• Physical Therapy Korea
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• v.28 no.1
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• pp.47-52
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• 2021

Background: Compared with normal people, stroke patients have decreased voluntary craniocervical motion, which affects their balance. Objects: This study was conducted in order to examine the effects of active craniocervical movement training using a cognitive game on stroke patient's cervical movement control ability, balance, and functional mobility. Methods: The subject of this study were 29chronic stroke patients who were randomly allocated to either an experimental, cognitive game group (n = 15), or control group (n = 14), to which only neuro-developmental treatment (NDT) was applied. The intervention was conducted 5 times per week, 30 minutes per each time, for a total of 4 weeks. Active angle reproduction test, static stability test, limits of stability test, and Time up and Go (TUG) test, respectively, were carried out in order to evaluate cervical movement control ability, static balance, dynamic balance, and functional mobility. Paired t-test was used in order to compare differences between prior to after the intervention, along with an independent-test in order to compare prior to and after-intervention differences between the two groups. Results: After the craniocervical training with a body-driven cognitive game, the experimental group showed significant differences in flexion, extension, and lateral flexion on the affected side, and rotation on the affected side in the active angle reproduction test. The experimental group indicated significant differences in sway length both with eyes-open and with eyesclosed in the static stability test and in limits of stability test and TUG test. The control group to which NDT was applied had significant differences in flexion in the active angle reproduction test and in limits of stability test and TUG test. Conclusion: The above results mean that craniocervical training using a body-driven cognitive game positively influences stroke patient's cervical movement control ability and as a result their balance and functional mobility.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.39-45
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• 2009

Purpose: The purpose of this study was to determine correlations between the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up & Go (TUG), Motor-Free Visual Perception Reach Test Vertical format (MVPT-V), Functional Independence Measure (FIM). Methods: The subjects used in this study were 35 stroke patients from Cheongju ST. Mary's hospital. Balance was measured by BBS, FRT. Functional mobility was measured by TUG. Visual perception was measured by MVPT-V. FIM was used to evaluate the activities of daily living. Data was analyzed using pearson product correlation. The TUG and MVPT-V index were analyzed by linear regression. Results: There was a statistically significant difference between FRT and BBS (r=0.89, p<0.01), FIM (r=0.74, p<0.05), MVPT-V (r=0.40, p<0.05), and TUG (r=-0.36, p<0.05). There was significant statistical differences between TUG and MVPT-V (r=-0.64, p<.01). However, statistically significant differences were observed between BBS and FIM (r=0.79, p<0.01). The visual close item of the MVPT-V showed the strongest variance in predicting TUG. Conclusion: The use of both quantitative and qualitive scales was shown to be a good measuring instrument for the classification of general clinical performances of stroke patients. In particular, the results suggest that the visual perception test may be able to predict functional locomotion in stroke patients.

• Korean Journal of Applied Biomechanics
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• v.32 no.4
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• pp.111-120
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• 2022

Objective: This study investigated the effect of pelvic tiltng according to the paralytic side on gait in stroke patients during a 10 m functional movement timed up and go (TUG) test. Method: In this study, gait parameters were measured using a gait analyzer for 20 stroke patients and their gait was analyzed during a 10 m TUG test. For statistical analysis, an independent sample t-test were performed for age, height, and weight among general characteristics of subjects and homogeneity was tested by performing a chi-square test for gender, paralysis side, period of onset, and K-MMSE score. In order to understand the relationship between each variable, Pearson correlation analysis was performed on the variables. Results: First, the right-hand paralyzed group showed correlations in cadence and gait velocity in the up and down tilt of the pelvis, and the left-hand paralyzed group showed correlations in cadence and step length in the anterior and posterior tilt of the pelvis. Second, the tilt of the pelvis was correlated with the Sit to stand, walk forward, walk backwards, turn around at the end point, sit on a chair and the total TUG time in the right hemiplegic group compared to the left hemiplegic group. Conclusion: In this study, a significant correlation was confirmed as a result of gait analysis of right-handed stroke patients divided into a right paraplegic group and a left paraplegic group. In the future, it is suggested that treatment for improving gait of stroke patients should be treated differently for the right and left paralyzed side.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.133-139
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• 2016

PURPOSE: The purpose of this study is to examine the impact of balance training on a three-dimensional balance trainer that provides the up-and-down vertical movement of the knee joint and left-and-right horizontal movement, along with visual feedback on the functional ability of children with spastic cerebral palsy (CPs). METHODS: 8 CPs participated in this study. The experiment was implemented for 40 minutes, three times a week for a total of six weeks. The subjects received general physiotherapy for 15 minutes in each session focused on balance and walking, as based on the neuro-developmental treatment theory. Balance training was performed for 20 minutes on a three-dimensional balance trainer where knee joint movement providing visual feedback is applied. The evaluations were conducted before and after the test, and posture sway was measured using 10 Meter Walking Test (10MWT), Timed Up & Go Test (TUG), and the Good Balance System to evaluate the functional ability and balance of the subjects RESULTS: 10MWT was not statistically significant (p>.05). On the contrary, TUG and postural sway indicate static balance showed a statistically significant decrease (p<.05). In a static balance test using the Good Balance System, the average moving speed statistically significantly decreased in the AP and ML directions (p<.05), and the mean velocity moment also significantly decreased (p<.05). CONCLUSION: These findings suggested that balance training using the three-dimensional balance trainer, with the features of visual feedback and up-and-down knee joint movement effects on increasing dynamic and static balance.

• PNF and Movement
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• v.16 no.1
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• pp.75-83
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• 2018

Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) exercise on the range of motion (ROM), pain, and functional activity of patients who received total knee arthroplasty (TKA). The purpose of this study was to provide fundamental data regarding the use of PNF exercise among patients with musculoskeletal disease. Methods: Fourteen patients who received TKA were randomly divided into an experimental group (n=7) that took part in PNF exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 2 weeks. For the measurement of ROM, the range of knee flexion was measured using a clinometer smartphone application. A visual analogue scale (VAS) was used for the measurement of the level of pain. The timed up and go test (TUG) was conducted to measure functional activity. A paired t-test was performed to compare within-group changes before and after the PNF exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in VAS and TUG scores in the experimental group and control group (p<0.01). There was also a significant between-group difference in VAS and TUG scores after the intervention (p<0.05). Conclusion: General rehabilitation exercise is commonly applied as a treatment for TKA patients and is relatively effective. The application of PNF exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.

• PNF and Movement
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• v.17 no.1
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• Physical Therapy Korea
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• v.21 no.4
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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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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• v.18 no.2
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• pp.195-204
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• 2020

Purpose: The study investigated the effect of combined balance exercise using visual feedback and balance pads in rehabilitation of chronic stroke patients. Methods: The participants were 30 patients diagnosed with stroke who met the study selection criteria. Participants were randomly divided into 3 groups of 10: a balance pad exercise (BPE) group, a visual feedback exercise (VFE) group, and a combined balance exercise (CBE) group. All three groups engaged in 30 minutes of exercise, 3 times per week, for 6 weeks. Results: Pre-test and post-test results were analyzed using the functional reach test (FRT), the Berg balance scale (BBS), the timed up & go test (TUG), and the Korean version of the activities-specific balance confidence (K-ABC) scale. The study yielded the following results. Pre- and post-program FRT measures showed significant differences between the BPE and CBE groups (p < 0.05). BBS, TUG, and K-ABC scores showed clear differences in all three groups. Secondly, the CBE group and the BPE group a differed significantly on the BBS before and after the 6-week program (p < 0.05). Finally, the CBE group and the VFE group differed significantly on the BBS before and after the 6-week program (p < 0.05). Conclusion: The study results indicate that combined balance exercise improves balance more effectively than the balance pad and visual feedback exercises. This finding should help to improve rehabilitation in the future.

• PNF and Movement
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• v.16 no.3
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• pp.405-414
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• 2018

Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.