뇌졸중 환자의 닌텐도 Wii 가상현실 프로그램 훈련이 우울과 삶의 질에 미치는 영향 = The Effect of Nintendo Wii Virtual Reality Program on Depression and Quality of Life in Stroke Patient

국문 초록 (Abstract)

본 연구의 목적은 뇌졸중 환자에게 닌텐도 Wii 가상현실 프로그램 훈련을 적용하여 우울과 삶의 질에 미치는 영향을 알아보는데 있다. 이에 따라 뇌졸중 환자를 대상으로 닌텐도 Wii 가상현실 프로그램 훈련을 적용하였다. 본 연구의 참여자는 선별 기준에 부합하는 26명을 닌텐도 Wii 가상현실 프로그램 훈련을 시행한 실험군 13명과 반복적 작업치료를 시행한 대조군 13명으로 무작위 배정을 하였으 며, 중재는 주 5회 1일 30분씩 4주로 시행하였다. 중재 전⋅후의 우울과 삶의 질을 비교하기 위해 벡의 우울검사와 뇌졸중 영향 척도3.0으로 평가 분석하였다. 중재 후 실험군에서 우울의 감소와 삶의 질에서 통계학적으로 유의한 차이를 보였다. 또한, 대조군에서는 삶의 질에서 유의한 차이를 보였으나(p< .05) 우울의 감소에서는 유의한 차이가 없었다. 또한, 대조군에 비해 실험군에서 우울 감소에 유의한 차이를 보였으나(p<.05) 삶의 질 향상에서는 유의한 차이가 없었다. 본 연구에서 닌텐도 Wii 가상현실 프로그램 훈련이 뇌졸중 환자의 우울 감소와 삶의 질의 증진에 있어 효과적인 영향을 주어 심리⋅사 회적인 측면에서도 유용하게 적용할 수 있을 것이라 생각되어진다.

다국어 초록 (Multilingual Abstract)

The purpose of this study is to examine the effects of virtual reality program training on stroke patients on depression and quality of life. Thus, virtual reality program training was applied to stroke patients. Participants in this study were randomly assigned to 13 members of the experimental groups that performed Nintendo Wii virtual reality program training and 13 members of the control groups that performed repeatable occupational therapy, and mediation was conducted five times a week, one day and 30 minutes a week. Beck Depression Inventory (BDI) and Stroke Impact Scale3.0 (SIS3.0) were evaluated to compare the quality of life before and after exercise. After exercise, the experimental group showed statistically significant differences in the reduction of depression and quality of life. In addition, the control group showed a significant difference in quality of life, but there was no significant difference in the reduction of depression.
In addition, the experimental group showed a significant difference in the reduction of depression compared to the control group, but there was no significant difference in the quality of life. In this study, it is believed that training in Nintendo Wii virtual reality programs will have an effective effect on the reduction of depression in stroke patients and the enhancement of quality of life, which will be useful in psychological and social aspects.

참고문헌 (Reference)

• 1 유영열, "체감형 게임이 뇌졸중 환자의 시지각 능력과 균형능력에 미치는 영향" 한국장애인재활협회 부설 재활연구소 15 (15): 1-17, 2011
• 2 김성희, "장애노인의 삶의 만족도 영향요인 연구" 한국장애인재활협회 부설 재활연구소 20 (20): 17-43, 2016
• 3 박수진, "시간사용중재가 뇌졸중 환자의 우울 및 재활동기에 미치는 영향" 대한작업치료학회 23 (23): 25-37, 2015
• 4 이민재, "보드게임 프로그램이 뇌졸중 노인의 우울과 삶의 질에 미치는 영향" 특수교육재활과학연구소 54 (54): 235-249, 2015
• 5 김대용, "뇌졸중 환자의 우울증에 영향을 미치는 요인" 고신대학교 의과대학 학술지 24 (24): 69-75, 2009
• 6 김형선, "뇌졸중 환자의 우울, 재활동기, 일상생활동작과 삶의 질 간의 상관관계" 대한작업치료학회 17 (17): 41-53, 2009
• 7 김덕용, "가상현실을 이용한 뇌졸중 재활" 대한의사협회 56 (56): 16-22, 2013
• 8 김은경, "가상현실 기반 게임이 만성기 뇌졸중 환자의 균형과 상지 기능에 미치는 효과" 특수교육재활과학연구소 49 (49): 131-149, 2010
• 9 김주홍, "가상현실 게임을 이용한 훈련이 뇌졸중환자의 기능회복에 미치는 영향" 대한작업치료학회 19 (19): 101-114, 2011
• 10 Mouawad, M. R., "Wii-based movement therapy to promote improved upper extremity function post-stroke: a pilot study" 43 (43): 527-533, 2011
• 11 World Health Organization, "WHO methods and data sources for country-level causes of death 2000-2015" World Health Organization 2016
• 12 Lohse, K. R., "Virtual reality therapy for adults post-stroke: a systematic review and meta-analysis exploring virtual environments and commercial games in therapy" 9 (9): e93318-, 2014
• 13 Meldrum, D., "Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii® Fit Plus" 7 (7): 205-210, 2012
• 14 Yin, C. W., "Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial" 2014
• 15 Weiss, P. L., "Video capture virtual reality as a flexible and effective rehabilitation tool" 1 (1): 12-, 2004
• 16 Higginson, I. J., "Using quality of life measures in the clinical setting" 322 (322): 1297-, 2001
• 17 Paek YoungSoo, "The transition from activity of daily living and quality of life for stroke patients after client centered occupation therapy intervention" Graduate school of DaeGu University 2010
• 18 Kim, Hyung Sun, "The impacts of stroke patients’ depression, motivation for rehabilitation and activities of daily living on quality of life" Graduate school of HanYang University 2009
• 19 Kim, J. H., "The effects of training using virtual reality games on stroke patients' functional recovery" Graduate school of DongShin University 2010
• 20 Park, Su-Hyang, "The effects of occupational therapy using a virtual reality program on cognition, depression, and the quality of life in dementia" Graduate school of Honam University 2016
• 21 Oh, Se-Il, "The effects of improved quality of daily life activities through a occupation-based intervention on the depression of stroke patients" Graduate school of Han Seo University 2015
• 22 Şimşek, T. T., "The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study" 126 (126): 1061-1070, 2016
• 23 Kim K. H., "The effect of stroke patient's activities of daily living and social support on quality of life" Graduate school of DaeGu University 2014
• 24 Jang, Yoon-young, "The effect of general rehabilitation program on depression and quality of life in chronic stroke patients with and without depression" graduate school of dongShin University 2011
• 25 이해정, "The Korean language version of Stroke Impact Scale 3.0: Cross-cultural adaptation and translation" 대한물리의학회 10 (10): 265-273, 2015
• 26 Celinder, D., "Stroke patients' experiences with wii sports® during inpatient rehabilitation" 19 (19): 457-463, 2012
• 27 Duncan, P. W., "Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale1" 84 (84): 950-963, 2003
• 28 Kauhanen, M. L., "Poststroke depression correlates with cognitive impairment and neurological deficits" 30 (30): 1875-1880, 1999
• 29 고미혜, "Post stroke depression and emotional incontinence : focused on TPH2 polymorphisms" 서울대학교 대학원 2013
• 30 Pedretti, L. W., "Occupational therapy practice skills for physical dysfunction" Mosby 2006
• 31 American Occupational Therapy Association, "Occupational therapy practice framework: domain and process" 56 : 609-639, 2002
• 32 American Occupational Therapy Association, "Occupational therapy practice frame work: domain and process 3rd ed" 68 (68): 1-48, 2014
• 33 Fisher, A. G., "Occupational therapy intervention process model" 2009
• 34 Trombly, C. A., "Occupational therapy for physical dysfunction" Lippincott Williams & Wilkins 2008
• 35 Burdea, Grigore, "Keynote address: Virtual rehabilitation-benefits and challenges" 1-11, 2002
• 36 World Health Organization, "International classification of functioning, disability and health: ICF" World Health Organization 2001
• 37 Chemerinski, E., "Improved recovery in activities of daily living associated with remission of poststroke depression" 32 (32): 113-117, 2001
• 38 An Eun Seo, "Factors with effects on quality of life of rehabilitating stroke patients" Graduate school of Kyungpook National University 2016
• 39 Shin, J. H., "Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: a single-blinded, randomized controlled trial" 13 (13): 17-, 2016
• 40 Bin Song, G., "Effect of virtual reality games on stroke patients’ balance, gait, depression, and interpersonal relationships" 27 (27): 2057-2060, 2015
• 41 Beck, A. T., "Depression: Clinical, experimental, and theoretical aspects" University of Pennsylvania Press 1967
• 42 Haghgoo, Hojjat Allah, "Depression, activities of daily living and quality of life in patients with stroke" 328 (328): 87-91, 2013
• 43 Altieri, M., "Depression after minor stroke: prevalence and predictors" 19 (19): 517-521, 2012
• 44 Hong Moo Hahn, "A standardization study of beck depression inventory in korea" 25 (25): 487-502, 1986
• 45 KOSTAT, "2014 cause of death statistics results"