Objective: The purpose of this study was to investigate the effect of treadmill exercise on the posture and walking speed of chronic stroke survivors with an ankle-foot orthosis. Design: Randomized controlled trial. Methods: Twenty-four chronic persons with chronic stroke admitted to Bobath Memorial Hospital in Seongnam city were divided into two groups by random blind method. Treadmill exercise with an elastic ankle-foot orthosis was performed in the experimental group and treadmill exercise was performed in the control group. The experiment was carried out for 6 weeks, and the experiment was carried out three times a week for 20 minutes per session. To measure the effect, static balance was measured using the MTD system before and after training, and the Berg Balance Scale (BBS) was used to measure functional balance. Results: There was a statistically significant difference between the 2 groups in the BBS measurement results for confirming the functional balance (p<0.05). Also, there was a significant difference between the 2 groups in single limb support time, step time and step length (p<0.05). Conclusions: In this study, it was found that treadmill exercise with an elastic ankle-foot orthosis in persons with chronic stroke was effective in maintaining functional balance, walking ability, step length, and step time. Therefore, it is necessary to use a flexible ankle-foot orthosis with proper treadmill exercise as a method of improving balance and walking speed of chronic stroke survivors.
The purpose of this study was to investigate the effect of pelvic traction and muscle energy technique(MET) for hemiplegic patients on static standing balance. The scale for static standing balance is measured by using mean balance(%), frequence(Hz), sway area($mm^2$), sway path(mm), max sway velocity(mm/s), ant/post sway angle($^{\circ}$), lateral sway angle($^{\circ}$), sway number, change of pelvic height is measured in relation to the height of ASIS and PSIS. The subjects of this study were thirty hemiplegic patients: 15men and 15 women, with an average ages of 50.80 years. The thirty subjects were divided into 3 group of 10 at random ; ten subjects had pelvic traction after bobath therapy (the pelvic traction group), ten subjects had muscle energy technique after bobath therapy (the MET group), and ten subjects had only bobath therapy (the control group). Static standing balance was measured using BPM (balance performance monitor; data print software version 5.3), pelvic height was measured using height measuring with an adjustable horizontal arm. In order to assure the statistical significant of the result, an one-way ANOVA, the paired t-test, and a person's correlation were applied at the.05 level of significance. The results of this study were as follows: 1) The change in pelvic height were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 2) The change in affected and non-affected on weight bearing were not statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p>.05). 3) The change in frequency were statistically significant between the MET group, the control group and the pelvic traction group on pre-treatment and post-treatment(p<.05). 4) The change in sway area were statistically significant between the MET group, the control group and the pelvic traction group on pre-treatment and post-treatment(p<.05). 5) The change in sway pa1h were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 6) The change in max sway velocity were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 7) The change in ant/post sway angle were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 8) The change in lateral sway angle were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 9) The change in sway number were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). In conclusion, there was a difference between the experimental group and the control group. In the future, we have to study continuously about pelvic traction and muscle energy technique in hemiplegic patients.
Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.
PURPOSE: The purpose of the present study was to examine the effect of gluteal taping on posture and balance during standing in children with hemiplegic cerebral palsy (CP). METHODS: The subjects of this study were 13 children (six females, seven males; mean aged 8.5) with hemiplegic CP who were gross motor function classification system (GMFCS) level I. The change of posture and balance during standing before and after gluteal taping were measured using inclinometer, gross motor function measure, and functional reaching test. The collected data were analyzed using the paired t-test. RESULTS: The results of this study were as follows : 1) There were statistically significant decrease in the ant. tilt angle of pelvis after gluteal taping in children with hemiplegic CP (p<.05). 2) There were statistically significant increase in functional reaching test after gluteal taping (p<.05). 3) There was no statistically significant difference in gross motor function measure, but significant increase in one leg standing was observed (p<.05). CONCLUSION: As the above results, we suggest that gluteal taping could be effective on improving body alignment and dynamic balance ability during standing in children with hemiplegic CP. Further studies will be required for the short and long term effects of gluteal taping on improving postural symmetry and balance.
This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.
Purpose: The aim of this study was to investigate the effects of gluteal taping on pelvic alignment, trunk stability, and balance during sitting posture in children with unilateral cerebral palsy (CP). Methods: Thirteen children with unilateral cerebral palsy (six females. seven males; mean age 8.5) participated in this study. All participants were evaluated before and after gluteal taping using an Inclinometer for pelvic lateral inclination, trunk impairment scale (TIS) for trunk stability, and modified functional reaching test for balance during sitting. The collected data were analyzed using a paired t-test. Results: The results of this study were as follows: 1) Statistically significant decreases in the angle of pelvic lateral inclination were observed after gluteal taping in children with unilateral CP (p<.05). 2) Statistically significant increases in TIS score were observed after gluteal taping (p<.05). 3) Statistically significant increases in the range of reaching during sitting were observed after gluteal taping (p<.05). Conclusion: : In conclusion, this study showed that gluteal taping improves pelvic alignment, trunk stability, and balance during sitting in children with unilateral cerebral palsy. Further studies will be required to determine the short- and long-term effects of gluteal taping on improving postural symmetry, trunk stability, and balance.
Objective: The purpose of this study was to determine the effects of Augmented Reality-based Postural Control (ARPC) training on balance and gait function in patients with stroke. Design: Single-blind randomized controlled trial. Methods: Twenty participants who experienced a stroke were enrolled in the study and randomly assigned to the ARPC (n=10) or control group (n=10). Subjects in both groups received conventional physical therapy for 60 min per session, 5 days per week, for 4 weeks. In addition, subjects in the ARPC group received ARPC training for 30 min per day, 3 days per week, for 4 weeks. The participants watched established normal postural control patterns on a head-mounted display and repeated the movements in ARPC training. Outcome measurements were assessed using the Berg Balance Scale (BBS) and 10-Meter Walk Test (10MWT) before and after 4 weeks of training. Results: Of the 20 randomized participants, only 18 completed the 4-week training program. The ARPC group showed significant improvement in the BBS and 10MWT after training (p<0.05). Meanwhile, the control group did not exhibit improvement in either variable. In addition, the ARPC group showed significantly greater improvement than the control group in the 10MWT (p<0.05), whereas no significant difference was observed between the groups for the BBS. Conclusions: The results of this study confirmed the benefits of ARPC training on dynamic balance and functional gait ability. Additionally, this study may provide evidence supporting the use of an ARPC training program for improving balance and gait ability in patients after a chronic stroke.
Purpose: This paper sought to classify, analyze, and investigate domestic research papers on the physical rehabilitation of children with cerebral palsy, and to suggest a direction for rehabilitation after the coronavirus disease 2019 (COVID-19) pandemic. Methods: A literature search was conducted from June 1 to June 30, 2022, and only papers published in domestic journals during the past 10 years were searched. The main search term was "rehabilitation for children with cerebral palsy", and "rehabilitation" such as "exercise rehabilitation," "equestrian rehabilitation", and "aquatic rehabilitation" were reviewed when they appeared in the titles and abstracts. A total of 18 books were selected according to the exclusion criteria. Results: Rehabilitation by area was divided into exercise rehabilitation, Bobath rehabilitation, equestrian rehabilitation, and aquatic rehabilitation. Analysis was undertaken based on the period of rehabilitation, area wise from 2012 to 2017, except for aquatic rehabilitation, which was studied once in 2020. The intervention effects of exercise rehabilitation were summarized as PICO (Participants, Intervention, Comparison, Outcome), and most of the studies showed improvements in the subject's physical functions. Conclusion: Research on the physical rehabilitation of children with cerebral palsy is being conducted in multiple directions and through several methods. In addition to the Bobath and Vojta approaches, equestrian rehabilitation, aquatic rehabilitation using the buoyancy of water, and computer rehabilitation are conducted. For the physical rehabilitation of children with cerebral palsy in the context of COVID-19, programs that are linked with families and those that incorporate Information Communications Technology (ICT) could be developed.
The age of specialization is upon physical therapy, as evidenced by the many special interest group. One of the special interest is manual therapy, which is the study of neurology, biomechanic, behavior science and pathology as well as the application of evaluative and treatment techniques of the neuromusculoskeletal system. Trend of manual therapy cover the whole medical in Europe. but America has two categories which is the neurologic manual therapy and the orthopedic manual therapy. The neurologic manual therapy was integrated with theory of PNF, Bobath technique, Vojta which is neurophysiologic approach concept. It is called motor control. A key aspect of the motor control requires a through knowledge of neurobiologic, biomechanic, and behavioral science. The orthopedic manual therapy runs to the evaluation and treatment of joints and their surrounding structures increase or decrease mobility and Fain control. In this article has to define and clarify the basic concepts of orthopedic manual therapy by comparing the general concepts, evaluation schemes, and treatment procedures of John McM Mennell, James Cyriax, Geoffrey Maitland, Freddy Kaltenborn and Ola Grimsby.
The hand is an integral part of normal hand functioning. The ability of the hand to grasp and manipulate objects or tools is necessary for accom-plishing many tasks of daily living. Therefore it is important to improve hand function for patient with hand impairment. The objectives of this article are to review the developmental process of hand function and to described the types of grasp, grip, pinch, and prehension. Developmental process of hand function is based on general developmental theory as Vojta, Bobath and Ayres. There are many kinds of classification of prehension, grasp, and pinch. This review include the classification by Malick, Kiel, Melvin, Sollrman & Sperling, Pedretti & Zoltan, Tyldesley & Grieve' book, Norkin & Levangie' book. This article hope to give the information for application in physical and occupational therapy practice.
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