• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.77-85
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• 2014

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.292-297
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• 2019

Purpose: This study examined the effects of backward walking training with task orientation on the functional walking ability of children with cerebral palsy. Methods: This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation facility with cross-over to the other intervention arm following a two-week break. For a total of 12 children with spastic hemiplegia cerebral palsy, the forward walking training group (n=6) underwent training three times a week for three weeks, 40 minutes a day, and the backward walking training group (n=6) was also trained under the same conditions. To identify the functional walking ability, variables, such as the walking speed, stride length, and step length, were measured using a walk analyzer (OptoGait, Microgate S.r.l, Italy). Results: Both groups showed significant increases in walking speed, stride length, and step length (p<0.01). The backward walking group showed more significant improvement in the walking speed from pre- to post-test (p<0.05). The gait characteristics were similar in the two groups (stride length and step length) but the walking speed in the backward walking group showed a mean difference between the positive effects higher than the forward walking group. Conclusion: Task-oriented backward walking training, which was conducted on the ground, may be a more effective treatment approach for improving the walking functions of spastic hemiplegia children than forward walk training.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.1-10
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• 2016

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.

• Physical Therapy Rehabilitation Science
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• 제6권3호
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• pp.120-126
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• 2017

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.

• 한국전문물리치료학회지
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• 제10권3호
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• pp.81-90
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• 2003

This study was conducted to assess the effects of the gait training method in incomplete spinal cord injured persons using an auto-walking machine. Persons with incomplete spinal cord injury level C or D on the American Spinal Injury Association impairment scale participated for eight weeks in an auto-walking training program. The gait training program was carried out for 15 minutes, three times per day for 8 weeks with an auto-walking machine. The foot rests of the auto-walking machine can be moved forward, downward, backward and upward to make the gait pattern with fixed on crank. The patient's body weight is supported by a harness during waking training. We evaluated the gait speed, physiologic cost index, motor score of lower extremities and the WISCI (walking index for spinal cord injury) level before the training and after the forth and eighth week of walking training. 1. The mean gait speed was significantly increased from .22 m/s at pre-training to .28 m/s after 4 weeks of training and .31 m/s after 8 weeks of training (p=.004). 2. The mean physiologic cost index was decreased from 4.6 beats/min at pre-training to 3.0 beats/min after 4 weeks and 2.0 beats/min after 8 weeks of training, but it was not statistically significant (p=.140). 3. The mean motor score of lower extrernities was significantly increased from 29.8 to 35.8 after 8 weeks of training (p=.043). 4. The mean WISCI level was significantly increased from level 10 to level 19 after 8 weeks of training (p=.007). The results of this study suggest that the gait training program using the auto-walking machine increased the gait speed, muscle strength and galt pattern (WISCI level) in persons with incomplete spinal cord injury. A large, controlled study of this technique is warranted.

• 한국운동역학회지
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• 제20권4호
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• pp.373-380
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• 2010

The purpose of this study was to evaluate the effect of balance training on gait stability. The study population included 17 male high school students who were divided into 3 groups, each of which underwent one of the following types of balance-training programs for 8 weeks: 1 foot standing on cushion foam, trunk muscle training, and inverted body position training. 0, 4, and 8 weeks, the following experiment was performed: The participants were asked to close their eyes and take 17 steps; the stability of forward and sideward movement was determined, and the direction linearity was measured. The results revealed that all the training programs caused a decrease in stride deviation and an increase in the and the stride length, thereby improving the stability of forward movement. All the programs decreased the variation in step width and were thus also effective in improving the stability of sideward movement. The inverted body position training program was considered very effective because the cross point appeared on post hoc graphic analysis after 4 weeks, and the deviation length for 10 m was low, i.e., below 4 cm. All the programs were effective with respect to direction linearity because they decreased the deviation in direction widths. The results indicate that whole-body neurocontrol training is more effective than simple muscle training and local focused balance training, although this neurocontrol training-in the form of inverted body position training-required a longer training period than did the other programs.

• 한국산학기술학회논문지
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• 제13권3호
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• pp.1153-1160
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• 2012

본 연구는 뇌졸중 환자의 보행수행을 저하시키는 발목 등쪽 굽힘근의 약화에 대해 발목 근력 강화 훈련과 정적 근육 신장 훈련을 이용하여 등쪽 굽힘을 시행한 훈련이 뇌졸중 환자의 족저압 및 보행에 미치는 영향을 알아보고자 하였다. 연구는 편마비 뇌졸중 환자 36명을 대상으로 뇌졸중 환자의 보행변수인 10m 걷기를 측정하고, 발바닥의 각 영역별 최대 족저압의 측정은 F-scan system을 사용하여 자료를 수집하여 연구하였다. 본 연구에서 각 훈련 전과 훈련 후의 보행의 변화 연구에서 발목 근력 강화 훈련군과 정적 근육 신장 훈련군은 10m 보행속도검사에서 보행속도가 감소하여 뇌졸중 환자의 보행에 좋은 영향을 미친다고 할 수 있겠다. 뇌졸중 환자 발의 압력측정에서 발목 근력 강화 훈련군 에서는 다른 그룹에 비해서 무지부, 족지부, 제1중족골두에서 최대 족저압이 증가 하였다.

• 대한물리의학회지
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• 제11권1호
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• pp.45-52
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• 2016

PURPOSE: The purpose of this study was to determine the effects of balance training on balance pad and sand on balance and gait ability in stroke patients. METHODS: Sixty stroke patients were divided into a Balance Pad group(BPG, N = 20), a Sand group (SG, N = 20) and a Hard Ground group (HGG, N = 20) randomly. The subjects in the Hard Ground group stood in a comfortable position, faced a therapist, then threw a Swiss ball back and forth. They then performed balance training in which they raised and lowered their ankles while facing forward or moved objects from one table to another. The BPG performed same tasks in HGG, on an unstable surface using a balance pad. The SG performed same tasks on sand ground. All groups received training 30min per day, five times per week, for eight weeks. RESULTS: After intervention, all groups showed significant increases balance and gait components. And the BPG and the SG showed significant increase in weight distribution rate, Sway length and BBS compared with the HGG, but there was no significant difference in Cadence, Stride length among three groups. CONCLUSION: According to the results of this study, balance training on unstable surface using balance pad and sand was more effective in improving balance in stroke patients.

• 디지털융복합연구
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• 제13권10호
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• pp.541-548
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• 2015

본 연구의 목적은 뇌졸중 환자를 대상으로 측방보행 훈련이 균형(기능적 보행 검사, 일어나 걸어가기 검사) 및 보행(10 미터 보행검사)에 미치는 영향을 알아보고자 하였다. 28명의 뇌졸중 환자를 대상으로 실험군(측방 보행군)과 대조군(전방 보행군)에 각각 14명씩 무작위로 배정하였다. 두 그룹 모두 재활 물리치료를 4주 동안 실시하였다. 실험군에는 4주 동안 1회당 20분씩 주 3회 측방보행 훈련을 실시하였고, 대조군에도 4주 동안 1회당 20분씩 주 3회 전방보행 훈련을 실시하였다. 측방보행 후 기능적 보행평가를 측정한 결과 실험군에서 16.86점에서 18.64점으로 유의하게 향상되었고(p<.05). 일어나 걸어가기 검사에서도 26.03초에서 22.43초로 감소하여 유의하게 향상되었다(p<.05). 10미터 보행검사에 있어서도 실험군에서 21.90초에서 19.10초 감소하여 유의하게 향상되었다(p<.05). 따라서 측방보행 훈련이 뇌졸중 환자의 균형 및 보행을 증진시키는데 유용한 훈련으로 제안할 수 있을 것이다.

• PNF and Movement
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• 제22권1호
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• pp.91-99
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• 2024

Purpose: Backward walking has shown positive effects on gait recovery in rehabilitation patients. It is increasingly used as an aerobic training method in rehabilitation populations, inducing more sensory and motor stimulation than forward walking. Therefore, the purpose of this study is to investigate the effects of visual stimulation during backward walking. Methods: Twenty-seven healthy adults with a visual acuity of 0.8 or higher participated in the study. To compare the effects of visual stimulation during various walking conditions among healthy individuals, the participants randomly selected cards numbered one to six and walked a distance of 10 meters. Walking ability was measured using Optogait. Results: Statistically significant differences were observed in speed, stride, and percentages of single support and contact phase during backward walking. Within eyes-closed conditions during backward walking, significant differences were found in percentages of single support, terminal stance, and contact phase. Moreover, the percentage of terminal swing significantly differed during backward walking with head turn conditions. Conclusion: Gait parameters such as speed, stride, and percentages of single support and contact phase were higher during backward walking than forward walking. These results indicate that backward walking involves multiple sensory systems and varying conditions.