• Physical Therapy Korea
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• v.21 no.4
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.139-146
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• 2017

PURPOSE: The purpose of this study was to systematically analyze the reliability and validity of the Korean-version of the balance assessment tools. METHODS: Two reviewers of this study independently evaluated the titles of articles and abstracts of studies published until December 2016 through electronic databases (RISS, NDSL, KISS, DBpia) using the keywords "Balance or posture or postural control or postural stability", "Test or assessment or measurement or outcome measure or assessment tool or measurement tool", "Korean version", "Reliability" and "Validity". Regarding the questions considered suitable for the purpose of this study, consensus was reached after reading the full text. Selecting journals suitable for the purpose of the study, they were analyzed as data. RESULTS: The reviewers selected nine papers suitable for the purpose of this study, and Korean-version of the balance assessment tools, included the Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC) scale, Postural Assessment Scale for Stroke (PASS), Motor Assessment Scale (MAS), Trunk Impairment Scale (TIS), Falls Efficacy Scale (FES), Tinetti-Balance scale, Fullerton Advanced Balance (FAB) scale, and Function In Sitting Test (FIST). Our study showed that the reliability and validity of the Korean-version of the balance assessment tools were high. CONCLUSION: The Korean-version of the balance assessment tools with high reliability and validity would enable physical therapists to make a more accurate evaluation of balance.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.33-39
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• 2012

Objective: The objective of this study is to investigate the effect of treadmill training with real optic flow scene on functional recovery of balance and balance self-efficacy in stroke patients. Design: Single blind, Randomized controlled trial. Methods: Nine patients following stroke were divided randomly into the treadmill with optic flow group (n=3), treadmill with virtual reality group (n=3), and control group (n=3). Subjects in the treadmill with optic flow group wore a head-mounted display in order to receive a speed modulated real optic flow scene during treadmill training for 30 minutes, while those in the treadmill with virtual reality group and control group received treadmill training with virtual reality and regular therapy for the same amount of time, five times per week for a period of three weeks. Timed up and go test (TUG) and activities-specific balance confidence scale (ABC scale) were evaluated before and after the intervention. Results: TUG in the treadmill training with optic flow group showed significantly greater improvement, compared with the treadmill training with virtual reality group and control group (p<0.05). Significantly greater improvement in the ABC scale was observed in the treadmill training with optic flow group and the tread mill training with virtual reality group, compared with the control group (p<0.05). Conclusions: Findings of this study demonstrate that treadmill training with real optic flow scene can be helpful in improving balance and balance self-efficacy of patients with chronic stroke and may be used as a practical adjunct to routine rehabilitation therapy.

• PNF and Movement
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• v.15 no.3
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• pp.317-331
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• 2017

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

• PNF and Movement
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• v.15 no.1
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• pp.77-84
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• 2017

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.88-93
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• 2018

Objective: Elevated cholesterol levels contribute to changes of the arterial endothelial permeability. Hyperlipidemia promotes atherosclerosis and is associated with an increased risk of stroke incidence. The purpose of this study was to investigate the effects of having a history of hyperlipidemia prior to a stroke incidence on postural balance, anticipatory dynamic postural control, gait endurance and gait performance in individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Fifty-two adults who were diagnosed with stroke 6 months ago or more were enrolled in this study. They were divided into two different groups according to hyperlipidemia history before stroke. All participants were assessed with the Activities-specific into Balance Confidence (ABC) scale, Berg Balance scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go test (TUG), and the 6-minute walk test (6MWT). An independent t-test was used to analyze the difference between the hyperlipidemia group and non-hyperlipidemia group. Results: After analysis, the BBS, TUG, and 6MWT scores were significantly different between the hyperlipidemia and non-hyperlipidemia group, but not the ABC and DGI scores. Conclusions: The results of this study show that having a history of hyperlipidemia before stroke affects static and dynamic postural balance performance, anticipatory dynamic postural balance, and gait endurance in individuals with chronic hemiparetic stroke. Based on the results of this study, we also suggest treatment for hyperlipidemia should be implemented throughout the therapeutic interventions, such as pharmacological or exercise programs, in order to restore the physical function of stroke survivors.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.57-62
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• 2022

Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.

• Physical Therapy Korea
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• v.15 no.2
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• pp.44-53
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• 2008

The purpose of this preliminary study was to develop a measurement for assessing risk factors for falling in community-dwelling elderly persons. Rasch analysis and principal component analysis were performed to examine whether items on the Activities-Specific Balance Confidence (ABC), assessing self-efficacy, and items on the Berg Balance Scale (BBS), assessing balance function, contribute jointly to a unidimensional construct in the elderly. A total of 35 elderly persons (4 men, 31 women) participated. In this study, each item of ABC (16 items) and BBS (14 items) was scored on a 5-point ordinal rating scale from 0 to 4. The initial Rasch and principal component analysis indicated that 3 of the ABC items and 2 of the BBS items were misfit for this study. These 5 items were excluded from further study. After combining ABC and BBS, Rasch and principal component analyses were examined and finally 23 items selected; 12 items from ABC, 11 items from BBS. The 23 combined ABC-BBC items were arranged in order of difficulty. The hardest item was 'walk outside on icy sidewalks' and the easiest item was 'pivot transfer'. Although structural calibration of each 5 rating scale categories was not ordered, the other three essential criteria of Linacre's optimal rating scale were satisfied. Overall, the ABC-BBS showed sound item psychometric properties. Each of the 5 rating scale categories appeared to distinctly identify subjects at different ability levels. The findings of this study support that the new ABC-BBS scale measure balance function and self-efficacy. It will be a clinically useful assessment of risk factors for falling in the elderly. However, the number of subjects was too small to generalize our results. Further study is needed to develop a new assessment considering more risk factors of falling in elderly.

• Journal of Digital Convergence
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• v.14 no.5
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• pp.485-491
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• 2016

The purpose of this study was to compare of the fall risk factors for elderly in the city. 62 people aged 65 years or older were classified as fallers and nonfallers based on experience of their falls in the previous year. By comparing the difference between the groups via evaluations of general characteristics, health related behavior and chronic disease, balance-related psychological (K-ABC) and physical measurement (BBS), depression (SGDS), and the correlations between the significant differences in variables were identified. According to the results, K-ABC, BBS, and SGDS are statistically significant differences between fallers and nonfallers (P<0.05). Also it has positive correlations between BBS and K-ABC (r=0.499) whereas negative correlation between K-ABC and SGDS(r=-0.472).

• Physical Therapy Korea
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• v.20 no.3
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• pp.9-18
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• 2013

The study aimed to compare the effect of the treadmill walking training combined with obstacle-crossing (TWT-OC) and treadmill walking training (TWT) on the walking function of patients with chronic stroke. 29 subjects volunteered to participate in this study; they were randomly assigned to either TWT-OC group (15 subjects) or TWT group (14 subjects). Subjects from the TWT-OC group underwent a treadmill walking combined with obstacles-crossing for 30 minutes daily, three days a week for four weeks, whereas subjects from the TWT group received only a treadmill walking. The 10 m walk test (10MWT), 6-min walk test (6MWT), berg balance scale (BBS), timed up and go test (TUG), activities-specific balance confidence-Korean version (ABC-K), and walking ability questionnaire (WAQ) were measured before and after the 4-week training. The TWT-OC group showed significantly better functional mobility of walking and balance measured by 6MWT (p<.01), BBS (p<.01), and TUG scores (p<.05) when compared with those of the TWT group. Further, within-group comparison showed significant improvement in all variables (p<.01) except for 10MWT. These findings suggest that the TWT-OC and TWT may be helpful for improving the walking function of patients with chronic stroke, and the TWT-OC has probably more favorable outcomes for chronic stroke, however, further trials with wider range of subjects are warranted for generalization and clinical relevance.