The effect of lower extremity exercise on gait, balance and proprioceptive sensation with or without AR
DOI:
https://doi.org/10.61841/z41tpm90Keywords:
Augmented Reality, Knee angle, Balance, Proprioception Center of pressureAbstract
Background/Objectives: The purpose of this study is to compare the effect of lower extremity muscle strength exercise on gait, balance and proprioception depending on presence and absence of the augmented reality.
Methods/Statistical analysis: After the preliminary investigation, 52 healthy male and female university students agreed to participate in this study and were physically disease free. The subjects were divided into randomized Augmented Reality Exercise group (AREG) and Non-Augmented Reality Exercise group (NAREG). We did not provide the augmented reality to the control group. The subjects have conducted the lower extremity strength exercise three times a week for a total of four weeks. The results were measured before and after 4 weeks. For data analysis, we used matching sample t-test for comparison between groups and the independent-sample t-test for comparison of changes in groups.
Findings: There were no significant differences between the groups in knee angle while walking, but there were no significant differences between the groups in balance and proprioception. Also In the experimental group(AREG), the balance and proprioception were activated, showing a statistically significant difference. In the control group (NAREG), the balance and angle of knee flexion during walking showed a statistically significant difference.
Improvements/Applications: As a result of this study, the group with AR exercise showed more changes in proprioception and sagittal plane of legs than the group without AR when they both exercise for strengthening lower body.
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References
1. Selma P, Floris M, Frans S. Virtual and augmented reality based balance and gait training. Motek: white paper; 2017. p. 2-8.
2. Lee CH, Kim YM, Lee BH. Augmented reality-based postural control training improves gait function in patients with stroke: randomised controlled trial. Hong kong physiotherapy journal. 2014 Dec;32(2):51-57. DOI: 10.1016/j.hkpj.2014.04.002
3. Zhihan L, Alaa H, Shengzhong F, Shafiq R, Haibo L. Touch-less interactive augmented reality game on vision- based wearable device. Personal and ubiquitous computing. 2015 Jan;19(3-4):551-67. DOI: 10.1007/s00779-015-0844- 1
4. Amico AP, Nisi M, Covelli I, Polito AM, Damiani S, Ianieri G, et al. Efficacy of proprioceptive training with prokin system in balance disorders from multiple sclerosis. J mult scler. 2014 Jul;1:110. DOI:10.4172/2376- 0389.1000110.
5. Bennour S, Ulrich B, Legrand T, Jolles BM, Favre J. A gait retraining system using augmented-reality to modify footprint parameters: effects on lower-limb sagittal-plane kinematics. Journal of biomechanics. 2018 Jan;66(3):26-35. DOI: 10.1016/j.jbiomech.2017.10.030.
6. Nafiseh K, Noor AAO, Abdul HM, Mahboobeh M, Wan ABWA. Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. Plos one. 2014 Mar;9(3): e92270. DOI: 10.1371/journal.pone.0092270.
7. Hillier S, Immink M, Thewlis D. Assessing proprioception: A systematic review of possibilities. Neurorehabil neural repair. 2015 Nov;29(10):933-49. DOI: 10.1177/1545968315573055
8. John S. Cognitive-motor rehabilitation through low-cost mobile augmented reality technology. Diss. 2017 Sep. p. 1-38.
9. Cho S, Ku J, Cho YK, Kim IY, Kang YJ, Jang DP. et al. Development of virtual reality proprioceptive rehabilitation system for stroke patients. Computer methods and programs in biomedicine. 2014 Jan;113(1):258-65. DOI: 10.1016/j.cmpb.2013.09.006
10. Van DRB, De Jong LA, Groen BE, Vos-van der Hulst M, Geurts ACH, Keijsers NLW. et al. Gait stability training in a virtual environment improves gait and dynamic balance capacity in incomplete spinal cord injury patients. Front neurol. 2018 Nov;20(9):963. DOI:10.3389/fneur.2018.00963.
11. Brown IE, Stephen HS. System and method for integrating gaze tracking with virtual reality or augmented reality. U.S. Patent and trademark office. 2014 May; Patent No. 8,730,266.
12. Morel M, Bideau B, Lardy J, Kulpa R. Advantages and limitations of virtual reality for balance assessment
and rehabilitation. Neurophysiologie clinique/clinical neurophysilogy. 2015 Nov;45(4-5):315-26. DOI: 10.1016/j.neucli.2015.09.007.
13. Han D, Jung T, Gibson A. Dublin AR: Implementing augmented reality in tourism. information and communication technologies in tourism. Springer. 2014 Jan. p.511-23. DOI: 10.1007/978-3-319-03973-2_37.
14. Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. Journal of exercise rehabilitation. 2017 Apr;13(2):200-5. DOI: 10.12965/jer.1734892.446.
15. Luis M, Rossana C, Leandro P. Selection of entropy-measure parameters for force plate-based human balance evaluation. In world congress on medical physics and biomedical engineering. Springer 2018 May;68(2):315-19. DOI: 10.1007/978-981-10-9038-7_59
16. Haarman JAM, Choi JT, Buurke JH, Rietman JS, Reenalda J. Performance of a visuomotor walking task in an augmented reality training setting. Human movement science. 2017 Dec;56(B):11-19. DOI: 10.1016/j.humov.2017.10.005.
17. Myer GD, Ford KR, McLean SG, Hewett TE. The effects of plyometric versus dynamic stabilization and balance training on lower extremity biomechanics. The american journal of sports medicine. 2016 Mar;34(3):445-55. DOI: 10.1177/0363546505281241
18. Cano Porras D, Sharon H, Inzelberg R, Ziv-Ner Y, Zeilig G, Plotnik M. Advanced virtual reality-based rehabilitation of balance and gait in clinical practice. Therapeutic advances in chronic disease. 2019 Aug;10:1-16. DOI: 10.1177/2040622319868379
19. Ku J, Kim YJ, Cho S, Lim T, Lee HS, Kang YJ. et al. Three-dimensional augmented reality system for balance and mobility rehabilitation in the elderly: a randomized controlled trial. Cyberpsychology, behavior, and social networking. 2019 Feb;22(2):132-41. DOI: 10.1089/cyber.2018.0261.
20. Mouraux D, Brassinne E, Sobczak S, Nonclercq A, Warzée N, Sizer PS. et al. 3D augmented reality mirror visual feedback therapy applied to the treatment of persistent, unilateral upper extremity neuropathic pain: a preliminary study. Journal of manual & manipulative therapy, 2017 Jul;25(3):137-43. DOI: 10.1080/10669817.2016.1176726
21. Eiji F, Nobuo T, Daisuke K, Yoshiji K. Effects of body-weight squat training on muscular size, strength and balance ability in physically frail older adults. Sport and health science. 2016 May;14:21-30. DOI: 10.5432/ijshs.201504
22. Adriano PS, Núbia CA, Rosalina TG, Camila DN, Vanessa AM, Aline SM. et al. Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis. Archives of physical medicine and rehabilitation. 2012 Oct;93(10):1692-1700.
23. Stephanie H, Raz L, Ilana N. The effect of dissociation between proprioception and vision on perception and grip force control in a stiffness judgment task. 2018 IEEE haptics symposium. 2016 May. DOI: 10.1109/HAPTICS.2018.8357166
24. Gabriele W. Attentional focus and motor learning: a review of 15 years. Intentional review of sport and exercise psychology. 2012 Aug;6(1):77-104. DOI: 10.1080/1750984X.2012.723728
25. Oh HT, Hwangbo G. The effects of proprioception exercise with and without visual feedback on the pain and balance in patients after total knee arthroplasty. Journal of physical therapy science. 2018 Jan;30(1):124–6. DOI: 10.1589/jpts.30.124
26. Antonio MA, Fidel HC, Rafael LV, Isabel CM, Alvarez PJ, Emilio ML. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial. Journal of strength and conditioning research. 2013 Aug; 27(8);2180-88. DOI:10.1519/jsc.0b013e31827da35f.
27. Pincivero DM, Bachmeier B, Coelho AJ. The effects of joint angle and reliability on knee proprioception. Journal of physical therapy science, 2001 Oct;33(10):1708-12.
28. Almosnino S, Kingston D, Graham RB. Three-dimensional knee joint moments during performance of the bodyweight squat: effects of stance width and foot rotation. Journal of applied biomechanics. 2013 Feb;29(1):33-43. DOI: 10.1123/jab.29.1.33
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