• 대한물리의학회지
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• 제13권2호
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• pp.43-51
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• 2018

PURPOSE: Stroke patients have limited ankle range of motion and balance problems. The purpose of this study was to determine the effects of Kaltenborn orthopedic manual therapy, Evjenth-hamberg stretching, and combination of both on ankle dorsiflexion range of motion and dynamic balance ability in stroke patients. METHODS: Thirty patients were placed in three groups, each of which received different treatments: Kaltenborn orthopedic manual therapy (15 mins), Evjenth-hamberg stretching (15 mins), or Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching (30 mins). Each group received three exercise sessions per week during four weeks. To determine its effectiveness of interventions an evaluation was carried out. ankle dorsiflexion range of motion was gauged using a tiltmeter application, and dynamic balance ability was measured using the Berg balance scale. RESULTS: All groups revealed significant improvements in ankle dorsiflexion range of motion, Berg Balance Scale (BBS) score before and after the intervention, and Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching group showed a significant improvement in ankle dorsiflexion range of motion and BBS score in comparison to other groups. CONCLUSION: We found out that each individual method was effective in ankle dorsiflexion range of motion, dynamic balance ability in stroke patients, and the combined method was more effective.

• The Journal of Korean Physical Therapy
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• 제30권5호
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• pp.159-165
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• 2018

Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

• PNF and Movement
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• 제14권2호
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• pp.67-74
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• 2016

Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.

• 디지털융복합연구
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• 제14권1호
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• pp.285-290
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• 2016

본 연구는 뇌졸중 환자의 상지 재활에 사용되는 컴퓨터-인간 연동을 이용한 가상현실 기반 훈련 프로그램 중재의 효과를 알아보고자 하였다. 2015년 2월까지 Medline 데이터베이스에서 뇌졸중 환자의 상지 재활을 위한 가상 현실 중재를 다루는 무작위 대조군 임상 연구들을 검색하였다. PEDro 스케일이 연구의 질을 사정하기 위해 사용되었다. 선정된 8개의 연구가 분석되어졌다. PEDro 스케일은 5 부터 8/10까지 다양했다. 모든 연구들은 가상현실 기반 훈련 그룹에서 상지 기능 회복에 유의한 결과를 보였다. 본 연구는 뇌졸중 환자의 상지 회복을 위해 사용되는 가상 현실 기반 훈련 프로그램의 적용이 다양하고 예측할 수 없는 실행으로 구성된 과제 지향적이고 점진적인 학습을 제공함을 통해 특히 배움에 효과가 있음을 보여주었다. 본 연구에서는 가상현실 훈련 프로그램을 뇌졸중 환자의 상지 기능 재활에 탁월한 학습 효과를 기대할 수 있으며 과제-지향과 등급화된 학습을 제공하는데 효과적이다.

• PNF and Movement
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• 제14권1호
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• pp.33-39
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• 2016

Purpose: The purpose of the present study was to examine the effects of the simultaneous application of the combination of isotonics (CI) in proprioceptive neuromuscular facilitation (PNF) and sport taping on the pain and grip strength of patients diagnosed with lateral epicondylitis among H badminton club members and to provide intervention methods for lateral epicondylitis. Methods: The subjects included 10 patients diagnosed with lateral epicondylitis. The CI technique in PNF as well as sport taping were applied to the subjects five times per week for two weeks. The visible analogue scale (VAS) was used to measure decreasing changes in pain, and a grip dynamometer was used to measure grip strength (GS). Paired sample t-tests were conducted to compare values measured before and after the experiment in order to determine differences. Results: The intensities of pain of the experimental groups changed significantly between the times before and after the experiment (p<0.05), and grip strength also changed significantly from the time before after the experiment (p<0.05). Conclusion: When the CI technique of PNF as well as sport taping were applied to patients with lateral epicondylitis, the patients showed significant improvements in pain and grip strength. Since the intervention had quite positive effects on the subjects that complained of lateral epicondylitis by reducing their pain and increasing their grip strength, studies of efficient exercise interventions will be continuously conducted to propose the development of intervention programs.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

• 디지털융복합연구
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• 제11권10호
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• pp.549-556
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• 2013

본 연구는 만성 뇌졸중으로 인한 편마비 환자를 대상으로 런지자세에서 자가신장과 움직임을 동반한 가동술을 적용후에 하지근육 근활성도와 안정성한계에 미치는 영향을 알아보는데 있다. 대상자 16명을 무작위 추출하여 실험군과 대조군으로 분류하였다. 실험군은 런지자세에서 자가신장을 중재하였고, 대조군은 런지자세에서 움직임을 동반한 가동술을 중재하였다. 중재는 8주 동안 주 5회, 1회 20분의 중재를 시행하였다. 통계학적 처리는 반복 측정분산분석을 이용하여 실시하였다. 결과는 실험군과 대조군의 그룹간 하지근육 근활성도(%MVIC)와 안정성 한계(LOS)는 통계학적 유의성이 없었다(p>.05). 하지만 실험군과 대조군의 그룹 내의 근활성도와 안정성 한계는 통계학적으로 유의하였다(p<.05). 따라서 뇌졸중으로 인한 편마비 환자들에게 런지자세에서 자가신장이 근력 및 균형에 긍정적인 영향을 줄 수 있을 것으로 생각된다.

• PNF and Movement
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• 제17권3호
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• pp.369-378
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• 2019

Purpose: This study investigated the effects of virtual reality-based task training (VRBTT) using a smart glove on upper extremity function and activity of daily living in stroke patients. Methods: Twenty-nine patients with chronic stroke disease were randomly allocated to two groups: the VRBTT group (n=14) and the control group (n=15). All patients received 30 minutes of standard occupational therapy, 5 times a week, for 8 weeks. The VRBTT group performed an additional 30 minutes of virtual reality-based rehabilitation training, 5 times a week, for 8 weeks. Results: Both groups showed significant improvements in upper extremity function, yielding an increase in FMA and K-WMFT (p<0.05). There was a more significant increase in the VRBTT group before and after interventions (p<0.05). There was no significant difference in MAS for the control group (p>0.05); however, there was a significant increase for the VRBTT group (p<0.05). In the activities of daily living, there was a significant difference in the values for K-MBI (p<0.05). In addition, both groups showed a significant increase for K-MBI and K-RNLI (p<0.05). Conclusion: This study showed that VRBTT using smart gloves can have a more positive effect on upper extremity function and activities of daily living in stroke patients than conventional intervention methods. A variety of virtual reality-based contents and glove-shaped wearable devices will help stroke patients in rehabilitation clinics recover and return to society.

• 대한물리의학회지
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• 제10권2호
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• pp.17-27
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• 2015

PURPOSE: The purpose of this study was to compare the effects of three interventions (intervention by passive range of motion exercise plus manual cervical traction, Mulligan's joint mobilization, and strengthening exercises) after Kaltenborn's joint mobilization on the cervical spine alignment, and muscle activity in patients with a forward head posture. METHODS: The subjects were 39 students from H University in Chungnam and C University in Jeonbuk. The subjects in each group attended training sessions three times a week for four weeks. We used one-way ANOVA and Scheffe's post hoc test to compare values between groups, and used paired t-test to compare the values of the dependent variables within groups. RESULTS: The results showed that the active intervention group experienced a significant increase compared to the passive intervention group in terms of the craniovertebral angle, cervical lordosis angle, and had significant decreases compared to the passive intervention group in terms of the upper trapezius muscle activity. The active intervention group also had significant increases in craniovertebral angle and decreased anterior scalene muscle activity than the active-assistive intervention group. The active-assistive intervention group had significant decreases compared to the active intervention group in terms of the serratus anterior, levator scapulae, and splenius capitis muscle activity. CONCLUSION: It appears that the subjects with a forward head posture had significant improvements in the cervical lordosis angle, cranial rotation angle, craniovertebral angle, and muscle activity after intervention by Mulligan's joint mobilization (active-assistive intervention component) and strengthening exercises (active intervention component) after applying Kaltenborn's joint mobilization.

• Physical Therapy Rehabilitation Science
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• 제7권2호
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• pp.88-93
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• 2018

Objective: Elevated cholesterol levels contribute to changes of the arterial endothelial permeability. Hyperlipidemia promotes atherosclerosis and is associated with an increased risk of stroke incidence. The purpose of this study was to investigate the effects of having a history of hyperlipidemia prior to a stroke incidence on postural balance, anticipatory dynamic postural control, gait endurance and gait performance in individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Fifty-two adults who were diagnosed with stroke 6 months ago or more were enrolled in this study. They were divided into two different groups according to hyperlipidemia history before stroke. All participants were assessed with the Activities-specific into Balance Confidence (ABC) scale, Berg Balance scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go test (TUG), and the 6-minute walk test (6MWT). An independent t-test was used to analyze the difference between the hyperlipidemia group and non-hyperlipidemia group. Results: After analysis, the BBS, TUG, and 6MWT scores were significantly different between the hyperlipidemia and non-hyperlipidemia group, but not the ABC and DGI scores. Conclusions: The results of this study show that having a history of hyperlipidemia before stroke affects static and dynamic postural balance performance, anticipatory dynamic postural balance, and gait endurance in individuals with chronic hemiparetic stroke. Based on the results of this study, we also suggest treatment for hyperlipidemia should be implemented throughout the therapeutic interventions, such as pharmacological or exercise programs, in order to restore the physical function of stroke survivors.