Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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The Effects of Underwater Treadmill Walking Training with Aquatic Cuff Weights on Balance and Walking Abilities in Stroke Patients

수중 발목 커프 착용 후 수중 트레드밀 보행 훈련이 뇌졸중 환자의 균형과 보행 능력에 미치는 영향

  • Yoon, Eui-Seob (Dept. of Physical Therapy, Graduate School of Health and Medicine, Daejeon University) ;
  • Choi, Jong-Duk (Dept. of Physical Therapy, College of Health and Medical Science, Daejeon University)
  • 윤의섭 (대전대학교 보건의료대학원 물리치료학과) ;
  • 최종덕 (대전대학교 보건의료과학대학 물리치료학과)
  • Received : 2017.11.13
  • Accepted : 2017.12.30
  • Published : 2018.02.28
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Abstract

PURPOSE: While underwater, patients with hemiplegia experience unwanted limb flotation on their paretic side due to low muscle mass and high body fat. However, only a limited number of studies support the effectiveness of this practice. Therefore, the purpose of this study was to determine how the balance and walking abilities of patients with hemiplegia due to stroke were affected by wearing an aquatic cuff on their ankles during underwater treadmill walking. METHODS: Twenty stroke patients were divided into an experimental group comprised of 20 patients who would wear an aquatic cuff and a control group comprised of 10 patients without an aquatic cuff. Both groups underwent a six-week intervention for 30 minutes a day three times a week. To evaluate the groups' balance and walking abilities before and after the intervention, the 10 m walking test, timed up go test, Berg Balance Scale, functional reaching test, and the GAITRite system were used. RESULTS: The results of the 10 m walking test, timed up go test, differences between the left and right gait cycles, and functional reaching test showed statistically significant differences in the rates of change between the two groups (p<.05). CONCLUSION: The study results suggest that underwater treadmill training in stroke patients can be more effective when they wear an aquatic cuff on their ankles compared to wearing no aquatic cuff.

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References

  1. Aaslund MK, Moe-Nilssen R. Treadmill walking with body weight support effect of treadmill, harness and body weight support systems. Gait Posture. 2008;28(2): 303-8. https://doi.org/10.1016/j.gaitpost.2008.01.011
  2. Ada L, Dean CM, Hall JM, et al. A treadmill and overground walking program improves walking in persons residing in the community after stroke: a placebocontrolled, randomized trial. Arch Phys Med Rehabil. 2003;84(10):1486-91. https://doi.org/10.1016/S0003-9993(03)00349-6
  3. Bang DH, Cho HS. The Effect of Arm Training in Standing Position on Balance and Walking Ability in Patients with Chronic Stroke. J Korean Soc Phys Med. 2017a;12(2):75-82. https://doi.org/10.13066/kspm.2017.12.2.75
  4. Bang DH, Cho HS. The Effect of Postural Control Training on Balance and Walking Ability in Patients with Chronic Stroke. J Korean Soc Phys Med. 2017b; 12(2):59-66. https://doi.org/10.13066/kspm.2017.12.2.59
  5. Barela AM, Duarte M. Biomechanical characteristics of elderly individuals walking on land and in water. J Electromyogr Kinesiol. 2008;18(3):446-54. https://doi.org/10.1016/j.jelekin.2006.10.008
  6. Bates A. Aquatic exercise therapy. WB Saunders Company. 1996.
  7. Bayat R, Barbeau H, Lamontagne A. Speed and temporaldistance adaptations during treadmill and overground walking following stroke. Neurorehabil Neural Repair. 2005;19(2):115-24. https://doi.org/10.1177/1545968305275286
  8. Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-80.
  9. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-17. https://doi.org/10.1053/mr.2000.3839
  10. Franceschini M, Carda S, Agosti M, et al. Walking after stroke: what does treadmill training with body weight support add to overground gait training in patients early after stroke? Stroke. 2009;40(9):3079-85. https://doi.org/10.1161/STROKEAHA.109.555540
  11. Hesse S, Konrad M, Uhlenbrock D. Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects. Arch Phys Med Rehabil. 1999;80(4):421-7. https://doi.org/10.1016/S0003-9993(99)90279-4
  12. Hunt SM, McKenna S, Williams J. Reliability of a population survey tool for measuring perceived health problems: a study of patients with osteoarthrosis. J Epidemiol Community Health. 1981;35(4):297-300. https://doi.org/10.1136/jech.35.4.297
  13. Jeong DG, Lee HK, Lee SY, et al. The Effect of Body Weight Support Treadmill Training on Gait and Balance in Patient with Subacute Stroke. J Korean Soc Phys Med. 2008;3(2):135-44.
  14. Jung T, Lee D, Charalambous C, et al. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke. Arch Phys Med Rehabil. 2010;91(1):129-36. https://doi.org/10.1016/j.apmr.2009.09.012
  15. Kang HK, Kim Y, Chung Y, et al. Effects of treadmill training with optic flow on balance and gait in individuals following stroke: randomized controlled trials. Clin Rehabil. 2012;26(3):246-55. https://doi.org/10.1177/0269215511419383
  16. Kim CS, Bae SS. The comparison of effect of treadmill and ergometer training on gait and balance in stroke. J Korean Soc Phys Med. 2010;5(3):435-43.
  17. Kim SH, Lee DK, Kim EK. Effect of aquatic exercise on balance and depression of stroke patients. J Korean Soc Phys Ther. 2014;26.
  18. Kirtley C. Clinical gait analysis: theory and practice. Elsevier Health Sciences. 2006.
  19. Lee D. Effect of the aquatic training on balance and walking in stroke patients. Journal of Special E Education & Rehabilitation Science. 2008;47:21-41.
  20. Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke. Stroke. 2005;36(10):2206-11.
  21. Marigold DS, Eng JJ. The relationship of asymmetric weightbearing with postural sway and visual reliance in stroke. Gait Posture. 2006;23(2):249-55. https://doi.org/10.1016/j.gaitpost.2005.03.001
  22. Masumoto K, Shono T, Hotta N, et al. Muscle activation, cardiorespiratory response, and rating of perceived exertion in older subjects while walking in water and on dry land. J Electromyogr Kinesiol. 2008; 18(4):581-90. https://doi.org/10.1016/j.jelekin.2006.12.009
  23. Miller EW, Quinn ME, Seddon PG. Body weight support treadmill and overground ambulation training for two patients with chronic disability secondary to stroke. Phys Ther. 2002;82(1):53-61. https://doi.org/10.1093/ptj/82.1.53
  24. Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7. https://doi.org/10.1016/j.apmr.2005.01.011
  25. Nishiyori R, Lai B, Lee DK, et al. The Use of Cuff Weights for Aquatic Gait Training in People Post-Stroke with Hemiparesis. Physiother Res Int. 2016;21(1):47-53. https://doi.org/10.1002/pri.1617
  26. O'Sullivan SB, Schmitz TJ. Physical rehabilitation. ed. Philadelphia, PA: FA Davis Company. 2007.
  27. Park JE, Lee JH, Cha YJ. The Effect of Treadmill Gait Training in an Adjusted Position from Functional Training System on Chronic Stroke Patients' Walking and Balance Ability. J Korean Soc Phys Med. 2017; 12(1):35-42. https://doi.org/10.13066/kspm.2017.12.1.35
  28. Park SE, Kim SH, Lee SB, et al. Comparison of underwater and overground treadmill walking to improve gait pattern and muscle strength after stroke. J Phys Ther Sci. 2012;24(11):1087-90. https://doi.org/10.1589/jpts.24.1087
  29. Patterson SL, Forrester LW, Rodgers MM, et al. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil. 2007;88(1):115-9. https://doi.org/10.1016/j.apmr.2006.10.025
  30. Perry J, Davids JR. Gait analysis: normal and pathological function. Journal of Pediatric Orthopaedics. 1992; 12(6):815.
  31. Polese JC, Ada L, Dean CM, et al. Treadmill training is effective for ambulatory adults with stroke: a systematic review. J Physiother. 2013;59(2):73-80. https://doi.org/10.1016/S1836-9553(13)70159-0
  32. Roth EJ, Merbitz C, Mroczek K, et al. Hemiplegic gait: Relationships between walking speed and other temporal parameters1. Am J Phys Med Rehabil. 1997;76(2):128-33. https://doi.org/10.1097/00002060-199703000-00008
  33. Schmid A, Duncan PW, Studenski S, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-100.
  34. Silver KH, Macko RF, Forrester LW, et al. Effects of aerobic treadmill training on gait velocity, cadence, and gait symmetry in chronic hemiparetic stroke: a preliminary report. Neurorehabil Neural Repair. 2000;14(1): 65-71. https://doi.org/10.1177/154596830001400108
  35. Trueblood PR. Partial body weight treadmill training in persons with chronic stroke. NeuroRehabilitation. 2001;16(3): 141-53.
  36. Visintin M, Barbeau H, Korner-Bitensky N, et al. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke. 1998;29(6):1122-8. https://doi.org/10.1161/01.STR.29.6.1122
  37. Wade D, Wood V, Heller A, et al. Walking after stroke. Measurement and recovery over the first 3 months. Scand J Rehabil Med. 1987;19(1):25-30.
  38. Webster KE, Wittwer JE, Feller JA. Validity of the $GAITRite^{(R)}$ walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture. 2005;22(4):317-21. https://doi.org/10.1016/j.gaitpost.2004.10.005
  39. Yang Hj, Choi Jd. Effects of Underwater Treadmill Gait Training on Gait, Balance, and Pulmonary Function in Stroke Patients. Phys Ther Korea. 2015;22(4):34-43. https://doi.org/10.12674/ptk.2015.22.4.034
  40. Yoon S. The effect of energy consumption during walking with arm sling in adult hemiplegic patients. master's thesis, Graduate School of Hanyang University. 2004.

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