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http://dx.doi.org/10.20540/JIAPTR.2020.11.3.2126

Effects of Therapeutic Climbing Training on the Balance and Gait Ability in Chronic Stroke Patients  

Lee, Soin (Department of Physical Therapy, Nambu University)
Ko, Mingyun (Department of Health Administration, Chosun College of Science & Technology)
Park, Seju (Department of Physical Therapy, Nambu University)
Publication Information
Journal of International Academy of Physical Therapy Research / v.11, no.3, 2020 , pp. 2126-2134 More about this Journal
Abstract
Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.
Keywords
Balance; Gait ability; Stroke; Therapeutic Climbing; Rehabilitation;
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Times Cited By KSCI : 7  (Citation Analysis)
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1 Lee GC, Kim CH, Kwak SY, et al. About Sex and Weight by Foot Pressure Distribution of Normal Twenties Men and Women Research. KSSPT. 2011;7(1):43-52.
2 Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148.   DOI
3 Kim EJ, Kim SH. A Comparison of Shoulder Stabilizer Muscle Activities of Therapeutic Climbing and Isometric Exercise in Patients with Shoulder Impingement Syndrome. J Kor Phys Ther. 2016;28(2):88-94.   DOI
4 Kim SH, Seo DY. Effects of a therapeutic climbing program on muscle activation and SF-36 scores of patients with lower back pain. J Phys Ther Sci. 2015;27:743-746.   DOI
5 Rene Kittel. Therapeutisches klettern-Das praxisbuch. Germany: TKS Verlag; 2015:58-59.
6 Bernstadt W, Kittel R, Luther S. Therapeutisches Klettern. Germany: Thieme Verlag; 2007.
7 Kittel R, Brunjes J. Aufwarts als Therapierichtung. Zeitschrift fur Physiotherapeuten. 2015;67(4):54-58.
8 Kim YJ, Kim TY. Oh DW. The effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Korean J Orthop Manu Ther. 2009;15(1):22-31.
9 Bertrand AM, Bourbonnais D. Effects of upper limb unilateral isometric efforts on postural stabilization in subjects with hemiparesis. Arch Phys Med Rehabil. 2001;82(3):403-411.   DOI
10 Shumway-Cook A, Marjorie H, Woollacott MH. Motor control: translating research into clinical practice. Philadelphia: Lippincott Williams & Wilkins; 2007.
11 Smania N, Picelli A, Gandolfi M, Fiaschi A, Tinazzi M. Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study. Neurol Sci. 2008;29(5):313-319.   DOI
12 Irion JM. Use of the gym ball in rehabilitation of spinal dysfunction. Orthop Phys Ther Clin North Am. 1992;1:375-398.
13 Melvyn R, Claudine L, Gert K, Piet W, Peter JB. Gait coordination after stroke: benefits of acoustically paced treadmill walking. Phys Ther. 2007;87(8):1009-1022.   DOI
14 Mackintosh SF, Hill KD, Dodd KJ, Goldie PA, Culham EG. Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation. Arch Phys Med Rehabil. 2006;87(12):1583-1589.   DOI
15 Geiger RA, Allen JB, O'Keefe J, Hicks RR. Balance and mobility following stroke: Effects of physical therapy interventions with and without biofeedback/forceplate training. Phys Ther. 2001;81(4):995-1005.   DOI
16 Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go test, and gait speeds. Phys Ther. 2002;82(2):128-137.   DOI
17 Bohannon RW. Standing balance, lower extremity muscle strength, and walking performance of patients referred for physical therapy. Percept Mot Skills. 1995;80(2):379-385.   DOI
18 Winzeler-Mercay U, Mudie H. The nature of the effects of stroke on trunk flexor and extensor muscles during work and at rest. Disabil Rehabil. 2002;24(17):875-886.   DOI
19 Grant S. Hasler T, Davies C, Aitchison TC, Wilson J, Whittaker A. A comparison of the anthropometric, strength, endurance and flexibility characteristics of female elite and recreational climbers and non-climbers. J Sports Sci. 2001;19(7):499-505.   DOI
20 Yang JH, Park SJ, Kim SH. Effects of Diagonal Pattern Self-Exercise on Trunk Control, Balance, and Gait Ability in Chronic Stroke Patients. J Int Acad Phys Ther Res. 2020;11(2):2028-2035.   DOI
21 Effect of PNF Approach to Scapular Adductor Muscles on Scapular Movements and Walking Ability in Patients with Stroke. J Int Acad Phys Ther Res. 2017;8(1):1090-1094.   DOI
22 Dittrich M, Eichner G, Bosse A, Beyer W.F. Therapeutisches Klettern bei chronisch unspezifischem Rückenschmerz. OUP. 2014;12:581-583.
23 Lin SI. Motor function and joint position sense in relation to gait performance in chronic stroke patients. Arch Phys Med Rehabil. 2005;86(2):197-203.   DOI
24 Schmid AA, Van Puymbroeck M, Altenburger PA, et al. Balance and balance self-efficacy are associated with activity and participation after stroke: a cross-sectional study in people with chronic stroke. Arch Phys Med Rehabil. 2012;93(6):1101-1107.   DOI
25 Bohannon RW, Walsh S. Nature, reliability, and predictive value of muscle performance measures in patients with hemiparesis following stroke. Arch Phys Med Rehabil. 1992:73(8):721-725.
26 Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006; 87(4):554-561.   DOI
27 Wall JC, Turnbull GI. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil. 1986;67(8):550-553.
28 Knutsson E, Richards C. Different types of disturbed motor control in gait of hemiparetic patients. Brain.1979;102(2):405-430.   DOI
29 Handa N, Yamamoto H, Tani T, Kawakami T, Takemasa R. The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain. J Orthop Sci. 2000;5(3):210-216.   DOI
30 Clark, M, Cummings, P. Treinamento de estabilizacao do "core". In: Ellenbecker TS, ed. Reabilitacao dos ligamentos do joelho. Sao Paulo: Manole; 2002.
31 Ellis AW, Young AW. Human cognitive neuropsychology: A textbook with readings. UK: Psychology Press; 2013.
32 Ryerson S, Byl NN, Brown DA, Wong RA, Hidler JM. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther. 2008;32(1):14-20.   DOI
33 Eils E, Rosenbaum DA. multi-station proprioceptive exercise program in patients with ankle instability. Med Sci Sports Exerc. 2001;33(12):1991-1998.   DOI
34 Gruber M, Gollhofer A. Impact of sensorimotor training on the rate of force development and neural activation. Eur J Appl Physiol. 2004;92(1-2):98-105.   DOI
35 Kohl B. Therapeutisches klettern untersuchung der auswirkungen eines klettertrainings an personen mit ruckenschmerzen", unveroffentliche diplomarbeit an der leopold-franzensuniversitat Innsbruck. Germany: Psychologie und Sportwissenschaften; 2005.
36 Mally F. Litzenberger S, Sabo A. Surface electromyography measurements of dorsal muscle cross-activation in therapeutic climbing. Procedia Eng. 2013;60:22-27.   DOI
37 Park SJ, Lee SI, Park SH, Cho WS. The Effect of Climbing Training on the Postural Alignment and Balance Ability. KAIS. 2018;19(8):254-259.
38 Berg K. Balance and its measure in the elderly: a review. Physiother Can. 1989;41(5):240-246.   DOI
39 Rebecca AL, Brenda J. Reliability and Validity of Measures Obtained From Stroke Patients Using the Balance Master. Arch Phys Med Rehabil. 1996;77:425-430.   DOI