• PNF and Movement
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• 제16권1호
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• pp.93-103
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• 2018

Purpose: The aim of this study was to investigate the effect of goal-oriented side walking training on balance and gait in chronic stroke patients. Methods: This study involved 18 chronic stroke patients who were divided into an experimental group (n=9) and a control group (n=9). The experimental group performed goal-oriented side walking training, and the control group performed general side walking training. The walking variables assessed were walking speed, stride length, and 10-m walking time. The balance variables assessed were foot pressure, timed up and go test (TUG), and Berg balance scale (BBS). These variables were measured before and after the exercise. Wilcoxon's signed-rank test was used to compare the participants' performances before and after the intervention in both groups. The Mann-Whitney U test was conducted for between-group comparisons after the intervention. Statistical significance was set at ${\alpha}=0.05$ Results: Walking speed, stride length, 10-m walking time, TUG, and foot pressure were significantly improved in both groups after the exercise (p<0.05). The between-group comparison showed a significant improvement in the goal-oriented side walking group (p<0.05). However, there were no significant between-group differences in 10-m walking times (p>0.05) and BBS (p=0.05). Conclusion: The results revealed that goal-oriented side walking training was effective in improving the balancing and walking ability of chronic stroke patients.

• 대한물리의학회지
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• 제17권4호
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• pp.133-139
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of a group exercise program with competitive games on balance in chronic stroke patients. METHODS: The subjects were chronic stroke patients living at home after their discharge from the hospital. A total of 32 subjects were divided into two groups. The experimental group performed a group exercise program with competitive games, and the control group performed individual exercises. The exercise program duration was one hour, and it comprised 10 minutes of stretching, 40 minutes of the main exercise, and 10 minutes of stretching at the end. The experimental group was divided into two teams of 8 players each and played competitive games (transfer a gym ball to another person, relay 10 m walking and return, transfer an object to the next person using both arms while sitting). The control group performed an arm/trunk exercise for 15 minutes and gait training for 25 minutes. These exercises were conducted twice a week (4 weeks). The Berg Balance Scale (BBS) and timed up-and-go (TUG) tests were performed to confirm the change in balance. RESULTS: In the experimental group, BBS showed a significant increase (p < .05) and TUG showed a significant decrease (p < .05). In the control group, there was no statistically significant change in the BBS. However, the TUG showed a significant decrease (p < .05). The BBS and TUG both showed statistically significant differences (p < .05) in the between-group comparison of the change in pre-post intervention values. CONCLUSION: A group exercise program with competitive games to improve the balance ability for fall prevention in chronic stroke patients could be used as a good intervention method.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• 한국융합학회논문지
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• 제11권5호
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• pp.253-260
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• 2020

본 연구의 목적은 시각적 되먹임 발목관절 운동 이후 기능적전기자극치료가 만성 뇌졸중 환자의 균형능력 및 보행능력에 대한 영향을 알아보기 위함이다. 선정기준에 따라 만성 뇌졸중 환자를 22명을 대상으로 두 군으로 실시하였다. VFAF군은 시각되먹임 발목관절운동 이후 기능적전기자극치료(n=11), CON군(n=11)은 보존적 물리치료를 시행하였다. 훈련은 1일 60분, 1주 5번, 총 8주간 시행하였다. 중재 전·후에 균형과 보행능력을 검사하였다. 훈련결과 VFAF군이 COP, LOS, BBS, FRT, 10m WT에서 CON군에 비해 통계학적으로 유의한 차이를 보였다. 그러므로 시각적 되먹임 발목관절 운동 이후 기능적전기자극치료의 융합은 뇌졸중 환자의 균형능력 및 보행능력의 향상을 위한 효과적인 중재로 임상에서 활용 될 수 있으며, 향후 졸중 환자를 위한 융합중재개발이 요구된다.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.18-27
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• 2014

The purpose of this study was to examine the effects of dual-task training (cognitive and exercise tasks) on the balance and gait performance of chronic stroke patients. Eighteen subjects with chronic stroke were divided equally into two groups, an experimental group and a control group. Subjects in both groups participated in an exercise program, performing the same tasks, for 45 minutes per day, three times per week for four weeks. The experimental group also performed additional cognitive task. The experimental group showed a more significant improvement than the control group on the Berg Balance Scale, the Timed Up and Go Test, the Korean Activities-Specific Balance Confidence Scale, and the Functional Gait Assessment (p<.05). The cognitive task error rates in the final week were significantly less than in the first week in the experimental group (p<.01). These results suggest that dual-task training for chronic stroke patients is effective in improving balance, gait, and cognitive abilities.

• 대한물리의학회지
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• 제8권2호
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• pp.175-182
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• 2013

PURPOSE: The purpose of this study was to investigate the effects of task oriented ADL exercise in different environments in patients with chronic stroke. METHODS: A total of 28 patients with hemiplegia resulting from stroke were included in this study. The patients were randomized into two groups. The control group(n=14) was received neurodevelopment therapy + task oriented ADL exercise and experimental group(n=14) was received neurodevelopment therapy + home based task oriented ADL exercise for 30 minutes twice per week during 6weeks. A task oriented ADL exercise pretest and postest design was used examine the change of FIM(Functional Independent Measure) and K-MBI(Korea-Modified Bathel Index) at the completion of 6 weeks task oriented ADL exercise. RESULTS: After 6 weeks, the experimental group compared with control group showed a significant improvement (p<.05) in FIM and K-MBI scores. CONCLUSION: The results indicate that the home based task oriented ADL exercise improves functions in the persons with chronic stroke.

• 대한통합의학회지
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• 제6권2호
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• pp.1-16
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• 2018

Purpose : This meta-analysis was aimed at guiding future research in stroke treatment and to provide real-world data relating to the effects of aquatic exercise therapy on balance in patients with chronic stroke. Methods : We performed a meta-analysis comprising 22 studies involving aquatic exercise therapy performed between 2006 and 2017. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publishing bias. Results : The mean effect size was 0.563. The effect size by outcome was observed to be the largest for the functional reach test, followed by the Berg balance scale, balance equipment, the Timed Up and Go test and one leg standing. Meta-regression analysis showed that effect size increased with an increase in the duration, number, length of exercise session. Conclusion : Aquatic exercise therapy appears to show a moderate effect on balance in patients with chronic stroke. A meta-analysis is warranted for further research to determine the effects of aquatic exercise on walking, muscle strength, and range of motion.

• The Journal of Korean Physical Therapy
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• 제21권1호
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• pp.19-25
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• 2009

Purpose: We investigated the changes that effects of load stimulation (LS) on static balance and muscle activities in normal healthy elders and chronic stroke patients. Methods: Subjects were instructed twenty normal healthy elders (8 men and 12 women) and ten chronic stroke patients (4 men and 6 women). They were tested while standing on a force platform under two conditions; LS, no LS were applied in random order. Prior to testing, adhesive surface EMG electrodes were fastened to the skin overlying the right (non-paralytic side in stroke patient) bellies of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles. They were assessed on postural sway and %MVC (Maximum voluntary contraction) of TA and LG. Results: Participants showed that the application of LS brought about a decrease in postural sway as expressed by average sway path and velocity. %MVC of TA and LG were increased. The application of LS to normal and stroke patients decreases postural sway during quite stance. Conclusion: These findings the application of LS to normal and stroke patients improves static balance.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.10-20
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• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.