• 한국전문물리치료학회지
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• 제26권4호
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• pp.35-41
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• 2019

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

• 한국운동역학회지
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• 제30권1호
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• pp.73-81
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• 2020

Objective: The purpose of this study is to analyze the effects of aquatic walking exercise on gait and balance parameters of elderly women. Method: 15 elderly people were recruited for this study (age: 73.20±5.19 yrs, height: 153.87±3.36 cm, mass: 60.33±5.73 kg). All variables were measured using Gaitview AFA-50. The variables were the heel contact time ratio, gait angle, and M/P change ratio for gait patterns and ENV, REC, RMS, Total Length, TLC, Sway velocity, and Length/ENV for balance abilities. A paired t-test and the Wilcoxon signed-rank test were carried out to verify the differences in the test scores after participating in the water walking program. The significance level for all statistical analyses was set to α=.05. Results: As for the changes in their walking function after the exercise, heel contact time ratio (p<.01) showed a statistical significance, while gait angle and M/P change ratio did not reveal statistically significant differences. In the test of balance ability on both feet and with eyes opened, statistical significance was found in ENV, REC, RMS, TLC (p<.01), and sway velocity (p<.05), while the test with eyes closed showed statistical significance in length/ENV as well as ENV, REC, RMS, sway velocity (p<.01) TLC, and total length (p<.05). As for the single-leg stance balance ability, ENV and REC revealed statistically significant differences. Conclusion: These results show that water walking is effective for improving the function of the ankle flexor muscles, providing stability to the ankle joint during walking and helping efficient walk. In addition, it is also expected to help prevent falls due to loss of balance by improving the stability of lower extremity muscles and trunk.

• 대한물리의학회지
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• 제13권1호
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• pp.89-98
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• 2018

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.

• 재활복지공학회논문지
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• 제10권2호
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• pp.107-112
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• 2016

본 연구는 수중 경사로 보행 훈련이 제2형 척수성근위축증(spinal muscular atrophy type II) 아동의 넙다리네갈래근 활성화와 보행 및 일상생활동작에 미치는 영향을 알아보고자 하였다. 본 연구의 대상자는 만 5세의 제2형 척수성근위축증으로 진단받은 아동이었다. 본 연구는 단일 대상자 반전 연구 설계(A-B-A)를 이용하여 일주일에 3번 12회기 실행하였고 기초선 설정기간(A), 실험 적용기간(B), 관찰기간(A)으로 나누어 진행하였다. 기초선 설정기간, 관찰기간에서는 일반적인 수중 치료가 적용되었고 실험 적용기간에는 일반적인 수중 치료와 수중 경사로 보행훈련(60m 경사로 걷기)이 추가되었다. 제2형 척수성근위축증 환자의 보행에 큰 영향을 끼치는 넙다리네갈래근 활성화 측정을 위해 표면 근전도 검사가 실시되었고, 동적인 기능평가를 위해 일어나 걷기 검사와 일상생활 기능평가(ACTIVLIM)를 실시하였다. 그 결과 기초선 설정기간에 비해 실험 적용기간에서 넙다리네갈래근의 활성화가 감소하였고 보행 시간도 감소하였다. 일상생활 기능은 변화가 나타나지 않았다. 하지만, 관찰기간동안 다시 넙다리네갈래근의 활성화 증가, 보행시간 증가, 일상생활 기능 감소가 나타난 것으로 보아 수중 경사로 보행 훈련이 본 아동에게 기능적으로 영향을 끼쳤음을 알 수 있었다.

• 한국운동역학회지
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• 제19권3호
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• pp.539-547
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• 2009

본 연구의 목적은 낙상 예방을 위한 12주간의 수중 운동 수행 후 장애물 보행의 특성을 운동학 및 운동역학적으로 분석하는 것이다. 여성 노인 8명이 참여하였으며, 대상자들은 수중 운동 전 후에 네 높이의 장애물(0, 2.5, 5.1, & 15.2cm)을 자기선호 속도로 넘었다. 수중 운동 수행 후 고관절의 최대각, 최소각, ROM(Range Of Motion)이 유의하게 증가하였으며, Swing 과 Stance 국면에서 소요시간은 줄어들었다. 수중 운동 후 모든 높이에서 보폭은 유의하게 증가하였고, 보간은 줄어들었다. 수중 운동 후 장애물을 넘는 순간 장애물과 오른발 사이의 수직 최단거리는 증가하였고(15.2cm 장애물 제외), 장애물을 넘는 속도는 증가하였다. 수중 운동 수행 후 제동력, 추진력, 제동 운동량, 추진 운동량은 통계적으로 유의하게 변화하였다. 12주간의 수중 운동은 여성 노인의 근력과 평형성을 향상시켰으며 이는 낙상과 관련된 장애물 보행의 운동학 및 운동역학적 변인의 변화를 가져와 여성 노인들이 장애물을 안전하고 신속하게 넘을 수 있었다. 따라서 노인에게 보행 능력 향상과 낙상 예방 운동으로 수중 운동이 추천된다.

• The Journal of Korean Physical Therapy
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• 제21권2호
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• pp.15-22
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• 2009

Purpose: This study examined the effect of aquatic exercise on the improvement in physical and pulmonary function after stroke. Methods: Fourteen candidates, who had experienced stroke, were enrolled in this study. The program was carried out three times weekly, 1 hour per session and for 10 consecutive weeks. At pre-treatment and post-treatment, the subjects were tested with a 10 m and 100 m timed gait test, a timed get up and go test, a functional reach test, the difference in thoracic girth at inspiration and expiration, and breaths per minute. The forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured using a spirometer. Results: After ten weekends of an aquatic exercise program, the subjects showed a significant difference in all the test results except for the FEV1 (p<0.05). Conclusion: Intervention with this aquatic exercise program can improve the physical and pulmonary function in people who have had a stroke.

• Physical Therapy Rehabilitation Science
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• 제7권1호
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• pp.6-12
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• 2018

Objective: The purpose of this study was to investigate the effects of an additional weight aquatic exercise program on the balance and lower extremity strength on aquatic environment in persons with stroke. Design: Randomized controlled trial. Methods: All subjects were randomly divided into three groups where thirteen subjects were in the additional weight aquatic exercise group, twelve subjects in the aquatic exercise group, and fifteen subjects in the control group. Subjects received a graded aquatic exercise program for 30 minutes, with 3 sessions per week for 6 weeks, and subjects in all groups received conventional physical therapy. All subjects were assessed with the Medical Research Council (MRC), the Berg Balance scale (BBS), Timed Up and Go test (TUG), and 10-meter walk test (10MWT) pre and post intervention. Results: The MRC, BBS, TUG, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas post-treatment (p<0.05). In addition, it has been confirmed that the additional weight aquatic exercise group had significantly improved in MRC, BBS, and TUG scores compared with the aquatic exercise and control group (p<0.05). Conclusions: The findings of this study suggested that the additional weight aquatic exercise program improves lower extremity and balance in persons with stroke.

• 대한물리치료과학회지
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• 제10권2호
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• pp.184-192
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• 2003

본 실험은 아킬레스건 손상 후 운동의 적용기간이 회복과정에 미치는 영향을 알아보고자, 흰쥐의 우측 아킬레스건을 손상한 후 수중운동을 적용하여 기능회복과정을 관찰하여 다음과 같은 결과를 얻었다. 1. 건 손상 후 회전봉에서의 보행시간이 대조군은 9일이후, 1일군은 10일 이후, 4일군과 7일군은 8일 이후 손상 전 보행시간데 대해 유의한 차이 없이 회복하였다. 2. 4일군은 육안관찰에서 손상부위를 찾기 어려울 정도로 정상 건에 가깝게 치유된 것을 볼 수 있으며, 대조군에 비해 유착의 정도가 아주 양호한 편이었다. 이상의 결과를 종합해보면 흰쥐 아킬레스건 손상에 대해 염증기를 지난 후 적용하는 수중운동가 건치유 과정을 촉진시킬 수 있을 것으로 사료된다.

• 대한임상전기생리학회지
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• 제10권2호
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• pp.15-21
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• 2012

Purpose : The purpose of this study is to compare the rehabilitation effects of hydrotherapy and Bobath therapy. Methods : The study was performed with patients of hemiparesis caused by cerebral stroke. The participants were divided into two groups based on random sampling method. One group received hydrotherapy while the other received Bobath therapy. Each rehabilitation program lasted 40 minutes a day, 5 days a week, for 6 weeks. Pertinent indicators-Berg's balance scale (BBS), gait parameter, and static balance analysis-were recorded before andafter the programs, as well as every 2 weeks during the rehabilitation programs Results : There was showed a significantly increase of BBS score. Static open and close showed statistically significant in interaction by time and groups. There was significant differences of gait velocity. Conclusion : These findings in this study that the hydrotherapy was effective therapy in improving balance and gait velocity.

• 한국운동역학회지
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• 제24권2호
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• pp.95-101
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• 2014

The purpose of this study was to investigate the training and detraining effects of a 8-week water exercise on lower extremities coordination during obstacle gait in the female elderly. Eight elderly participants (age: $76.58{\pm}4.97$ yrs, height: $148.88{\pm}7.19$ cm, body mass: $56.62{\pm}6.82$ kg, and leg length: $82.36{\pm}2.98$ cm), who stayed at the Seoul K welfare center, were recruited for this study. All participants had no history of orthopedic abnormality within the past 1 year and completed the aquatic exercise program which lasted for 8 weeks. To identify the training and detraining effect of 8 weeks of water exercise, a 3-D motion analysis with 7 infrared cameras and one force plate sampling frequency set at 100 Hz and 1,000 Hz, respectively, was performed. A two-way ANOVA was performed to find training and detraining effects among diferent obstacle heights. In this study significant level was set at .05. Significant training effects of LTS (lead foot thigh and shank) coordination in all obstacle height were found (p<.05). It is also found that the training effect of LTS remained 37%, 58%, and 25% in obstacle height of 30%, 40%, and 50%, respectively. Lead foot showed the greater detraining effect of coordination compared with trail foot, and SF (shank and foot) coordination revealed better detraining effects of coordination compare with TS (thigh and shank) in both feet. Based on the findings, a 8 week water exercise give an positive effects to the elderly in terms of segment cooperation which potentially helps reducing their accident falls. The magnitude of detraining may also help the elderly to find the retraining moment.