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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

Unusual or unexpected effect of treatment

Soungkyun Hong, GyuChang Lee

South Korea Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, South Korea

Am J Case Rep 2019; 20:1636-1642

DOI: 10.12659/AJCR.918521

Available online:

Published: 2019-11-07


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.

Keywords: Arthroplasty, Replacement, Knee, case reports, Virtual Reality Exposure Therapy



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