and stroke patients. In addition, this study investigated whether task variability within the VR-guided MI programs would influence corticomotor excitability. METHODS: The present study included 15 stroke patients and 15 healthy right-handed volunteers who were presented with four different conditions in a random order: rest, MI alone, VR-guided MI, and VR-guided MI with task variability. The corticomotor excitability of each participant was assessed before, during, and after each condition by measuring changes in the various parameters of motor-evoked potentials (MEPs) of the extensor carpi radials (ECR). Changes in intracortical inhibition (ICI) and intracortical facilitation (ICF) were calculated after each condition as percentages of inhibition (%INH) and facilitation (%FAC) at rest. RESULTS: In both groups, the increases in MEP amplitudes were greater during the two VR-guided MI conditions than during MI alone. Additionally, the reductions in ECR %INH in both groups were greater under the condition involving VR-guided MI with task variability than under that involving VR-guided MI with regular interval. CONCLUSION: The corticomotor excitability elicited by MI using a VR avatar representation was greater than that elicited by MI with real body observations. Furthermore, the use of task variability in a VR program may enhance neural regeneration after stroke by reducing ICI. The present findings support the use of various VR programs as well as the concept of combining MI with VR programs for neurorehabilitation.
Healthy Volunteers* ; Humans ; Imagery (Psychotherapy) ; Neurological Rehabilitation ; Regeneration ; Stroke* ; Transcranial Magnetic Stimulation ; Upper Extremity ; Virtual Reality Exposure Therapy ; Volunteers

OBJECTIVE: Authors conducted the pilot trial to evaluate whether the virtual reality using mirror therapy induces analgesia and functional improvement to the patients of rheumatoid wrist arthritis. METHOD: Three patients with no symptom or sign of active phase at both wrists were recruited. Voluntary range of motion (ROM) of each wrist over as far as possible was recorded and then the same movement was recorded only over 60% of the previous one after break of 5 minutes. For the virtual reality treatment, the second recorded motion was reconstructed into the another one of as same ROM and spent time as the first one, providing confusing visual information to the patients while patients were instructed to reach only the red flags (60% ROM of 1st one). This exercise was repeated for 5 days. Numerous scales such as VAS, ROM, Michigan Hand Outcomes Questionaire (MHQ), Performance and Satisfaction in Activities of Daily Living (PS-ADL), patient-rated wrist evaluation (PRWE) were evaluated before and after repetition. RESULTS: The increased satisfaction with their hands (satisfaction score of MHQ; 5.8 ± 2.3, [6-30]), improved ADL performances (PS-ADL score: 5.0 ± 3.5, [0-117]), and no side effect were noticed. CONCLUSION: The virtual reality using mirror therapy may be safe and has some analgesic effect, which warrants a clinical trial in the future for the patients of rheumatoid wrist arthritis.
Activities of Daily Living ; Analgesia ; Arthritis ; Arthritis, Rheumatoid* ; Hand ; Humans ; Michigan ; Range of Motion, Articular ; Virtual Reality Exposure Therapy ; Weights and Measures ; Wrist

OBJECTIVETo study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

METHODSThirty-five children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment.

RESULTSBefore treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P>0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P<0.05).

CONCLUSIONSVR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

Cerebral Palsy ; physiopathology ; therapy ; Child ; Child, Preschool ; Extremities ; physiopathology ; Female ; Humans ; Male ; Movement ; Virtual Reality Exposure Therapy

The effect of combined low-frequency repetitive transcranial magnetic stimulation (LF rTMS) and virtual reality (VR) training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups: experimental and control. In experimental group, the patients received LF rTMS and VR training treatment, and those in control group received sham rTMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment (U-FMA) and wolf motor function test (WMFT), and the secondary endpoint including modified Barthel index (MBI) and 36-item Short Form Health Survey Questionnaire (SF-36) were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study (55 in experimental group and 53 in control group respectively). After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval (CI) 3.6 to 22.7, P<0.01], WMFT scores (mean difference of 2.9, 95% CI 2.7 to 12.3, P<0.01), and MBI scores (mean difference 16.1, 95% CI 3.8 to 9.4, P<0.05) were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF rTMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.
Aged ; Arm ; physiopathology ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stroke ; physiopathology ; therapy ; Transcranial Magnetic Stimulation ; Virtual Reality Exposure Therapy

Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient's disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts.
Aged ; Biomechanical Phenomena ; Female ; Humans ; Occupational Therapy ; Physical Therapy Modalities ; Recovery of Function ; Stroke ; therapy ; Stroke Rehabilitation ; methods ; Treatment Outcome ; Upper Extremity ; physiopathology ; Video Games ; Virtual Reality Exposure Therapy ; methods

OBJECTIVE: To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. METHODS: Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. RESULTS: There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. CONCLUSION: These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients.
Activities of Daily Living ; Hand Strength ; Humans ; Occupational Therapy ; Paresis ; Stroke* ; Upper Extremity* ; Virtual Reality Exposure Therapy

OBJECTIVE: To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. METHODS: Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. RESULTS: The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. CONCLUSION: VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment.
Brain Neoplasms* ; Cognition ; Humans ; Male ; Neuropsychological Tests ; Rehabilitation ; Trail Making Test ; Verbal Learning ; Virtual Reality Exposure Therapy

OBJECTIVE: To investigate the effect of virtual reality (VR) and a tetra-ataxiometric posturography (Tetrax) program on stroke patients with impaired standing balance. METHODS: Thirty acute stroke patients with impaired standing balance were recruited and randomly assigned to a VR, Tetrax, or control group. All patients received conventional balance training as a baseline; and VR and Tetrax patients received VR or Tetrax treatment, in addition. The primary outcome measures to evaluate the overall standing balance were the Berg Balance Scale (BBS) and the falling index (FI). The secondary outcome measures were the stability index (SI) and the weight distribution index (WDI), which were used to evaluate the balance status according to specific body positions. The FI, SI, and WDI were measured using the Tetrax instrument. RESULTS: The BBS and FI scores were improved in all groups, with no significant differences between groups. In open-eyed positions, the VR group showed significantly greater improvement in SI and WDI scores than the control group (p<0.017). In closed-eyed positions, the Tetrax group showed significantly greater improvement in SI and WDI scores than the control group (p<0.017). CONCLUSION: The inclusion of VR and Tetrax programs did not lead to an overall benefit in balance. VR and Tetrax did, however, demonstrate a benefit in specific positions. A Tetrax program may benefit patients with abnormal proprioceptive function, whereas a VR program may benefit patients with normal sensory function.
Humans ; Outcome Assessment (Health Care) ; Postural Balance ; Sensation ; Stroke* ; Virtual Reality Exposure Therapy