• The Journal of Korean Physical Therapy
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• 제29권2호
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• pp.74-79
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• 2017

Purpose: The purpose of this study was to compare the effects of the FES-gait with augmented feedback training to the FES alone on the gait and functional performance in individuals with chronic stroke. Methods: This study used a pretest and posttest randomized control design. The subjects who signed the agreement were randomly divided into 12 experimental groups and 12 control groups. The experimental groups performed two types of augmented feedback training (knowledge of performance and knowledge of results) together with FES, and the control group performed FES on the TA and GM without augmented feedback and then walked for 30 minutes for 40 meters. Both the experimental groups and the control groups received training five times a week for four weeks. Results: The groups that received the FES with augmented feedback training significantly showed a greater improvement in single limb support (SLS) and gait velocity than the groups that received FES alone. In addition, timed up and go (TUG) test and six minute walk test (6MWT) showed a significant improvement in the groups that received FES with augmented feedback compared to the groups that received FES alone. Conclusion: Compared with the existing FES gait training, augmented feedback showed improvements in gait parameters, walking ability, and dynamic balance. The augmented feedback will be an important method that can provide motivation for motor learning to stroke patients.

• PNF and Movement
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• 제4권1호
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• pp.37-44
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• 2006

Purpose : Improved walking is a common goal after stroke. Although the neurodevelopmental intervention(PNF) is the most widely used approach in the walking training of hemiparetic subjects. There is little neurophysiological evidence for its presumed effects on gait symmetry and facilitation of paretic muscles during the therapeutic intervention. The study, therefore, investigated the immediate effects of gait entrainment by a PNF techniques. Methods : Included persons with stroke who were living in the community. Sixteen subjects were assigned to the experimental group participated in a measures design that evaluated the subjects with pre-treatment, post-treatment(8 weeks). Temporal-spatial parameter of gait were analysed for using the computerized GAITRite system. Intervention : Training for the experimental group was carried out 3 times a week for 8 weeks. The training sessions were comprised of 50 minutes of walking with pattern and techniques in PNF. Results : The experimental group had improvements in the functional walking ability after 8 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. The treatment group demonstrated significantly post-treatment test improvement in gait velocity, cadence and FAP. Post-treatment test scores were more significant than the pre-treatment score(p<0.05). Conclusion : The results of this study showed that the PNF exercise intervention can improve functional gait ability. This study provides evidence for the efficacy of PNF treatment at improving locomotor function in chronic stroke.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.280-286
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• 2019

본 연구는 발의 피로와 통증을 줄이고 발의 정상적인 기능을 유지해주는 기능적 인솔 적용 유무가 노인 보행 시 하지의 생체 역학적 변인 및 패턴에 미치는 영향을 규명하고자 하였다. 본 연구의 대상자는 10명(연령, 73.2 세: 신장, 152.1 cm: 체중, 59.4 kg)이며, 기능적 인솔 착용과 비 착용 시의 보행을 분석하였다. 보행분석은 퀄리시스 시스템 (Qualisys system)으로 촬영 후 비쥬얼 3D (Visual-3D)로 분석하였다. 그 결과, 기능적 인솔을 착용했을 경우, 보장과 유각기 속도가 유의미하게 증가하였다 (p<.05). 또한 하지의 신전 모멘트가 입각기에서 유의미하게 증가하였다 (p<.05). 본 연구 결과 기능적 인솔은 노인의 보행 안정성을 향상시는 효과가 있었다. 그러나 이 연구의 결과를 일반화하기 위해서는 더 많은 대상자들을 통해 보다 많은 정량적 자료를 축적할 필요가 있으며, 대상자들에게 오랜 시간동안 인솔을 사용하게 한 후 보행변인 및 패턴의 변화를 검토하는 연구가 추후 이뤄져야 할 것으로 판단된다.

• 대한물리의학회지
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• 제17권1호
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.55-63
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• 2021

Objective: The purpose of this study was to examine the effects of balance training with Functional Electrical Stimulation (FES) on balance and gait in patients with chronic stroke. Design: A cross over design Methods: Nine patients with stroke were recruited into this study. They were measuring their balance ability and gait ability. The intervention "A" included 4 weeks of balance training with Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Intervention "B" included 4 weeks of balance training with placebo Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Of the 9 patients who completed the study, 5 were randomly assigned to" group A-B", and 4 to group B-A. The crossover occurred after 4 weeks. Results: Following are the specific results of balance training with Functional Electrical Stimulation (FES) on patients with chronic stroke. First, patients who received treatment A showed improvement compared with patients who received treatment B in static balance. There were significant decreases in anterioposterior, mediolateral postural sway extension and velocity moment (p<0.05) with their eyes opened and closed conditions. Second, they had significantly improved in dynamic balance (p<0.05). Lastly, there were also improvement in their gait velocity and cadence (p<0.05). Conclusions: These findings suggest that, the Functional Electrical Stimulation (FES) combined with balance training more effectively improves the balance and gait ability, I'm convinced that it could be actively used in clinics added to the conventional physical therapy in the future.

• 한국산림과학회지
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• 제103권3호
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• pp.503-509
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• 2014

이 연구는 노인들을 대상으로 산림 걷기 운동이 어떻게 기능적 체력과 보행형태에 영향을 미치는지를 규명하고자 하는데 목적이었다. 본 연구를 위하여 37명의 노인들이 참여하였으며 산림 걷기 운동 집단(n=19, $66.34{\pm}4.31$세)과 실내 트레드밀 걷기 운동 집단(n=18, $67.18{\pm}2.78$세)으로 구분되어, 12주간 주에 3회 80분 씩 각각 산림 걷기 운동과 실내 트레드밀 걷기 운동에 참여하였다. 기능적 체력(근력, 지구력, 유연성, 민첩성/평형성, BMI)과 보행형태(보행박자, 보행속도, 보행안정성) 검사는 12 주간 프로그램 전과 후에 측정되었다. 자료 분석을 위하여 평균과 표준편차가 이용되었으며, 독립 t-test와 반복 이원변량분석이 이용되었다. 그 결과, 12주간의 산림 걷기 운동을 실시한 집단이 실내에서 트레드밀 걷기 운동한 집단보다 하지 근력, 허리 유연성, 민첩성/동적 평형성, 그리고 심폐지구력에서 더 크게 향상을 보였다. 그러나 상지 근력, 견관절 유연성, BMI에서는 두집단 모두 똑같은 향상을 보였다. 둘째, 12주간의 산림 걷기 운동을 실시한 집단이 실내에서 트레드밀 걷기 운동한 집단보다 보행박자, 보행속도, 보행안정성에서 더 유의한 향상을 보였다. 따라서 본 연구는 감각-운동신경의 기능적 통합에 기초한 산림 걷기 운동이 노인들의 기능적 체력과 보행형태를 효율적으로 향상시키고, 나아가서 생활을 더 역동적으로 만들며, 낙상을 예방하는 효과적인 운동방법이 될 수 있음을 제안한다.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.32-39
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• 2021

Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.

• 한국전문물리치료학회지
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• 제18권2호
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• pp.43-51
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• 2011

Balance is a complex motor skill that depends on interactions between multiple sensorimotor processes and environmental and functional contexts. Many rehabilitation specialists believe that balance assessment under multitask conditions may be a more sensitive indicator of balance problems and falls than balance assessment in a single-task context. Functional Gait Assessment has many tasks that allow for testing under multitask conditions. The purpose of this study was to determine the concurrent validity between the Functional Gait Assessment (FGA), Berg Balance Scale (BBS), and Timed "Up & Go" Test (TUG) in patients with stroke. One hundred and five participants with at least 3 months post stroke and able to walk at least 6 m with or without a mono cane, participated in this study. Concurrent validity between the FGA, BBS, and TUG was assessed using Spearman rank order correlation. The FGA correlated with the BBS (r=.80, p<.01) and TUG (r=-.77, p<.01). The good and moderate correlation between the FGA, BBS, and TUG establishes the concurrent validity of the FGA in patients with stroke. These measures provide clinicians with valuable information about patients' functional balance capabilities.

• The Journal of Korean Physical Therapy
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• 제22권1호
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• pp.39-45
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• 2010

Purpose: The purpose of this study was to examine changes in functional assessment measures (FAMs) and spatiotemporal gait parameters (STGPs) in healthy older adults before and after a 6-week intervention of a proprioceptive neuromuscular facilitation (PNF) training program. Methods: Thirty healthy older adults (mean age: $73.37{\pm}1.21$ age range: 65-79) were randomly assigned either to an experimental group (participating in a 6-week intervention of PNF training) or a control group (only performing daily activities). Participants in the control group did not receive any training program. Performance was assessed by recording changes in the FAMs and STGPs using functional assessment tools and GAITRite. Results: Participants in the PNF group showed significantly improved functional assessment measures and increased stride length, cadence, velocity, and step width (p<0.05). No significant differences in FAMs and STGPs were found in the control group (p>0.05). Conclusion: Participation in a PNF training program improves FAMs and STGPs, thereby increasing the ability of healthy older adults to maintain dynamic balance during functional performance and gait. These findings support the use of PNF training programs as effective fall-prevention programs for the elderly.

• The Journal of Korean Physical Therapy
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• 제36권1호
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• pp.33-38
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• 2024

Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.