• 제목/요약/키워드: Bobath therapy

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팔걸이 형태에 따른 편마비 환자의 보행 변수 및 비마비측 견갑대의 근활성도 변화 (The Variations in Gait Parameters and the Muscle Activities on the Non-Affected Side of the Shoulder Girdle According to Arm Sling Type in Patients with Hemiplegia)

  • 이옥경;안덕현;유원규;오재섭;윤지연
    • 한국전문물리치료학회지
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    • 제17권3호
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    • pp.77-86
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    • 2010
  • The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

The Effect of Different Head Positions with Whole Body Vibration on Muscle Activation related to Postural Stability in Standing

  • Seo, Hye-Jung;Kim, Joong-Hwi;Son, Kuk-Kyung
    • The Journal of Korean Physical Therapy
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    • 제26권3호
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    • pp.156-162
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    • 2014
  • Purpose: The purpose of this study was to investigate muscle activation related to postural stability depending on different head positions with whole body vibration (WBV) in standing. Methods: Eighteen healthy subjects voluntarily participated in this single-group, repeated-measures study in which the surface electromyography (EMG) data from upper trapezius, rectus abdominis, external oblique abdominis, erector spinae, gluteus maximus, rectus femoris, semitendinosus, medial gastrocnemius were collected over 3 different frequencies (0-10-20Hz) and 4 different head positions (neutral, flexion, extension, chin tuck) for each subject on WBV while standing. Results: The results of this study demonstrated that the EMG activity of all recorded muscles shows significant difference between three different frequencies and four head positions of WBV while standing (p<0.05). In the multiple comparison, significant differences could be observed for most of different frequency conditions except 0-10Hz of RA, 10-20Hz of ST. In contrast, no significant difference showed the comparison of the EMG activity depending on different head positions (p<0.05). Conclusion: These findings suggest that different head positions on WBV do not activate muscles related to postural stability. However, higher frequency on WBV is highly effective to activate whole body muscles included postural muscles regardless of different head positions.

밀기증후군 유무에 따른 기능변화에 관한 연구 (A Study of Changing the Functional Activities with and without Pusher Syndrome)

  • 황병용;김한수
    • The Journal of Korean Physical Therapy
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    • 제11권2호
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    • pp.111-114
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    • 1999
  • Some hemiplegic patients show a particular posture that pushing away from the nonaffected side of the body. A few study has been conducted of any aspect of this syndrome. But despite the lack of a scientific basis, this term is widely used in the physical therapy of hemiplegic patients. The purposes of this study was to investigate whether pusher syndrome has an adverse impact on functional outcome. Included were all acute stroke patients admitted in a months period a hospital in Seoul. The presence of pusher syndrome was assessed by a Bobath trained physical therapist. The ability of transfer was assessed by the Functional Independence Measure(FIM), Activities of daily living by the Modified Barthel Index(MBI), and standing balance by Bohannon's Standing Balance Scale(BSBS) on admission, weekly during the hospital stay, and at discharge. Pusher syndrome was found in $52.4\%$ of the left side and $50.0\%$ of the right aide hemiplegic patients. Significant differences were found in the score of transfer, ADL and standing balance between patients with and without pusher syndrome.

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뇌졸중 환자의 체간하부 안정성 강화운동이 균형과 보행에 미치는 영향 (The Effect of Core Strength Exercises on Balance and Walking in Patients with Stroke)

  • 김은자;황병용;김재현
    • The Journal of Korean Physical Therapy
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    • 제21권4호
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    • pp.17-22
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    • 2009
  • Purpose: The goal of this study was to investigate the effect of core strength exercises on the balance control and walking ability of stroke patients. Methods: Twelve stroke patients participated in this study. These patients were divided into two groups (a core stability group and a control group). There were 6 subjects in each group. They participated in core strength exercises for 3 weeks. These exercises included The Timed Up and Go Test (TUG). Messen Trairuieren Dokumentieren (MTD) Systems for balance and walking were measured and compared before and after the treatment. Results: First, core strength exercises improved balance control of patients with stroke by increasing weight shifting to the affected side. Second, core strength exercises improved the walking ability of patients with stroke by reducing the TUG score. Third, there was a significant correlation between balance control and walking. Conclusion: Core strength exercises are effective for improving both balance control and walking.

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전동식 보행 훈련기를 이용한 뇌졸중 환자 보행훈련의 사전연구 (Preliminary Study of Ambulation Training on Electromechanical Gait Trainer in Stroke Patients)

  • 김재현;안승헌;배성수
    • 대한물리의학회지
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    • 제1권1호
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    • pp.1-12
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    • 2006
  • Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.

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동작관찰훈련이 뇌졸중 환자의 손 조작능력에 미치는 영향 (The Effect of Action Observational Physical Training on Manual Dexterity in Stroke Patients)

  • 김종만;양병일;이문규
    • 한국전문물리치료학회지
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    • 제17권2호
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    • pp.17-24
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    • 2010
  • The aim of this study was to determine the effect of action observational physical training (AOPT) on manual dexterity and corticomotor facilitation in stroke patients. Ten hemiparetic patients participated in this study. Each subject was asked to participate the three conditions; base condition (Base), physical training (PT), AOPT. Participants were asked to observe the action in the video that a therapist moved the blocks during the AOPT conditions. Corticomotor facilitation was determined in three conditions by monitoring changes in the amplitude of motor-evoked potentials (MEPs) elicited in hand muscles by transcranial magnetic stimulation. MEP responses were measured from the first dorsal interosseous after participants attended to three conditions. For the manual dexterity, Box and Block test (BBT) was used. The results of present study were summarized as follows: MEPs amplitude significantly tended to be larger than PT and Base condition. The scores of BBT in the AOPT condition were also significantly larger than other conditions. In conclusion, this finding of present study indicates that physical training for observation of an action is beneficial for enhancing a dexterity of paretic arm in stroke patients.

The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients

  • Song, Bo-Kyung
    • The Journal of Korean Physical Therapy
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    • 제23권3호
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    • pp.71-77
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    • 2011
  • Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

Comparison of characteristics during backward walking according to various stride frequencies in underwater and ground environments

  • Kim, Heejoong;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • 제7권2호
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    • pp.83-87
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    • 2018
  • Objective: The purpose of this study was to investigate the relationship between heart rate (HR), self-awareness of exercise intensity (rating of perceived exertion, RPE), and 5-meter walk test (5MWT) of persons affected by stroke during backward walking according to the preferred stride frequency (PSF), PSF+3 and PSF+6 conditions. Design: Cross-sectional study. Methods: A total of 11 persons with stroke (9 males, 2 females) participated voluntarily. All patients underwent backward walking under the PSF, PSF+3, and PSF+6 conditions in underwater and ground environments, and each condition was performed for 5 minutes. The HR, RPE, and walking speeds were measured during walking, and the measured values from underwater and ground environments were compared. Results: The HR and RPE in the ground environment were significantly increased (p<0.05), and although the 5MWT showed an increase in speed, it was not significant. The HR and RPE in the underwater environment were also significantly increased (p<0.05), however, although the 5MWT results was increased, it was not significant. The HR and RPE were significantly increased in the PSF+6 condition (p<0.05). Conclusions: The results of this study showed that backward gait training underwater can provide an appropriate exercise intensity for stroke survivors and suggests that exercises performed in an underwater environment is more effective compared to the ground environment.

트레드밀 훈련이 뇌졸중 환자의 보행, 균형 및 체간조절에 미치는 영향 (The effect of independent treadmill training on gait, balance and trunk control in a patient with chronic stroke)

  • 윤성익;천승철;이주상;정신호;이덕성;오덕원;심재훈;이규완
    • 대한물리치료과학회지
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    • 제13권2호
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    • pp.37-45
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    • 2006
  • The purpose of this study was to determine the effect of treadmill training on gait, balance, and trunk control in a patient with hemiparesis. A female subject who had suffered a left hemiparesis 12 months previously was selected for this study. A single subject ABA design was used. Eight data-collection sessions were conducted during each of three phases (baseline-intervention-withdrawal). During baseline and withdrawal phases, the treatment based on Bobath approach was performed for the subject, and during the intervention phase, treadmill walking training was added. Assessment tools were made using the 10 m walk test, Rivermead Visual Gait Assessment(RVGA), Berg Balance Scale(BBS), and a seated Lateral Reach Test(LRT). During the intervention phase, the time measured in 10 m walk test and the scores of RVGA and BBS were significantly improved, and the number of steps in 10 m walk test and LRT showed a small improvement. During withdrawal phase, the time measured in 10 m walk test and the scores of RVGA and BBS were shown the carry-over effect. This findings indicate that treadmill training has significant effect to gait function and balance in a patient with chronic hemiparesis.

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전방머리자세를 가진 성인에서 기능성 키네시오 테이핑 적용이 컴퓨터 작업 시 전방머리 각도에 미치는 영향 (The Effect of Functional Kinesio Taping on the Forward Head Angle in Computer Work in Adults with Forward Head Posture)

  • 심용현;송형봉;김윤환;김태원;박종항
    • 대한정형도수물리치료학회지
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    • 제25권2호
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    • pp.57-64
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    • 2019
  • Background: This study was designed to identify the effect of the taping on the forward head posture during computer work. Methods: Twenty healthy adults were statistically assigned into 2 groups, the taping group (n=10) and the control group (n=10). In order to induce delayed onset muscle soreness (DOMS), twenty subjects performed isometric exercise of the neck on Bobath table for 20 minutes. During the experiment, subjects in taping group were attached Kinesio-tape on their upper trapezius. By using 2-D motion analysis, measurements were taken before taping, at 24 hour, 48 hour, and 72 hour after inducing DOMS. The effects of taping were evaluated by the angle of the head. Results: The results of this study were as follows; 1) There was no significant difference between the taping group and the control group (p>.05). 2) The control group had no significance, but the taping group shown a significance on the angle of head during computer work (p<.01). The interaction of group x period also shown a significance (p<.01). Conclusion: From these result, it was revealed that the taping therapy on upper trapezius could improve the angle of head during computer work.