• PNF and Movement
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• v.21 no.1
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• pp.11-18
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• 2023

Purpose: This study aims to compare the effects of obstacle walking training combined with cognitive tasks on balance, gait, and activities of daily living in patients with stroke. Methods: A single-subject design was used, where one stroke patient participated. Obstacle walking training combined with cognitive tasks was performed for 1 hour per day for a total of 10 times during the intervention phase. The subjects were measured five times in the baseline phase, 10 times in the intervention phase, and five times in the follow-up phase. The outcome measurements included the Berg balance scale (BBS), the 10-meter walk test (10 MWT), and the Korean modified Barthel index (K-MBI). Results: In this study, the results showed that the 10 MWT scores during the intervention period improved and that this improvement remained, even during the post-period. In addition, BBS and K-MBI values for stroke patients increased significantly after training. Conclusion: The results of this study revealed that obstacle walking training combined with cognitive task training may be helpful to improve balance, gait, and activities of daily living in stroke patients. Therefore, obstacle walking training combined with cognitive tasks is recommended for stroke patients.

• Journal of Korean Physical Therapy Science
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• v.16 no.2
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• pp.1-9
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• 2009

Background: The ability for backward walking is considered to be necessary for the neuromuscular control and maintenance of balance in daily ambulatory activity. This study aimed to determine the effect of backward walking training on the walking speed and balance control in patients with hemiplegia. Methods: Fourteen patients with hemiplegia were randomly allocated to an experimental and control groups of seven patients each. For the experimental group, we performed both conventional training and backward walking training, and conventional training only for the control group. The conventional training programs for the 2 groups were conducted for 30 min, twice a day, 5 times a week for 4 weeks, and backward walking training for the experimental group was conducted for 30 min, 3 times a week. The outcomes were assessed using the functional reach test (FRT), timed up-and-go (TUG) Test, and the 10 meter walk time test (10mWT). Result: A comparison of the FRT, TUG test, and 10mWT scores obtained before and after the 4-week treatment revealed statistically significant differences (p<.05) for the experimental group; however, there was no such difference in the case of the control group (p>.05). On assessment after the 4-week treatment, statistically significant differences were noted in the TUG test and 10mWT scores of the experimental group (p<.05). Conclusion: Our findings suggest that backward walking training is an effective clinical strategy for improving the walking speed and functional mobility of patients with hemiplegia.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.145-151
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• 2022

Purpose : Stroke patients exhibit abnormal walking patterns such as slow walking speed and asymmetrical walking values. The recovery of symmetrical walking in the stance phase using a treadmill means improvements in walking speed and asymmetrical walking. The purpose of this research was to investigate the effect of unilateral step treadmill training (USTT) on gait speed and the recovery of symmetrical walking in chronic stroke patients. Methods : Fifteen patients (11 men and 4 women) with chronic stroke participated in this study. The 10-meter walk test (10MWT) and GAITRite system were used to determine the intervention-related changes in gait speed and symmetrical walking values such as non-paretic step length (NSL), non-paretic step time (NST), paretic single-support time (PSST), step length asymmetry (SLA), and step time asymmetry (STA) after USTT. All participants completed USTT and underwent measurements at 3 different times: at pretest, posttest, and the follow-up test. Repeated-measures analysis of variance was used to compare walking speed and asymmetrical walking values. The statistical significance level was set at p<.05. Results : Walking speed by 10MWT (p<.05) showed significant improvements after USTT as follows: at pretest and posttest (p<.05), posttest and follow-up test (p<.05), and pretest and follow-up test (p<.05). Recovery of symmetrical walking patterns such as NSL (p<.05), NST (p<.05), and SLA (p<.05) were observed after USTT. However, no significant improvements were found in PSST (p>.05) and STA (p>.05) in symmetrical gait. Conclusion : This study suggests that USTT may have a positive effect on walking speed and symmetrical walking patterns in chronic stroke patients. Thus, this study contributes to the existing knowledge about the usefulness of USTT for the effective management of patients with chronic stroke. Further studies are needed to generalize these findings.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.137-145
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• 2018

PURPOSE: The purpose of this study was to investigate the effect of action observational physical training with rhythmic auditory stimulation on muscle activity and gait ability in patients with stroke. METHODS: Twenty-six chronic stroke patients participated in this study were assigned into three groups, experimental group 1 (10% faster tempo rhythmic auditory stimulation with action observation training) n=8, experimental group 2 (average tempo rhythmic auditory stimulation with action observation training) n=9, and control group (action observation training) n=9. In this experiment, the corresponding exercise were applied into the subjects of three group for 30 minute a day, 3 time a week during 4 weeks. All participants were measured to muscle activity of lower limb, 10 meter walking test, Figure of 8 walk test, Dynamic gait Index. The collected data were analyzed by using SPSS (version 18.0 for window) and verified that each data was a normal distribution based on Shapiro-Wilk test. Between-group and within-group comparison was analyzed by using One-way ANOVA test, Paired t-test respectively. In all statistical analyses, significance level, ${\alpha}$ was set by .05. RESULTS: The above results revealed that the all experimental group 1 and experimental group 2 and control group were all effective to improve the lower limb muscle activities, gait ability. However more positive effects shown action observational physical training with rhythmic auditory stimulation experimental group. CONCLUSION: This study suggest that action observation physical training with rhythmic auditory stimulation is effective intervention for improvement of muscle activity and walking ability in chronic stroke patients.

• PNF and Movement
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• v.17 no.1
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.21-31
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• 2017

PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.236-241
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• 2019

Purpose: This study examined the effects of aquatic proprioceptive neuromuscular facilitation pattern exercise on the balance, gait ability, and depression in patients with chronic stroke. Methods: Thirty patients with chronic stroke were assigned randomly to an experimental (n=15) or control (n=15) group. The experimental group performed aquatic proprioceptive neuromuscular facilitation pattern exercise. The control group performed ground proprioceptive neuromuscular facilitation pattern exercise. Training was conducted once a day for 30 minutes, five days per week for six weeks. The balance ability was measured using the Berg balance scale. The gait ability was measured using the 10 Meter walk test. Depression was measured using the Beck depression inventory. Results: As a result of a comparison within groups, the experimental and control group showed a significant difference for balance, gait ability, and depression after the experiment (p<0.05). In a comparison between the two groups, the experimental group, in which aquatic proprioceptive neuromuscular facilitation pattern exercise was applied, showed more significant changes in balance, gait ability, and depression than the control group (p<0.05). Conclusion: Based on these results, aquatic proprioceptive neuromuscular facilitation pattern exercise effectively improved the balance, gait ability and depression in patients with chronic stroke.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2359-2364
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• 2021

Background: Patients with stroke have limited ankle range of motion (ROM) due to soft tissue abnormalities around the ankle and thus experience functional impairment. Increased muscle tension and reduced ankle ROM impair gait and hinder the activities of daily living. Joint mobilization and stretching are effective interventions that improve gait performance by enhancing the ankle ROM. Objectives: To investigate the effects of ankle joint mobilization and calf muscle stretching on gait speed and gait performance in patients with stroke. Design: This was a randomized controlled trial. Methods: Twenty patients with stroke patients were randomized into two groups. The joint mobilization group (JMG) underwent anteroposterior mobilization of the talocrural joint and the joint mobilization stretching group (JMSG) underwent calf muscle stretching in addition to joint mobilization. Gait speed and gait parameters were measured using the 10-meter walk test and the GAITRite. Results: Both the JMG and JMSG groups showed significant improvements in gait speed, affected-side step length, and cadence after the intervention (P<.05). Conclusion: Joint mobilization and stretching were effective interventions for improving gait performance by enhancing ankle function in patients with stroke.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.20-27
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• 2022

Background: The purpose of the present study was to determine whether balance training combined with light touch improves the postural sway and gait speed in stroke patients. Design: Randomized Controlled Trial Study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the balance training with light touch (LT) group (n=20) and the balance training with heavy touch (HT) group (n=20). Both groups performed balance training on a stable and unstable ground. Additionally, the LT group provided light touch stimulation, and the HT group provided heavy touch stimulation. All the participants underwent 20 sessions of STS training (thirty minutes, five days per week for four weeks). In this study, postural sway was measured using a force platform, and walking speed was measured using a 10 meter walk test. Results: The improvements in postural sway and gait speed were observed to be significantly greater in the LT group, compared to the HT group (p<0.05). Conclusion: The results of the current study imply that balance training combined with light touch is a beneficial and effective therapeutic modality that can be employed to improve the postural sway and gait speed in stroke patients.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.344-349
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• 2022

Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.