• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.145-151
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• 2022

Purpose : Stroke patients exhibit abnormal walking patterns such as slow walking speed and asymmetrical walking values. The recovery of symmetrical walking in the stance phase using a treadmill means improvements in walking speed and asymmetrical walking. The purpose of this research was to investigate the effect of unilateral step treadmill training (USTT) on gait speed and the recovery of symmetrical walking in chronic stroke patients. Methods : Fifteen patients (11 men and 4 women) with chronic stroke participated in this study. The 10-meter walk test (10MWT) and GAITRite system were used to determine the intervention-related changes in gait speed and symmetrical walking values such as non-paretic step length (NSL), non-paretic step time (NST), paretic single-support time (PSST), step length asymmetry (SLA), and step time asymmetry (STA) after USTT. All participants completed USTT and underwent measurements at 3 different times: at pretest, posttest, and the follow-up test. Repeated-measures analysis of variance was used to compare walking speed and asymmetrical walking values. The statistical significance level was set at p<.05. Results : Walking speed by 10MWT (p<.05) showed significant improvements after USTT as follows: at pretest and posttest (p<.05), posttest and follow-up test (p<.05), and pretest and follow-up test (p<.05). Recovery of symmetrical walking patterns such as NSL (p<.05), NST (p<.05), and SLA (p<.05) were observed after USTT. However, no significant improvements were found in PSST (p>.05) and STA (p>.05) in symmetrical gait. Conclusion : This study suggests that USTT may have a positive effect on walking speed and symmetrical walking patterns in chronic stroke patients. Thus, this study contributes to the existing knowledge about the usefulness of USTT for the effective management of patients with chronic stroke. Further studies are needed to generalize these findings.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.221-230
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• 2023

Purpose : This study was performed to evaluate the effects of virtual reality combined robot assist gait training (VRG) on improvement of balance and respiratory function in chronic stroke patients. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 35 chronic stroke patients. They were randomly allocated 2 groups; VRG group (n=18) and conservative treatment group (CG; n=17). The VRG group received 30 minutes robot assisted gait training combined virtual reality training, robot assisted gait training was conducted in parallel using a virtual reality device (2 sessions of 15 minutes in a 3D-recorded walking environment and 15 minutes in a downtown walking environment). In the conservative treatment group, neurodevelopmental therapy and exercise therapy were performed according to the function of stroke patients. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome balance and respiratory function were measured by a balance measurement system (BioRescue, Marseille, France), Berg balance scale, functional reach test for balance, Spirometry (Cosmed Micro Quark, Cosmed, Italy) for respiratory function Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximum expiratory volume (PEF) were measured according to the protocol. The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in balance and respiratory function during intervention period. VRG revealed significant differences in balance and respiratory function as compared to the CG groups (p<.05). Our results showed that VRG was more effective on balance and respiratory function in patients with chronic stroke. Conclusion : Our findings indicate that VRG can improve balance and respiratory function, highlight the benefits of VRG. This study will be able to be used as an intervention data for recovering balance and respiratory function in chronic stroke patients.

• Physical Therapy Korea
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• v.12 no.4
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• pp.1-6
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• 2005

Community-based group exercise programs for people with chronic stroke are relatively uncommon in Korea. In addition, it is currently not known whether a community-based group exercise program is effective or not. The purpose of this study was to evaluate an 8 week community-based functional exercise program for its effects on balance performance and occupational performance in persons with chronic stroke. Twenty-five community-dwelling individuals with stroke participated in this program. Outcome of the program was assessed by the Berg Balance Scale and the Canadian Occupational Performance Measure (COPM). The functional exercise program lasted for eight weeks, with a 1-hour program twice per week and it consisted of mobility, stability, balance, functional strength, and gait training. The subjects were trained by one physical therapist but were under one-to-one supervision from students. The data of sixteen individuals who scored more than 24 on the Mini-Mental State Examination (MMSE) were analyzed. There was a significant effect both in terms of the COPM Performance Score & the Satisfaction Score (p=.002) and with the Berg Balance Score (p=.001). It was found that a short-term community-based exercise program could improve both performance of activities and balance. Further, all subjects reported that they were satisfied with this program.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.11-21
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• 2017

PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p<.05). Post hoc test results differed significantly in the 10-meter walk test after intervention (p<.05). However, there were no significant differences in limits of stability test after intervention (p>.05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

• Journal of Korean Physical Therapy Science
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• v.24 no.3
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to investigate the effects of virtual reality based treadmill training on muscle architecture of gastrocnemius in chronic stroke patients. Methods: Thirty chronic stroke patients were randomly assigned to either the virtual reality based treadmill training (VRTT) group (n=15) or treadmill training (TT) group (n=15). Both groups participated in a standard rehabilitation program; in addition, the VRTT group participated in virtual reality based treadmill training for 30 minutes per day, three times per week, for 6 weeks, and TT group participated in treadmill walking training for 30 minutes per day, three times per week, for 6 weeks. Ultrasound image was used for measurement of pennation angle and muscle thickness of the medial gastrocnemius muscle at rest and during maximum voluntary contraction. Results: In the paretic side medial gastrocnemius muscle, greater improvement on the pennation angle and muscle thickness while resting and maximal voluntary contraction were observed in the VRTT group compared with the TT group. Conclusion: Findings of this study demonstrated that the virtual reality based treadmill training has an effect on muscle architecture of medial gastrocnemius in chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.345-350
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• 2015

Purpose: This study was conducted to determine the effects of ankle joint position during closed kinetic chain (CKC) exercise on knee extensor strength and balance in patients with chronic stroke. Methods: Sixteen patients with chronic stroke participated in the study. Participants were randomly assigned to two groups: $15^{\circ}$ ankle joint plantar flexion group (n=8) and ankle joint neutral group (n=8) during CKC exercise. All participants underwent conventional physical therapy for 30 minutes. In addition, the experimental group ($15^{\circ}$ ankle joint plantar flexion group) and control group (ankle joint neutral group) participated in a 20-minute CKC exercise program. In both groups exercise was performed three times a week for four weeks. Outcomes including knee extensor strength and balance ability (Five times sit-to-stand test, Timed up and go test, and Balancia) were measured before and after exercise. Results: Significant differences in knee extensor strength and balance ability were observed between pre- and post-exercise in all groups (p<0.05). The improvement of knee extensor strength and dynamic balance was significantly higher in the experimental group than in the control group (p<0.05). Conclusion: These findings demonstrated that $15^{\circ}$ ankle joint plantar flexion during closed kinetic chain exercise is effective in improvement of knee extensor strength and dynamic balance in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.146-150
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• 2018

Purpose: This study aimed to investigate the effect of active vibration exercise on trunk muscle activity, balance, and activities of daily living in patients with chronic stroke. Methods: Twenty-four patients with chronic stroke were randomly assigned to an experimental (n=12) or a control (n=12) group. The experimental group performed an active vibration exercise workout for 20 minutes a day five times a week for 4 weeks using a flexi-bar. Trunk muscle activity was measured using surface electromyography. Balance was measured using the Berg balance scale. Activities of daily living were measured using the functional independence measure. Results: The intragroup comparison showed significant differences in the rectus abdominis, internal oblique, and external oblique muscle activity values, Berg balance scale score, and functional independence measurement values in the experimental group. The intergroup comparison showed that differences in the rectus abdominis and internal oblique external oblique muscle values, Berg balance scale score, and functional independence measurement value for the experimental group were significantly related to those in the control group. Conclusion: Based on these results, this study proved that the active vibration exercise effectively improved trunk muscle activity, balance, and activities of daily living in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.334-340
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• 2016

Purpose: This study was conducted to investigate the effects of skater exercise on cardiopulmonary fitness and balance function in patients with mild chronic stroke. Methods: A total of ten chronic stroke patients with mild neurologic deficits were recruited. The participants were divided into two groups, a skater exercise (n=5) and a control group (n=5). Skater exercise was performed by physical therapists in the experimental group, whereas patients in the control group conducted self-exercise. One session of the intervention was carried out for 30 minutes, three times per week for eight weeks. Cardiopulmonary function, falling index, and Euro-Quality of Life-5 Dimension (EQ-5D) were measured before and after the intervention. Results: No side effects were reported during and after skater exercise intervention. The peak aerobic capacity, falling index, and EQ-5D improved significantly in the experimental group compared with the control group after eight weeks of skater exercise (p=0.002, p=0.010, and p=0.006). Significant relationships were identified between the change in EQ-5D and peak aerobic capacity (R2=0.75, p=0.002)/falling index (R2=0.65, p=0.002). Conclusion: Skater exercise was an effective physical therapy to improve cardiopulmonary fitness and balance function in patients with mild chronic stroke.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.27-34
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• 2016

Background: The purpose of this study was to investigate the immediate effects of neuro-dynamics technique (NDT) to the balance and gait for chronic stroke patients. Methods: This study was composed of the cross-sectional design. Nine patients with chronic stroke applied to NDT. Balance ability function was measured using the Good Balance System device for static balance, timed up and go test (TUG) and functional reach test (FRT) for dynamic balance. The 10 meter walk test (10MWT) and GAITRite device were used for measurement of gait ability for patients. Results: There were significant improvements were observed on dynamic balance ability (p<.05) and gait ability function (p<.05). Conclusions: This research shows that the NDT is immediate effective on dynamic balance and gait ability of the chronic stroke patients. Further studies may be needed to continuously intervention of NDT for more patients.

• Physical Therapy Korea
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• v.19 no.1
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• pp.86-93
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• 2012

The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.