The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance ($R^2$=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.
The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.
Journal of The Korean Society of Integrative Medicine
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v.9
no.2
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pp.1-12
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2021
Purpose : We aimed to determine whether improvements in balance, gait, and motor function were different when the same exercise was performed, with and without mirror therapy, by patients with subacute stroke using the affected and unaffected lower limbs. Methods : Eight patients with subacute stroke were randomly divided into experimental groups 1, 2 and the control group. A mirror therapy program was performed with group 1 using the unaffected lower limb and group 2 the affected lower limb. The exercise lasted 30 min per session, five times weekly, for 4 weeks. The control group did not perform the exercises. BT-4, BBS, POMA, 10MWT, and BRS were used to evaluate balance, gait, and motor function before and after the intervention. Results : Post-intervention analysis showed that all three groups had higher BBS scores. After training, the postural sway in groups 1 and 2 decreased in the post eye opened and closed positions; that of the control group increased. The scores of two subjects in group 1 increased by 4 and 5 points in POMA, resulting in significant changes compared to those in the other groups. No group showed significant results in 10MWT. BRS improved in all subjects in group 1 from BRS 2 to 1 and in only one subject in group 2 there was no change in the control group. Conclusion : Static and dynamic balance and significant results are noted in POMA, BBS, but not gait velocity. Therefore, mirror therapy seems to show a positive change in subacute patients, but the research results are not clear and the difference between groups is unknown due to the small number of subjects. The effects of mirror therapy and exercise therapy should be compared using more subjects in future.
Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.
Control of a biped robot which has compliant ankle joints is dealt in this paper. Simulated version of a human ankle joint is built using springs and mechanical constraints, which gives a flexibility of joint and compliance against the touching ground. The biped robot with compliant ankle joints proposed here gives a good contact between its sole and the ground and makes foot landing soft. As a result, installing force sensors for measuring the center of gravity of the biped becomes easier. A motor to drive an ankle joint is not needed which makes legs light. However, the control problem becomes more difficult because the torque of the ankle joint to put the biped in a desired walking gait cannot be provided from the compliant ankle joint. To solve this problem, we proposed a dynamic gait modification method by adjusting the position of a hip joint. Simulation results for the mathematical model of the SD-2 biped in the Ohio State University are given to show the validity of the proposed controller.
Ceruloplasmin (Cp) is a copper protein with important functions in iron homeostasis and in inflammation. Cp mRNA expression is induced by interferon (IFN)-${\gamma}$ in U937 monocytic cells, but synthesis of Cp protein is halted after about 12 h by transcript-specific translational silencing. The silencing mechanism requires binding of a 4-component cytosolic inhibitor complex, IFN-gamma-activated inhibitor of translation (GAIT), to a defined structural element (GAIT element) in the Cp 3'-UTR. Translational silencing of Cp mRNA requires the essential proteins of mRNA circularization, suggesting that the translational inhibition requires end-to-end mRNA closure. These studies describe a new mechanism of translational control, and may shed light on the role that macrophage-derived Cp plays at the intersection of iron homeostasis and inflammation.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2018.05a
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pp.576-579
/
2018
Purpose : This study was conducted to evaluate the effects of an action-observational task oriented training on balance and gait ability of patients with chronic stroke. Method : The subjects of this study were 30 patients with chronic stroke who agreed to participate and were picked up. Participants were randomly divided into equal groups; namely, an experimental group that underwent action-observational task oriented training for at least 30 minutes/day for 6 weeks and a control group that underwent general task-oriented training. Patients' balance was assessed using the Sway Length(SL), Sway Area (SA) and Limit of Stability (LOS) test. In addition, gait ability was assessed using the 10 Meter Walking Test (10MWT). Gait time and speed taken to walk 10 metres were used to examine gait ability. Result : There were significant improvements in the subscales of the balance and gait ability test of those who participated in the action-observational task oriented training, while the control group showed no significant changes. Conclusion : Therefore, Action-observational training effectively improved the balance and gait abiltiy in patients with chronic stroke.
This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; $n_1=14$) and a group to receive RAS using a metronome only (the control group; $n_2=14$). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients' gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at ${\alpha}=.05$. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients' gait.
The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with mirror therapy on balance and gait ability in chronic stroke patients. Thirty-five subjects who met the inclusion criteria were randomly allocated into three groups: the functional electrical stimulation with mirror therapy group(FMT group, n=11), mirror therapy group(MT group, n=12), and control group (n=12). The exercises were conducted for 30 min per day, five, per week for four weeks. Balance and gait ability were examined at baseline and after 4 weeks of intervention. After training, the FMT group showed significant improvement in berg balance scale (BBS), center of pressure (COP) length, affected step length (ASL), Cadence and average gait speed (AGS) compared MT group and control group(p<0.05). This findings show that FES and MT convergence can be an effective intervention for stroke patients balance and gait ability. Continued development of convergence interventions for stroke patients with balance and gait ability in practice, are suggested.
Purpose: This study examined the effects of taping therapy on the balance and gait of stroke patients. Methods: The subjects of this study were 30 stroke patients. The treatment groups were prescribed a combination of taping, therapy applied simultaneously to the ankle and the hip joint, and general physical therapy twice a day for 30 minutes each, five days per week for 4 weeks for a total of 40 times. The control group was treated with general physical therapy for 30 minutes, 5 times per week for 4 weeks, and total 40 times. All subjects were followed up on a Berg balance scale, timed up and go test, activity-specific balance confidence scale, and GaitRite. Results: The group that simultaneously received taping therapy to the ankle and hip joint showed more significant effects than the group treated with ankle joint taping only (p<0.05). Effects were noted in the Berg balance scale, timed up and go test, activity-specific balance confidence scale and gait ability test. Compared to the control group, the group treated at the ankle and hip joint showed significant effects after the experiment in the Berg balance scale, timed up and go test, activity-specific balance confidence scale, and gait ability test (p<0.05). Conclusion: Taping therapy applied to both the ankle and hip joints, and combined with general physical therapy appears to be effective in patients with chronic stroke who have an impaired balance and gait ability.
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