Pengembangan Terapi Cermin Pada Latihan Bersepeda Berbasis Virtual Reality Untuk Meningkatkan Gerak Motorik Ekstremitas Atas Pasca Stroke

Penulis

I Putu Dody Lesmana, Beni Widiawan, Didit Rahmat Hartadi, Muhammad Fuad Al Haris

Abstrak

Latihan bersepeda berbasis virtual reality (VR-Bicycling) bagi penderita pasca stroke merupakan teknologi yang dikembangkan untuk meningkatkan gerak motorik otot. Penerapan VR-Bicycling umumnya untuk melatih gerak motorik ekstremitas bawah daripada gerak motorik ekstremitas atas. Penggunaan terapi cermin (Mirror Therapy-MT) merupakan bentuk terapi gerak motorik ekstremitas atas dengan mempengaruhi propriosepsi otak yang berfikir bahwa eksterimitas atas yang mengalami hemiparesis dapat bergerak baik. Dalam penelitian ini dikembangan modul VR-Bicycling untuk melatih gerak motorik ekstremitas atas berbasis MT dengan mengkombinasikan umpan balik visual dan audio pada lingkungan virtual (Virtual Environment-VE). Umpan balik visual untuk mengetahui waktu tunda dan perbedaan spasial berupa ketepatan lengan virtual dalam menangkap apel atau menghindari bom sepanjang lintasan bersepeda. Sedangkan umpan balik audio menggunakan metronome untuk melatih operabilitas dan kontrol lengan virtual. Kinect digunakan sebagai motion capture gerakan lengan nyata. Pengujian melibatkan sepuluh penderita pasca stroke untuk melatih gerak motorik ekstremitas atas yang mengalami hemiparesis dalam mengontrol gerakan lengan virtual pada VR-Bicycling. Evaluasi sistem dilakukan dengan meminta penderita pasca stroke menjawab daftar pertanyaan yang mengandung faktor operabilitas, konsentrasi, kontrol gerakan, waktu tunda, dan perbedaan spasial dari terapi ekstremitas atas pada VR-Bicycling menggunakan konsep terapi cermin. Dari hasil evaluasi diketahui bahwa waktu tunda dan perbedaan spasial pada terapi ekstremitas atas menggunakan VR-Bicycling dengan MT merupakan dua variabel penting untuk mengontrol arah dan ketepatan gerakan lengan virtual pada VE.

 

Abstract

A virtual reality bicycling (VR-Bicycling) was encouraged to address motor control and fitness deficits of person post-stroke. The applied of VR-Bicycling for therapy of person post-stroke has focused primarily on improving movement and use of the lower extremity than upper extremity. Mirror therapy (MT) is an instrument that enables a person with an amputation to view a reflection of an intact limb in the visual plane of the missing limb by tricking the brain into believing the missing limb is actually moving. The use of virtual reality (VR) over MT is that VR allows more complete immersion into the illusion, whereas MT requires tight focus and concentration to truly see the illusion as real. In this research, we had developed a VR-Bicycling module based MT for training upper extremity of person post-stroke while doing simulated bicycling. Person post-stroke cycled with guidance of visual cueing (represented as apples and bombs) and auditory condition (provided by metronome) in the virtual environment (VE). We tested ten person post-stroke as they cycled on a stationary bicycle while moving their virtual limb to hit apples or avoid bombs in VE. A VR-Bicycling module measures the motion data of upper extremity by Kinect and evaluate immersion and motor cognition by using factor analysis with three factors consisting of controllability, concentration, sense of delay, and spatial difference. The evaluation result indicates that temporal delay and spatial fluctuation have strong relationship to control virtual limb movement correctly.

Kata Kunci


VR-Bicycling; Kinect; Operabilitas; Kontrol; Waktu tunda; Perbedaan spasial

Teks Lengkap:

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Referensi


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DOI: http://dx.doi.org/10.25126/jtiik.201854914