• Physical Therapy Korea
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• v.17 no.1
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• pp.43-52
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• 2010

The Dynamic Gait Index (DGI) was developed and widely used as a clinical tool to assess balance performance during gait. The purpose of this study was to validate the Korean translated DGI using Rasch analysis. A total of 105 community-dwelling elderly was participated in this study (age range = 65~95 years; mean = 78.0 years). The translated DGI showed sound item psychometric properties, and the 8 items were arranged in order of difficulty for the total participants. The most difficult item was 'Steps' and the easiest item was 'Level surface'. Also, each of the original 4 rating scale categories satisfied the Linacre's essential criteria suggestions for optimal rating scale category effectiveness. Although, thirty eight person (36.2%) showed the maximal high score, but the most of them was no history of fall in the preceding year. For subjects who has falling history, all of the person's ability was arranged within the item's difficulty. The 8-item Korean translated DGI can be used to measure gain in elderly person with balance disorders without compromising important clinical measurement characteristics in Korea.

• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.74-79
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• 2017

Purpose: The purpose of this study was to compare the effects of the FES-gait with augmented feedback training to the FES alone on the gait and functional performance in individuals with chronic stroke. Methods: This study used a pretest and posttest randomized control design. The subjects who signed the agreement were randomly divided into 12 experimental groups and 12 control groups. The experimental groups performed two types of augmented feedback training (knowledge of performance and knowledge of results) together with FES, and the control group performed FES on the TA and GM without augmented feedback and then walked for 30 minutes for 40 meters. Both the experimental groups and the control groups received training five times a week for four weeks. Results: The groups that received the FES with augmented feedback training significantly showed a greater improvement in single limb support (SLS) and gait velocity than the groups that received FES alone. In addition, timed up and go (TUG) test and six minute walk test (6MWT) showed a significant improvement in the groups that received FES with augmented feedback compared to the groups that received FES alone. Conclusion: Compared with the existing FES gait training, augmented feedback showed improvements in gait parameters, walking ability, and dynamic balance. The augmented feedback will be an important method that can provide motivation for motor learning to stroke patients.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Physical Therapy Rehabilitation Science
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• v.7 no.1
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• pp.29-34
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• 2018

Objective: This study aimed to predict balance and gait abilities with the Trunk Impairment scales (TIS) in persons with stroke. Design: Cross-sectional study. Methods: Sixty-eight participants with stoke were assessed with the TIS, Berg Balance scale (BBS), and Functional Gait Assessment (FGA) by a therapist. To describe of general characteristics, we used descriptive and frequency analyses, and the TIS was used as a predictive variable to determine the BBS. In the simple regression analysis, the TIS was used as a predictive variable for the BBS and FGA, and the TIS and BBS were used as predictive variables to determine the FGA in multiple regression analysis. Results: In the group with a BBS score of >45 for regression equation for predicting BBS score using TIS score, the coefficient of determination ($R^2$) was 0.234, and the $R^2$ was 0.500 in the group with a BBS score of ${\leq}45$. In the group with an FGA score >15 for regression equation for predicting FGA score using TIS score, the $R^2$ was 0.193, and regression equation for predicting FGA score using TIS score, the $R^2$ was 0.181 in the group of FGA score ${\leq}15$. In the group of FGA score >15 for regression equation for predicting FGA score using TIS and BBS score, the $R^2$ was 0.327. In the group of FGA score ${\leq}15$ for regression equation for predicting FGA score using TIS and BBS score, the $R^2$ was 0.316. Conclusions: The TIS scores are insufficient in predicting the FGA and BBS scores in those with higher balance ability, and the BBS and TIS could be used for predicting variables for FGA. However, TIS is a strong predictive variable for persons with stroke who have poor balance ability.

• Journal of Digital Convergence
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• v.13 no.1
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• pp.367-373
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• 2015

The purpose of this study was to examine the effect of backward walking training on the balance capability(Functional Gait Assessment; FGA, Timed Up & Go Test; TUG) and gait performance(10 meter Walking Test; 10 mWT) of stroke patients. Eighteen with stroke patients were randomly allocated to an experimental and contral group of nine patients each. both groups received general neurorehabilitative physical therapy for 45 minutes per day 5 times per week during 4 weeks. The experimental group also performed additional backward walking training for 20 minutes per day 3 times per week during 4 weeks. There were signicantly increase by backward walking training in outcome of the balance capability from the FGA was increase from $17.67{\pm}1.00scores$ to $19.22{\pm}1.00scores$(p<.05), TUG was decrease from $26.45{\pm}1.37sec$ to $23.28{\pm}1.35sec$(p<.05) and 10 mWT was decreased from $21.74{\pm}1.35sec$ to $18.33{\pm}1.10sec$ (p<.05). These result suggest that backward walking training for stroke patients is effective in improving balance capability(FGA, TUG) and gait performance(10 mWT).

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.31-41
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• 2023

Purpose : This study was conducted to identify the common characteristics of older persons with sarcopenia and to explore the relationship between gait, balance, and stress using an integrated assessment tool. Methods : In this study, 95 people aged 65 years or older were screened using the sarcopenia diagnostic evaluation algorithm presented by the Asian Working Group for Sarcopenia in 2019. Skeletal muscle index, grip strength, and short physical performance battery were used as sarcopenia evaluation measurements. Based on the results of this evaluation, participants were grouped into the 'non-sarcopenia group' (41 participants) or the 'sarcopenia group' (54 participants). Participants underwent further assessment using an integrated evaluation tool capable of measuring gait, balance, and stress. Gait ability was evaluated using the timed up and go test, and balance ability was evaluated using the berg balance scale. And the stress of the last month was measured by modifying the stress index developed by a Korean researcher. Collected data were statistically analyzed using the independent t-test and Mann Whitney-U test. Results : The sarcopenia group and the non-sarcopenia group showed significant differences in all elements of the sarcopenia diagnostic evaluation. There were significant differences in all three integrated evaluation tools. For the evaluation of walking ability, the time measured in the timed up and go test was longer in the sarcopenia group, the berg balance scale score for the evaluation of balance ability was lower in the sarcopenia group, and the stress index was higher in the sarcopenia group. Conclusion : Through sarcopenia analysis using an integrated evaluation tool, it was confirmed that sarcopenia is closely related to decreased walking ability, poor balance, and increased stress. We recommend using this tool to reduce the risk of sarcopenia progression and stress exposure through the planning and implementation of an exercise program for sarcopenia prevention.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.93-102
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• 2016

PURPOSE: The purpose of this study is to evaluate the functional effects of action observation plus functional electrical stimulation (FES) treatment on the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities, and stride lengths of stroke patients. METHODS: The subjects, who were all more than six months post stroke, were randomly divided into two groups of ten each: an experimental group and a control group. TETRAX (Tetrax Interactive Balance System) and GAITRite (GAITRite$^{TM}$ computerized gait analysis system) were measured at baseline, six weeks after treatment. Participants in both the groups received functional electrical stimulation treatment, but the experimental group was provided with additional action observation. Independent t-tests were used to compare the differences between the groups, and repeated measured two-way ANOVA was used to compare the interaction between the groups. RESULTS: The result of the interactions between the groups and the periods showed significant increases in the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities and stride lengths (p<0.05). However, a comparison between the groups showed no significance in the weight distribution indexes (heel and toe), stability indexes, and stride lengths (p>0.05). CONCLUSION: Action observation plus functional electrical stimulation treatment should be considered as a therapeutic method for physical therapy for stroke patients to improve the weight distribution indexes, stability indexes, gait velocities, and stride lengths.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.655-666
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• 2010

Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.

• Physical Therapy Korea
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• v.24 no.2
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.