• 대한물리의학회지
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• 제17권4호
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• pp.133-139
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of a group exercise program with competitive games on balance in chronic stroke patients. METHODS: The subjects were chronic stroke patients living at home after their discharge from the hospital. A total of 32 subjects were divided into two groups. The experimental group performed a group exercise program with competitive games, and the control group performed individual exercises. The exercise program duration was one hour, and it comprised 10 minutes of stretching, 40 minutes of the main exercise, and 10 minutes of stretching at the end. The experimental group was divided into two teams of 8 players each and played competitive games (transfer a gym ball to another person, relay 10 m walking and return, transfer an object to the next person using both arms while sitting). The control group performed an arm/trunk exercise for 15 minutes and gait training for 25 minutes. These exercises were conducted twice a week (4 weeks). The Berg Balance Scale (BBS) and timed up-and-go (TUG) tests were performed to confirm the change in balance. RESULTS: In the experimental group, BBS showed a significant increase (p < .05) and TUG showed a significant decrease (p < .05). In the control group, there was no statistically significant change in the BBS. However, the TUG showed a significant decrease (p < .05). The BBS and TUG both showed statistically significant differences (p < .05) in the between-group comparison of the change in pre-post intervention values. CONCLUSION: A group exercise program with competitive games to improve the balance ability for fall prevention in chronic stroke patients could be used as a good intervention method.

• 대한물리치료과학회지
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• 제15권2호
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• pp.87-95
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• 2008

Background: Hemiplegic patients usually have difficulty maintaining balance. Balance training is a major component of there habilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of PLS(Posterior Leaf Spring), FES(Functional Electrical stimulation), treadmill training, and neurodevelopmental treatment on the improvement of balance in patients with hemiplegia. Methods: We looked into published studies from Dankook University’s electronic library databases of RISS4U, KMbase, NCBI, and MEDLIS concerning the effectiveness of any form of intervention leading to improvement of balance. All types of studies relevant to the topic that were published in English during the time period of 1986 to 2005 were included. Results: 1. There were significant differences in standing balance, dynamic activity balance, and gait speed between barefoot subjects and subjects who wore SPAFO and HPAFO(p<.05). 2. The changes in ROM and FRT related to sex, age, height, and weight part of the diagnosis, as well as experience relapse, was of meaningless value. Changes in ROM related to the duration of pain and experiences of falling down were also meaningless. However, FRT showed significant static differences(p<.05). 3. The body-weight-support treadmill training scoring of standing balance, step length, and a timed 10m walking test showed definite improvement. 4. The proprioceptive control approach improved dynamic balance in patients with hemiplegia. Conclusion: Consequently, further study is needed to verify methods when physical therapists are researching balance ability in hemiplegic patient.

• 국제물리치료학회지
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• 제5권1호
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• pp.683-690
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• 2014

This study purposed to provide a scientific base for understanding the effect of therapeutic intervention using motivation on chronic stroke patients' balance and determining whether it is applicable as a new therapeutic intervention. For this study, we sampled 38 chronic stroke patients, and divided them randomly into a motivation training group(n=20) and a control group(n=18). To the control group was applied neurological physiotherapy 5 times a week, and 30 minutes each time, and to the motivation training group was applied neurological physiotherapy and then, additionally, a Nintendo Wii-Fit program 3 times a week, and 30 minutes each time. Before and after the experiment, the subjects' dynamic balance was measured with functional reach test(FRT), timed up & go test(TUG), and 10m gait test, and their static balance was measured with the Romberger Test. When dynamic balance ability was compared between before and after the experiment and between the motivation training group and the control group, significant difference was observed in the results of FRT, TUG, and 10m walking test between before and after the intervention(p<.05). As to static balance, in addition, body balance movement distance was not significantly different. Therapeutic intervention using dynamic motivation was found to be more effective than the control group in improving dynamic balance.

• The Journal of Korean Physical Therapy
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• 제26권5호
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• pp.296-301
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• 2014

Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.34-39
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• 2014

The purpose of this study was to examine the effect of three cognitive tasks on gait at a preferred walking speed, and at a fast speed, using dual-task methodology. A total of 29 stroke patients participated in the study. All 29 subjects performed 2 motor tasks (10-meter walk task and timed up and go task each at a preferred and a fast speed) and three cognitive tasks [Stroop, word list generation (WLG), serial subtraction (SS)] under dual-task conditions [cognitive-motor interference (CMI)] in a randomized order. Gait speeds were measured in six different conditions. A repeated-measure analysis of variance was employed to compare the results of the Stroop training, WLG, and SS tasks during preferred and fast walking. A Bonferroni adjustment use for post hoc analysis. The level of statistical significance was set at ${\alpha}=.05$. A CMI effect occurred for performance of a 10-meter walking task at two different speed and a cognitive task (p<.05). Stroop had a significantly greater effect than SS and WLG (p<.05). The timed up and go task was affected when performed with fast walking speed during Stroop cognitive task (p<.05), but was not affected if performed with preferred walking speed during a cognitive task (p>.05). This study showed that CMI of Stroop can be used as a rehabilitation program for stroke patients.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.22-31
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• 2021

Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• 한국산학기술학회논문지
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• 제17권12호
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• pp.363-370
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• 2016

본 연구의 목적은 속도가 다른 트레드밀 훈련이 다리 근두께에 어떠한 영향을 미치는지 알아보고자 하였다. 대상자는 대학생 남녀 36명을 평보군 (n=12)과 속보군 (n=12), 교차보행군 (n=12)으로 나누어 평보군은 평균 속도의 100%의 속도로 훈련을 실시하였고, 속보군은 평균 속도의 130%의 속도로 실시하였으며, 교차보행군은 130%의 속도와 100%의 속도를 각각 교차하면서 보행 훈련을 실시하였다. 훈련은 6주 동안 시행하였고, 주당 3회, 회당 60분간 시행하였다. 측정은 넙다리곧은근과 가쪽넓은근, 장딴지근, 앞정강근의 두께를 비교하기 위해 초음파영상장치를 이용하였다. 연구 결과 넙다리곧은근, 가쪽넓은근, 장딴지근에서 시간에 따라 유의한 증가가 있는 것으로 나타났고, 상호작용 또한 있는 것으로 나타났다. 그리고 앞정강근에서는 시간에 따라 유의한 증가가 있는 것으로 나타났다. 이상과 같은 결과로 보아 평속보다는 속도를 달리한 훈련을 실시하였을 때 다리 근육의 두께 변화에 영향을 미치는 것으로 생각되며, 추후 연구에서는 신경계나 근골격계 질환으로 인한 보행 장애를 가진 환자를 대상으로 재활 프로그램에 적용하는 연구가 지속적으로 이루어져야 할 것으로 생각된다.

• 생명과학회지
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• 제19권9호
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• pp.1299-1303
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• 2009

뇌졸중 환 6명을 대상으로 발병후 3개월 지난 시기에 1차 실험을 실시하였고, 6개월 지난 시기에 2차 실험을 하여 뇌졸중환자들을 대상으로 운동학적변인, 각운동학적변인 그리고 지면반력과 발바닥의 압력분포를 알아보았다. 운동학적변인의 결과 통계적으로 유의한 차이는 나타나지 않았으나 6개월간 꾸준히 재활운동에 참가한 환자는 3개월 때 보다 훨씬 보폭(step length)이 크게 나타났으며(11.18 cm, 12.25 cm, p=0.58), 보폭의 빈도(step time) 또한 빠르게 나타났다(1.20 sec, 1.18 sec, p=0.53). 환측의 발만 지지면에 닿아 있는 시간(single support time)의 연구에서는 재활운동에 꾸준히 참가한 환자가 발을 지면으로부터 빨리 떼는 것으로 나타났다(34.97%, 29.02%, p=0.74). 환측다리 움직임의 빠르기를 나타내는 변인(cadence)에서는 1분당 움직임의 회수가 6개월 운동에 참가한 사람의 보폭회수가 3개월 운동에 참가한 사람의 보폭회수 보다 훨씬 빠르게 나타났다(21.04 step/min, 28.89 step/min, 0.27). 각 운동학변인에서는 통계적으로 모든 변인에서 유의한 차이는 나타나지 않았으나 평균의 비교에서 꾸준하게 6개월 동안 재활운동에 참가한 환자는 발목관절, 무릎관절 그리고 엉덩관절 모두의 가동범위가 크게 나타났다. 걷기동작에서 상해의 원인이되는 최초 접촉 순간의 충격력(impact force)의 비교에서는 6개월간 꾸준히 재활운동에 참가한 환자는 충격력이 작게 나타났다(1.20 N/kg, 1.13 N/kg, p=0.45). 전방으로의 추진력(anterior propulsion force)과 후방으로의 감속력(posterior braking force)은 통계적으로 유의한 차이(p=0.28, p=0.39)를 나타내지 않았으나 재활운동에 꾸준히 참가한 환자들은 전후방의 힘(0.10 N/kg, 0.15 N/kg; -0.12 N/kg, -0.18 N/kg)이 좋아지는 것을 볼 수 있었다. 걷기 동작 시 환측발의 최대 압력분포값은 통계적으로 유의한 차이(p=0.24)는 없었으나 6개월 재활훈련참가자(15.51 N/$cm^2$)가 3개월 재활훈련참가자(13.99 N/$cm^2$) 보다 지면을 더욱 가볍게 밟고 지나가는 것으로 나타났다. 위의 연구결과들을 바탕으로 볼 때 뇌졸중 환자들은 꾸준하게 재활운동에 참가하여야 하며 주위 사람들의 관심이 항상 필요하다고 사료된다.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.26-34
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• 2006

The aim of this study was to assess the effectiveness of group therapeutic exercise programs on the cognitive function, Activities of Daily Living (ADL), and balance-performing ability in older adults. Fifteen community-dwelling subjects (mean age 73.7 yrs, standard deviation 2.4) participated in this study. An 8-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-Korean (MMSE-K), Modified Barthel Index (MBI), Berg Balance Scale (BBS), Functional Reaching Test (FRT), and Timed Up & Go (TUG) test were measured during pre-exercise and post-exercise points. The results of this study were as follows: 1. After eight weeks, the MMSE-K and MBI total score was more significantly increased for post-exercise tests than pre-exercise tests (respectively, p<.05, p<.01). 2. Of the MBI contents, personal hygiene, dressing, ambulation, and chair/bed transfers scores were significant increased for post-exercise tests. 3. Post exercise BBS, FRT, and TUG scores were higher than the pre-exercise scores. The difference was statistically significant (respectively, p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise can be used to improve the cognitive function, ADL, and balance-performing ability in elderly persons.