Ann Rehabil Med.  2015 Jun;39(3):462-472. 10.5535/arm.2015.39.3.462.

Utility of a Three-Dimensional Interactive Augmented Reality Program for Balance and Mobility Rehabilitation in the Elderly: A Feasibility Study

• Im DJ
• Ku J
• Kim YJ
• Cho S
• Cho YK
• Lim T
• Lee HS
• Kim HJ
• Kang YJ

• KMID: 2165650
• DOI: http://doi.org/10.5535/arm.2015.39.3.462

Abstract

OBJECTIVE
To improve lower extremity function and balance in elderly persons, we developed a novel, three-dimensional interactive augmented reality system (3D ARS). In this feasibility study, we assessed clinical and kinematic improvements, user participation, and the side effects of our system.
METHODS
Eighteen participants (age, 56-76 years) capable of walking independently and standing on one leg were recruited. The participants received 3D ARS training during 10 sessions (30-minute duration each) for 4 weeks. Berg Balance Scale (BBS) and the Timed Up and Go (TUG) scores were obtained before and after the exercises. Outcome performance variables, including response time and success rate, and kinematic variables, such as hip and knee joint angle, were evaluated after each session.
RESULTS
Participants exhibited significant clinical improvements in lower extremity balance and mobility following the intervention, as shown by improved BBS and TUG scores (p<0.001). Consistent kinematic improvements in the maximum joint angles of the hip and knee were observed across sessions. Outcome performance variables, such as success rate and response time, improved gradually across sessions, for each exercise. The level of participant interest also increased across sessions (p<0.001). All participants completed the program without experiencing any adverse effects.
CONCLUSION
Substantial clinical and kinematic improvements were observed after applying a novel 3D ARS training program, suggesting that this system can enhance lower extremity function and facilitate assessments of lower extremity kinematic capacity.

Keyword

Balance; Aged; Exercise; Virtual reality; Augmented reality

MeSH Terms

Aged*
Education
Exercise
Feasibility Studies*
Hip
Humans
Joints
Knee
Knee Joint
Leg
Lower Extremity
Reaction Time
Rehabilitation*
Walking

Figure

• 

  Fig. 1 Participants engaged with a three-dimensional, interactive, augmented reality rehabilitation system, comprised of the balloon game (A), the cave game (B, C), and the rhythm game (D).

• 

  Fig. 2 The angle of each joint (curved arrow) was calculated based on joint position using the 3D kinetic sensor. (A) External hip rotation angle, (B) internal hip rotation angle (angle of a vector from the knee to the ankle, with a vertical reference vector in the coronal plane), (C) hip extension and flexion angle, and (D) knee flexion angle (angle of a vector from the hip to the knee, with a vertical reference vector in the sagittal plane).

• 

  Fig. 3 Mean success rate (%) and response time (s) to stimuli for each trial in each game improved as sessions progressed: (A) ball game, (B) cave game, and (C) rhythm game. Error bars indicate standard error.

• 

  Fig. 4 Maximum hip external rotation during the balloon game (A) and maximum knee flexion angle during the cave game (B), increased following training. Mean success rate (%) per target in the rhythm game (C) increased as sessions progressed. (D) The Pittsburgh Rehabilitation Participation Scale (PRPS) scores after every session also increased. Error bars indicate standard errors.

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