• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.139-150
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• 2019

PURPOSE: This study was conducted to determine the effects of treadmill gait training with obstacle-crossing on the static and dynamic balance ability of patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into three groups as: treadmill gait training with obstacle-crossing (TOG, n=7), treadmill gait training without obstacle-crossing (TGG, n=7) and a control (CON, n=7). TOG and TGG performed exercise for 20 minutes, three times a week for 8 weeks. Static balance ability (stability typical, ST; weight distribution index, WDI; fourier harmony index, FHI; and fall index, FI) and dynamic balance ability (berg balance scale, BBS and timed up and go test, TUG) were measured before and after 8 -weeks in each exercise group. Statistical analyses were conducted using two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Tukey's HSD. RESULTS: FHI and BBS were significantly increased at TOG (p<.01) and TGG (p<.05) after 8-weeks compared to before treadmill gait training with obstacle-crossing. FHI and BBS were significantly increased at TOG compared with CON and TGG (p<.05). CONCLUSION: Treadmill gait training with obstacle-crossing was more effective than that without obstacle-crossing to improve posture control and independent daily life performance of hemiplegia patients.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.13-21
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• 2021

PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.

• Physical Therapy Korea
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• v.29 no.1
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• pp.19-27
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• 2022

Background: Foot drop is a common symptom in stroke patients. Tape applications are widely used to manage foot drop symptoms. Previous studies have evaluated the effects of static and dynamic balance and gait on foot drop using kinesiology tape; however, only few studies have used dynamic tape application in stroke patients with foot drop. Objects: The purpose of this study was to investigate the immediate effects of dynamic taping, which facilitates the dorsiflexor muscle, on static and dynamic balance and gait speed in stroke patients with foot drop. Methods: The study included 34 voluntary patients (17 men, 17 women) with stroke. The patients were randomly assigned to the experimental group (n = 17), wherein dynamic taping was used to facilitate the dorsiflexor muscle, or the control group (n = 17), wherein kinesiology taping was used. Before the taping application, velocity average, path-length average, Berg balance scale, and timed up and go test (TUG) were recorded to measure static and dynamic balance, whereas the 10-meter walk test (10MWT) was used to measure gait speed. After the taping application, these parameters were re-evaluated in both groups. Repeated measure analysis of variance was used. Statistical significance levels were set to α = 0.05. Results: Except for the 10MWT scores in the control group, significant differences were noted in all the parameters measured for static and dynamic balance and gait speed between the pre and post-test (p < 0.05). However, the parameters showed significant interaction effects between group and time in the TUG and 10MWT (p < 0.01). Conclusion: These results indicate that compared with kinesiology taping, dynamic taping used in chronic stroke patients with foot drop had a more significant effect on dynamic balance and gait speed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.57-65
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• 2022

Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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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.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.89-98
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• 2020

PURPOSE: This study investigated the effects of unilateral static stretching on the flexibility and symmetry of the lower leg, and temporal gait variables in gait asymmetry people. METHODS: Twenty gait asymmetry people were divided into a unilateral static stretching group (USG, n = 10) and control group (CON, n = 10). The USG performed unilateral static stretching for 60 minutes, three times a week, and eight weeks. The flexibility of the lower leg (SR), and symmetry (BR), and temporal gait variables (Step length; SL, gait speed; GS) were measured before, after four and eight weeks of unilateral static stretching. Moreover, SI (symmetry index; SI) was calculated from the measured SL value. Statistical analyses were conducted using one-way ANOVA and two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Scheffe. RESULTS: SR and BR in the dominant and non-dominant side, and GS were increased significantly at USG after eight-weeks compared to before unilateral static stretching (p < .05). The difference in BR in the dominant and non-dominant side, and step length (SI) decreased significantly at USG after eight-weeks compared to before unilateral static stretching (p < .05). CONCLUSION: Unilateral static stretching improves the flexibility and symmetry of the lower leg, and temporal gait variables in gait asymmetry people.

• PNF and Movement
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• v.12 no.2
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• pp.107-113
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• 2014

Purpose: The objective of this study was to identify functional problems, including walking ability, of patients with strokes using the International Classification of Functioning, Disability, and Health (ICF) and to present a method that could solve functional problems, thereby determining the applicability of the ICF to increase the quality of evaluation and intervention in clinical fields in the future. Methods: Information on stroke patients who were admitted and treated in a hospital was collected. The authors conducted evaluations, interventions, and measurements of the results of the ICF tool in order to improve gait abilities of patients. The subjects were trained using proprioceptive neuromuscular facilitation (PNF) one hour a day and five times a week for four weeks. The result measurement variables were a six-minute gait test, 10 m velocity test, gait instability test, and measurements using the ICF sheet. Results: In the six-minute gait test, gait distance increased by 48 m, from 102 m to 150 m. The gait velocity test result showed an improvement from 0.36m/s to 0.44m/s. The subjects performed a gait instabilitytestwithacupfilledwith50mmwater. In the gait instability test, the amount of water was 38 mm before the intervention; however, it was 50 mm after the intervention. The gait velocity with a cup filled with water improved from 0.25m/s to 0.31m/s. Conclusion: An evaluation and intervention were designed with the ICF tool for stroke patients. Gait abilities improved when the PNF technique was used. The IFC method can be used for evaluation and intervention, and it could help improve gait abilities of stroke patients.

• PNF and Movement
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• v.19 no.2
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• pp.261-267
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• 2021

Purpose: This study aimed to investigate changes in gait variables depending on whether a task was performed using a smartphone while walking on a ramp. Methods: The participants of this study were 41 college students attending U University located in Gyeongju City, Gyeongsangbuk-do. In this study, gait variables were measured during ramp gait while using a smartphone to perform a task and during ramp gait without performing such tasks. In other words, four walking conditions were used: 1) walking up a ramp, 2) walking up a ramp while using a smartphone to perform a task, 3) walking down a ramp, and 4) walking down a ramp while using a smart phone to perform a task. Gait variables were measured using a gait analysis tool (Legsys; BioSensics, USA), and stride time, stride length, stride velocity, cadence, and double support were analyzed. The order of measurements was randomized to control for order effects due to repeated measurements. Results: The comparative analysis of gait variables according to the presence or absence of smartphone use during ramp gait showed that there were significant differences in stride time, stride length, and stride velocity during both ramp ascent and ramp descent (p < 0.05). In both ramp ascent and ramp descent, stride time increased when walking using a smartphone, compared to when walking without using a smartphone (p < 0.05). However, in both ramp ascent and ramp descent, stride length and stride velocity were decreased when walking using a smartphone compared to when walking without using a smartphone (p < 0.05). Conclusion: The study results showed that the use of a smartphone during walking can affect safety. Therefore, it is necessary to improve the awareness of risks associated with walking while using a smartphone, and further research needs to be conducted in various environments and with different ramps.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Physical Therapy Korea
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• v.30 no.2
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• pp.92-101
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• 2023

Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.