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      Effects of an Immersive Virtual Reality Environment on Muscle Strength, Proprioception, Balance, and Gait of a Middle-Aged Woman Who Had Total Knee Replacement: A Case Report

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          Abstract

          Patient: Female, 62

          Final Diagnosis: Knee joint osteoarthritis

          Symptoms: Knee pain • range of motion limitation • swelling

          Medication: —

          Clinical Procedure: —

          Specialty: Rehabilitation

          Objective:

          Unusual or unexpected effect of treatment

          Background:

          The purpose of this case study was to apply a training program using virtual reality to a middle-aged woman who had total knee replacement surgery and to investigate its effects on her muscle strength, proprioception, balance, and gait ability.

          Case Report:

          The subject who participated in this study was a 62-year-old woman, who had been diagnosed with moderate osteoarthritis and had a total knee replacement. Post-operative treatment consisted of virtual reality training along with range of motion exercise of the knee joint, light quadriceps isometric exercise, and conventional physical therapy. This also included thermal and electric therapy for pain control conducted on 10 occasions (5 times a week for 2 weeks). Total treatment time, which included 30 min of conventional physical therapy, was 60 min. Measurement of the subject’s lower extremity muscle strength after intervention decreased to 9.43 s, and the error in proprioception decreased to 1.5°. In addition, balance score increased to 56 points, and the time taken to measure gait ability decreased to 9.87 s.

          Conclusions:

          The patient responded positively to rehabilitation using virtual reality, and her muscle strength, proprioception, balance, and gait ability improved. These results suggest that the application of rehabilitative training through virtual reality for total knee replacement patients warrants further study and consideration.

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          Most cited references39

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          The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke.

          The objective of this study was to assess the reliability of the Balance Scale. Subjects were chosen from a larger group of 113 elderly residents and 70 stroke patients participating in a psychometric study. Elderly residents were examined at baseline, and at 3, 6 and 9 months, and the stroke patients were evaluated at 2, 4, 6 and 12 weeks post onset. The Cronbach's alphas at each evaluation were greater than 0.83 and 0.97 for the elderly residents and stroke patients respectively, showing strong internal consistency. To assess inter-rater reliability, therapists treating 35 stroke patients were asked to administer the Balance Scale within 24 hours of the independent evaluator. Similarly, caregivers at the Residence were asked to test the elderly residents within one week of the independent evaluator. To assess intra-rater reliability, 18 residents and 6 stroke patients were assessed one week apart by the same rater. The agreement between raters was excellent (ICC = 0.98) as was the consistency within the same rater at two points in time (ICC = 0.97). The results support the use of the Balance Scale in these groups.
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            • Article: not found

            Simple method for measurement of lower extremity muscle strength

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              • Article: not found

              Future clinical and economic impact of revision total hip and knee arthroplasty.

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                Author and article information

                Journal
                Am J Case Rep
                Am J Case Rep
                amjcaserep
                The American Journal of Case Reports
                International Scientific Literature, Inc.
                1941-5923
                2019
                07 November 2019
                : 20
                : 1636-1642
                Affiliations
                [1 ]Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, South Korea
                [2 ]Department of Physical Therapy, Kyungnam University, Changwon, South Korea
                Author notes

                Authors’ Contribution:

                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Conflict of interest: None declared

                Corresponding Author: GyuChang Lee, e-mail: leegc76@ 123456kyungnam.ac.kr
                Article
                918521
                10.12659/AJCR.918521
                6859930
                31695020
                b43f40cd-6c07-4105-a8b5-617f791c36ac
                © Am J Case Rep, 2019

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 05 July 2019
                : 27 August 2019
                Categories
                Articles

                arthroplasty, replacement, knee,case reports,virtual reality exposure therapy

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