| Abstract [eng] |
The Effect of Virtual Reality Method on Biopsychosocial Functions in Stroke Patients Author of thesis: Vilnius University, Faculty of Medicine, Department of Rehabilitation, Physical and Sports Medicine Rehabilitation master's program second year student Agnė Grigonytė. Academic advisor: prof. Dr. Vidmantas Alekna, Vilnius University, Faculty of Medicine, Department of Rehabilitation, Physical and Sports Medicine The aim of the research work is to assess the effect of VRM in developing the biopsychosocial functions in stroke patients. Tasks of work: 1. Examine the independence in everyday life, functional hand movements and cognitive functions in patients that have a stroke prior to the research. 2. Assess the independence, upper extremity functional movements and cognitive development after the application of VRM or traditional OT techniques in rehabilitation. 3. Compare the changes in independence, upper extremity functional movements and changes in cognitive function using VRM or only after the traditional OT. Materials and Methods: The research was carried out at PE Abromiškių rehabilitative hospital throughout the months of June - January, 2015. The study involved 58 individuals that had experienced a stroke, aged from 60 to 74, experiencing various disorders. These individuals were randomly divided into two groups. The examination was performed two times - at the time of the arrival and departure of the patient. To assess daily living activities we used ICF; functional hand movements - FMS, dynamometry; cognitive assessment - ACE - RLT, The Volitional Questionnaire, HAD. The experimental group patients were subject to traditional OT program (2 times per week, 30 min. each) and VRM (3 times per week, 30 min. each). The control group were subject only to traditional OT program (5 times per week, 30min. each). Results: 58 subjects, of which 32 (55.2 %) were men and 26 (44.8 %) were women, average age 68,19±4,35 years old. The week average of all subjects after the stroke was 10,26±5,45. In assessing the homogeneity of the groups, the estimates between the groups were not statistically significant (p>0,05). The analysis of the results before and after the research showed a key function improvement in all evaluation categories (p<0.05). Those who used Xbox 306 Kinect, had less difficulty bathing, wiping themselves, using the toilet, family relationships, leisure activities (p <0.05). FMS showed a statistically more significant change (p<0.05): active bending movements 1.65±3.71 points, active bending movements and construction with and without synergies - 1.06±1.85 points, wrist stability - 0.31±0.71 points, wrist flexion - 0.37±0.67 points, 0.93±1.60 points greater co-ordination and speed estimate, the change in hand function had changed in many of the research data; Dynamometry results essentially remained unchanged (p>0.05) as well as the ACE - RLT. Evaluation of patients' motivation and the will showed a significant change in displaying curiosity (p=0.019) and the efforts to complete an action (p=0.028). HAD scale estimates showed that the average anxiety level between the groups at the time of departure did not change significantly (p=0.112). Conclusions: Subjects independence in daily activities, functional hand movements after stroke had average dysfunctions, slight cognitive impairment. Function estimates prior to the research, between the test and control groups of participants, were not statistically significant (p>0.05). The application of VRM or only traditional methods of OT significantly improves independence, upper extremity functional movements and cognitive levels (p<0.05). The changes are reliably more significant (p<0.05) in functional hand movements, self-care, leisure when the VRM is applied. Dynamometry indicators, wrist rotation, the grip I and III of the finger, cognitive function level did not change significantly, with the exception of the level of depression (p<0,05). |
