• 대한물리치료과학회지
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• 제16권4호
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• pp.49-57
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• 2009

Background: The purpose of this study was to assess the test-retest reliability of balance measurements in older adults using balance measurement system(Good Balance). Methods: The subjects consisted of 49 female and 20 male in community-dwelling older adults. This study used a repeated-measure design. Each subject completed all the different tests once and they were then repeated with 2 minutes in between. Repeated two-ways analysis of variance(ANOVA), representing two test times and both sexes, was calculated for each of the two dependent variables. Intraclass correlation coefficients(ICCs) were used to assess the test-retest reliability. Results: 1) There was not significant difference between test and retest for mediolateral sway speed and anterioposterior sway speed under conditions of normal standing with eyes open, normal standing with eyes closed and semitandem standing with eyes open. There was not significant difference between males and females for mediolateral sway speed and anterioposterior sway speed under conditions of normal standing with eyes open, normal standing with eyes closed and semitandem standing with eyes open. There were not the interaction effects between genders and test time under three conditions. 2) The reproducibility between test and retest was excellent for anterioposterior sway speed(ICC=.77) under condition of normal standing with eyes open, and for mediolateral sway speed(ICC=.76) and anterioposterior sway speed(ICC=.84) under condition of semitandem standing with eyes open. The reproducibility between test and retest was fair to good for mediolateral sway speed(ICC=.64) under condition of normal standing with eyes open, for mediolateral sway speed(ICC=.63) and anterioposterior sway speed(ICC=.75) under condition of normal standing with eyes closed. Conclusion: Balance tests in older adults using balance measurement system(Good Balance) demonstrated acceptable levels of reliability.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.7-12
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• 2014

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

• PNF and Movement
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• 제15권1호
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• pp.57-65
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• 2017

Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.

• PNF and Movement
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• 제13권4호
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• pp.189-196
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• 2015

Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) upper and lower limb coordinated exercises on balance in elderly women. Methods: The study was conducted with 27 elderly women who were at least 65-year-old. The subjects were randomly assigned to a PNF upper and lower limb coordinated exercise group consisting of 14 subjects and an aero step balance exercise group consisting of 13 subjects, and the exercises were performed for 30 minutes, three times per week, for eight weeks. One Leg Stance Tests (OLST), Functional Reaching Tests (FRT), Four Square Step Tests (FSST), and Timed Up and Go (TUB) tests were conducted before and after the exercises to evaluate the subjects' static balance ability and dynamic balance ability. Among the collected data, the subjects' general characteristics were evaluated using descriptive statistics, the intra-group differences of the test results before and after the intervention were compared using paired sample t-tests, and the inter-group differences in the results before and after the intervention were evaluated using independent sample t-tests. The statistical significance level was set to 0.05. Results: Among the OLST, FRT, FSST, and TUG tests, the experimental group showed positive FSST results that were statistically significantly greater than the control group; the results of the other tests were also more positive for this group, but the differences between the groups were not statistically significant. The magnitude of the effects for both groups was clinically significant. Conclusion: Since inter-limb coordinated exercises for PNF applied to elderly women were found to produce good results for both static balance ability and dynamic balance ability, these exercises can be used in exercise programs to improve balance in elderly women.

• 대한통합의학회지
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• 제6권4호
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• pp.139-148
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• 2018

Purpose : The purpose of this study was to examine the effects of waist mobilization technique intervention for patients with chronic back pain on balance and the low back pain disability index. Methods : The subjects were 30 patients with chronic back pain. They were sampled and divided into a manual therapy group and a spinal decompression group. 15 subjects were randomly assigned to each group. Each training in this study participated for 6 weeks, 5 times a week, once a day, 15 minutes a day. Balance ability was measured with a balance analyzer, and the low back pain disability index was measured using the Oswestry Disability Index (ODI). Results : In the balance abilities, there was a significant difference in the manual therapy group compared to the spinal decompression group. In the low back pain disability index, there was a significant difference in the manual therapy group compared to the spinal decompression group. Conclusion : The analysis results of the effect of 6 weeks of waist mobilization technique intervention on the balance and low back pain disability index for patients with chronic back pain revealed that the manual therapy is more effective for static and dynamic balance ability and the low back pain disability index. In the future, we can promote independent life skills and expect a rapid recovery of patients with chronic back pain. Based on this study, further studies are needed on the effects of balance, the mechanical properties of muscle, and the low back pain disability index depending on various manual therapy techniques.

• 대한통합의학회지
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• 제7권2호
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• pp.49-57
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• 2019

Purpose: This study aimed to investigate the application of temperature to balance the training by observing the effect of sensory changes in the foot sole area on dynamic equilibrium ability through change in the sole temperature. Methods: Participants (n=49), who were selected as a certain standard, applied cold and hot packs for ten minutes at two-week intervals, and the laboratory's internal temperature was maintained at $25^{\circ}C$. The subjects were measured before and after the cold and hot applications in the stable condition with bare feet. Before each experiment applied the cold and hot packs, the balance ability of the ordinary temperature was measured once by conducting a limit of stability test using Biorescue, and the changes in balance ability were observed by measuring once after applying the temperature to the foot sole by means of the ice pack and the hot pack. Results: The results of the dynamic balance test, both before and after the temperature application, were compared, and it was confirmed that the moving area before and after cold application decreased significantly, and the moving area before and after application was not significantly different. The mean of pre-post area differences was found to have decreased at a statistically significant rate in the forward, backward, rightward, leftward, and total areas for the group that received the cold application compared to the group that received the hot application. Conclusion: These findings showed that cold application to the foot sole decreased dynamic balance. There was no significant difference in the dynamic balance ability both before and after the hot application to the foot sole, so it is difficult to conclude that the hot application affected dynamic balance.

• 대한물리의학회지
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• 제14권2호
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• pp.107-115
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• 2019

PURPOSE: This study examined the effects of the chopping pattern of proprioceptive neuromuscular facilitation (PNF) on the neglect, balance ability, and activities of daily living in stroke patients with hemi-spatial neglect. METHODS: Twenty stroke patients with neglect volunteered for this study. The subjects were assigned randomly to either the experimental group (EG, n=10) or control group (CG, n=10). The chopping pattern of PNF and exercise therapy were applied in the EG and CG, respectively, for four weeks. Neglect, balance, and activities of daily living were evaluated at the pre-and post-intervention. The assessment tools included a line-bisection test, balance test using Space balance 3D, and modified Barthel index. The pre-and post-intervention values were compared in each group using a paired t-test and the between-group differences were assessed using an independent t-test. Statistical significance was set to ${\alpha}=.05$ for all variables. RESULTS: Significant differences were observed between the EG and CG in terms of neglect, balance, and activities of daily living (p<.05). Both groups showed significant improvement in neglect, balance, and activities of daily living (p<.05). CONCLUSION: These results suggest that the chopping pattern of PNF is effective in improving the hemi-spatial neglect, balance, and activities of daily living in stroke patients with neglect.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.205-210
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• 2018

Purpose: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. Methods: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: $0^{\circ}$ treadmill gait training (n=14), $5^{\circ}$ treadmill gait training (n=15), and $10^{\circ}$ treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. Results: This study showed that gait training on a treadmill at controlled inclinations of $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ positively influenced the stroke patients' standing balance. The $5^{\circ}$ and $10^{\circ}$ inclination gait training groups showed significantly more improvement than the $0^{\circ}$ inclination group. Conclusion: Gait training on a treadmill with inclinations of $0^{\circ}$, $5^{\circ}$, or $10^{\circ}$ can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, $5^{\circ}$ and $10^{\circ}$ inclination gait training offered more significant improvement than the $0^{\circ}$ inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.

• 대한통합의학회지
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• 제9권4호
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• pp.191-200
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• 2021

Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.

• 대한통합의학회지
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• 제9권1호
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• pp.41-48
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• 2021

Purpose : The purpose of this study is to find out if it helps to improve static balance ability and weight bearing rate for chronic stroke patients with poor balance in clinical intervention through a method of correcting movement errors while performing a task by vibrotactile bio-feedback providing pressure information. Methods : Fifteen chronic stroke patients (12 male and 3 female) were participated in this study. To examine the effects of vibrotactile bio-feedback and general standing without bio-feedback on static balance ability and weight distribution symmetric index in all subjects randomized with R Studio. The static balance ability and weight distribution symmetric index of the participants was evaluated using a force plate. A paired t-test was used for comparison of each conditions. Statistical significance was set at α=0.05. Results : The comparisons of static balance ability and weight distribution symmetric index in chronic stroke patients after two different condition are as follows. In the static balance ability and weight distribution symmetric index, the vibrotactile feedback providing pressure information showed a significant difference compared to none feedback (p<.001). Conclusion : The vibrotactile bio-feedback providing pressure information in real time can support an improve in static balance ability, uniform weight bearing rehabilitation in chronic stroke patients. In the future, it is hoped that a follow-up study that provides a better direction of intervention compared to various feedback interventions commonly used in clinical practice.