Agnė Grigonytė, Aušra Adomavičienė, Vidmantas Alekna
Abstract
Cerebral infarction (stroke) is an acute focal cerebral blood flow disruption that disturbs persons biopsychosocial functions. In order to improve the stroke patient’s activities and participation in everyday life a virtual reality device – “Microsoft Xbox Kinect 360” is used by training to help repair the impaired functions. The objective of the study was to assess the impact of the virtual reality method effectiveness on patients after cerebral infarction independence in everyday life. The study was carried out in the neurological department of PI Abromiskes Hospital from June of 2015 to January of 2016. The study included patients who experienced cerebral ischemic infarction (not later than 6 months ago). 58 patients, of whom 32 (55.2 percent.) were men and 26 (44.8 percent.) were women, 60-74 years old, had a variety of biopsychosocial dysfunctions, that restricted their full independence in life. Patients were randomly divided into two groups: a control group (K), which has been subjected to the traditional occupational therapy program (5 times per week, 30 min. sessions) and basic rehabilitation treatment and research group (T) that had to the basic rehabilitation procedures had been subjected to the traditional occupational therapy program (2 times per week, 30 min. sessions) and the virtual therapy (3 times per week, 30 min. sessions) using the Xbox 360 gaming device Kinect appendix. Biopsychosocial functions were evaluated for the first time in the rehabilitation programs at the beginning, and again at the end of the rehabilitation program (after 15 sessions). International Classification of Functioning, Disability and Health (ICF) questionnaire was applied to assess biopsychosocial functions in the study. At the beginning of the treatment the subjects ability to perform self-care was not statistically significant (p>0.05), but the end of rehabilitation, statistically significantly better results have been identified in the research activities group (p<0.05) respectively. At the beginning of rehabilitation, while bathing (d5101) 13.79% of the subjects experienced insignificant difficulties, 27,59% – moderate 39.66% – severe problems and 18,97% – full inability. However, after the therapy 34,48% of subjects experienced slight difficulty, 44,83% – average, 18,97% severe difficulty in this activity. A comparison of the results between the treatment and control groups set very significant result differences (p=0.001). Similar trends have been identified in such actions as “toweling and drying yourself” step (d5102), a statistically significant improvement was established in both the treatment and the control group (p<0.05). In both groups at the end of the rehabilitation a small to moderate difficulty dominated during this activity. Significantly better results between the groups reflect (p <0.05) when the experimental group representatives eat and drink, put their shoes on, dress and undressing themselves, using the toilet, family relationships, leisure activities (p<0,05). Although, not all of the ICF data results in patients after stroke between the treatment and control groups are statistically significant, better results of the monitored patient groups are seen when using national virtual therapy instead of traditional occupational therapy, therefore we can conclude that virtual reality contributes to the education of autonomy in everyday life.
Keyword(s): virtual reality; ICF (The International Classification of Functioning; Disability and Health); stroke; independence.
DOI: 10.5200/sm-hs.2016.040
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