Objective: This study aimed to compare gait ability through gait evaluations in indoor and outdoor environments according to the general characteristics and walking ability of stroke patients. Design: Crossed-sectional study. Methods: The subjects of this study were 57 hospitalized stroke patients.The study subjects were asked to select an indoor environment and an outdoor environment in random order, and the Timed Up and Go Test (TUG), 10-Meter Walk Test (10MWT), Figure-Eight Walk Test (F8WT) and the Functional Gait Assessment (FGA) were used to assess each environment. Results: The TUG, 10MWT, F8WT time and number of steps, and FGA showed a significant decrease in gait ability in the outdoor environment compared to the indoor environment (p<0.05). Although the TUG, 10MWT, and the time required for the F8WT were statistically higher in the outdoor compared to the indoor environment at points 2, 3, and 4, but not 5 of the functional ambulatory category (FAC), significant increases in the number of steps of the F8WT were found in the outdoor compared to the indoor environment for only points 2 and 3 of the FAC (p<0.05). In the FAC 3 and 4, there was a statistically significant decrease in the outdoor compared to the indoor environment only in the FGA (p<0.05). Conclusions: Therefore, it has been shown that the gait ability of stroke patients is reduced in the outdoor environment compared to the gait ability in the indoor environment.
Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.29
no.1
/
pp.93-102
/
2016
Objective : This study performed to evaluate that duration of acne scars effects on Qualitative Global Acne Scarring Grading System(QGASC) grade changing and treatment duration. Also this study performed to evaluate the relationship between dysmenorrhea and acne scars, and the effects of each treatment on treatment duration and Korean Acne Grading System(KAGS) and QGASC grade.Methods : 95 patients with acne scars were understood by medical records and case photos, and we evaluated pre and post acne scar grade based on KAGS and QGASC. We analyzed data by SPSS 22 for windows program, and figured out the relation between duration of acne and QGASC grade and treatment duration by Spearman correlation analysis, and performed Mann-Whitney U-test to figure out the relation between dysmenorrhea and QGASC grade. We performed Wilcoxon test to evaluate that treatment of acne scars effects on KAGS grade and QGASC grade, and performed Kruskal-Wallis test to figure out the difference of each treatment which effects on KAGS grade and QGASC grade, and performed Post-hoc analysis to figure out the group comparison.Results & Conclusions : QGASC grade depending on duration of acne was statistically significance. Subcision and Microneedle Therapy System(MTS) and pharmacopuncture were significantly improved acne scars. Other treatments were significantly more effective than subcision and pharmacopuncture combined treatment. Treatment duration of Subcision and MTS combined treatment was significantly most shortest than other treatment.
Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on strength, proprioception, and walking ability in persons with stroke. Design: Randomized control trial. Methods: Twenty eight subjects participated in the study in which they were randomly assigned to either the underwater backward treadmill training (UBTT) group (n=13) or the BTT group (n=15). In both groups, forward gait training was performed for 20 minutes on the ground treadmill. The UBTT group performed backward gait on an underwater treadmill for 20 minutes while the BTT group performed backward gait on a ground treadmill for 20 minutes. The gait training in each group was performed twice a week for a total of six weeks. Muscle strength, proprioception, and gait ability was assessed using a digital power meter, joint angle recurrence method using the smartphone protractor application, the Figure-of-Eight walk test (F8W) and the functional gait assessment (FGA) respectively. Results: Both groups showed significant improvement in strength, F8W and FGA scores after training (p<0.05). However, there was no statistically significant difference between the two groups. Both groups showed significant improvement in proprioception after training (p<0.05). In the comparison between the two groups, there was a greater significant change in the UBTT group for joint proprioception (p<0.05). Conclusions: In this study, it was found that both backward treadmill gait training programs were effective on strength, proprioception, and gait ability, and that underwater training was particularly effective on proprioception compared to ground training.
Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.
Journal of the Korean Society of Physical Medicine
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v.11
no.3
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pp.11-17
/
2016
PURPOSE: The aim of the present study was to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) can improve balance ability in acute stage stroke patients. METHODS: The study was conducted on 30 subjects diagnosed with hemiparesis caused by stroke. The experimental group consisted of 15 patients that underwent rTMS for 15 mins and the control group consisted of 15 patients that underwent sham rTMS (for 15 minutes). A 70-mm figure 8 coil and a Magstim Rapid stimulator was used in both groups. Patients in the experimental group received 10 Hz rTMS applied to the hotspot in the lesioned hemisphere in 10-second trains with 50-second intervals between trains, for 15 minutes (total 2,000 pulses). Both groups received conventional physical therapy for 30 minutes a day, 5 days a week, for 4 weeks. Static balance ability analysis was performed using the Gaitview system to measure pressure rate, postural sway, and total pressure, and dynamic balance ability analysis was performed to measure pressure variables using a balance system. RESULTS: A significant difference was observed in post-training gains for pressure rate, total pressure in static balance, and overall stability index in dynamic balance between the experimental group and the control group (p<.05). CONCLUSION: The results of this study indicate that high frequency rTMS may be beneficial for improving static and dynamic balance recovery in acute stroke patients.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.14
no.2
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pp.60-67
/
2008
Purpose : The purpose of this study is to investigate that the change of lower-limb muscle activity when normal gait and assistive gait of older. Methods : The selected subjects of this study were 11 older who be in good physical health and have not problem to gait and over 60 age to analyze the muscle activity. This study has been conducted to analyze the muscle activity of normal gait and assistive gait in unitary status without any contrast group. We have them gait condition of a gradient of 0% and velocity of 1km/h, 2km/h, 3km/h electrode were attached to the motor point of Rectus femoris, Hamstrings, Tibialis anterior, Calf muscle. When normal gait and assistive gait performs, there are meaningful differences that the muscle activity takes a small drop in Rectus femoris by 9.17% at 1km/h, 9.79% at 2km/h, 13.80% at 3km/h, hamstring by 14.78% at 1km/h, 17.82% at 2km/h, 17.26% at 3km/h, Tibialis anterior by 24.38% at 1km/h, 23.85% at 2km/h, 33.52% at 3km/h, Calf muscle by 13.68% at 1km/h, 16.70% at 2km/h, 18.37% at 3km/h(p<0.05). Results : They show the significant difference in statistical figure. We've received the significant through the comparison between normal gait and assistive gait. These results will be utilized for the preliminary date in the future.
Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.
This study was performed to figure out effects of stroke rehabilitation on education using isokinetic exercise on physical function recovery. It is considered isokinetic exercise will playa primary role in muscle strength, ROM of joint, and body balance recovery for stroke rehabilitation and so far can be used as a basic references to increase the health of all people. The study consisted of 42 stroke patient(21 training group, 21 control group) diagnosed as cerebral hemorrhage from Oriental Rehabilitation Department of Kyung Hee University. Upper extremity and lower extremity exercise was performed in the training group using isokinetic ergometer. The recovery of physical function(muscle strength, ROM of joint, body balance) data between the two groups were compared and ana lysed by paired t-test are as followed. 1. Muscle testing record showed increased in the strength of elbow flexion, knee flexion, knee extension, ankle extension of the training group com paired to control group(p < .05). In the measurement of ROM, however other parts of the body motion showed no significant changes, only shoulder extension of the training group was increased(p < .05). 2. Body balance increase was highly significant in all training group compaired to control group(p<001). Based on these findings, stroke rehabilitation education with isokinetic ergometer showed available effects on recovery of physical function rehabilitation program with isokinetic exercise will play a primary role in the recovery of physical function of stroke or brain injury patients as well as to promote the health of all people.
Purpose: The purpose of the present current study was to examine control of upper limb multi-joint movements with differential coordination stability. To achieve the goals of the study, torque analyses were utilized to answer questions about how torque components were differed among various elbow-wrist coordination patterns. Methods: Eight self-reported right-handed college students (3 males and 5 females, mean age=20.6 yr) were volunteered. The task required participants to rhythmically coordinate the flexion-extension motions of their elbow and wrist with coordination relationship of $0^{\circ}$, $90^{\circ}$, and $180^{\circ}$relative phases between the two joints. Mean relative phase and phase stability (standard deviation of relative phase) were computed to for analysisze of overall coordination performance. To determine the figure out characteristics of torque components in elbow and wrist joints, impulse values of muscle torque (MT) and interactive torque (IT) and MT as a percentage of cycle duration (MT-PCD) were analyzed. Results: Torque results showed that the proximal elbow joint generated motions with mainly muscle efforts regardless of coordination patterns, while the distal wrist joint adjusted the coordination patterns by changing amount of MT. Impulse analyses showed that the least stable $90^{\circ}$ pattern was performed by utilizing a similar coordination strategy of the most stable $0^{\circ}$ pattern. Conclusion: The present current study suggests that the roles of distal and proximal joints differ in order to achieve various multi-joint coordination movements. This study provides information for use in gives an idea to development of rehabilitation or training programs for to persons with an impaired upper limb motor ability.
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