• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2021-2027
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• 2020

Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.1-13
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• 2022

Background: This research was conducted to understand balance training in trunk control, balance, and walking in stroke patients. Design: Randomized controlled trial. Methods: The subjects included 40 stroke patients, of whom 20 undertook balance training using visual information and the other 20 undertook balance training using balance boards. Using visual feedback, the balance training group used a training program within the static balanced evaluation tool, while the balance training group trained using a balance board. All subjects underwent 20 mins of neurodevelopmental treatment, and both target groups underwent 10 mins each of balance training by using either visual feedback or a balance board. The treatment period lasted a total of 4 weeks, twice a day. Trunk control before and after training was evaluated with the Trunk Impairment Scale. Balance capability was assessed by the Berg Balance Scale, Functional Reach Test, Timed Up and Go test, and Static balance measurement tool. Walking capacity was measured using gait measuring equipment, and cadence and velocity were measured. Results: Both groups showed a significant improvement in their interstitial control, balance, and gait ability after the experiments compared to before the experiments (p<0.05). The difference between the two groups was not significant. The visual feedback balance training group showed a more substantial improvement than the balance board training group. Conclusion: In this study, we found that the balance training combined with visual feedback contributes to improving trunk control, balance, and gait in patients with hemiplegia due to stroke. In addition to this, I believe that balanced training combined with visual feedback can be used as a training method when considering patients who lack interstitial control, balance, and gait ability.

• PNF and Movement
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• v.22 no.1
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• pp.139-149
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• 2024

Purpose: This study aimed to investigate the effects of gradually increasing treadmill inclination on the electroencephalogram (EEG) of stroke patients during gait training. Methods: Three stroke patients who were diagnosed with stroke within six months and capable of walking on a treadmill were selected as subjects. EEG electrodes were attached at Fp1, Fp2, F3, F4, C3, C4, P3, and P4 positions of the cerebral hemispheres using the International 10-20 system. The intervention involved walking for 2 minutes each at 0 degrees, 15 degrees, and 30 degrees inclination on the treadmill while focusing on a target point located in front during the treadmill gait training. The EEG (Smartingmobi, Serbia) generated when the treadmill gradient gradually increased was measured. In addition, relative alpha and relative beta waves were visualized through the Brain mapping program in the TeleScan program to assess the changes in each brain region for the activity of the EEG. Results: The relative alpha wave value decreased as treadmill inclination increased, while the relative beta wave value increased. Conclusion: Gradually increasing the inclination during treadmill gait training appears to be a crucial parameter for increasing the brain activity levels of stroke patients.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.112-117
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• 2015

Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• Annals of Geriatric Medicine and Research
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• v.21 no.1
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• pp.17-23
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• 2017

Background: In at-risk older adults, gait speed is an important factor associated with quality of life and falling risk. In this study, we assessed whether therapeutic exercise could improve gait speed. Methods: We conducted a meta-analysis to evaluate the 'best' therapeutic exercise method by analyzing each exercise in terms of intensity, type, and several gait speed indices. For the analysis, we gathered 122 papers through a database search and selected 9 (n=627) that were appropriate for the meta-analysis. Results: In 8 of the 9 included papers, gait speed improved with therapeutic exercise. Usual gait speed (n=246) improved more than maximal gait speed (n=574). A resistance program was more effective than a nonresistance program for improving maximal, but not usual, gait speed. We also found that the effects of therapeutic exercise were greater in noncommunity than in community-dwelling elderly people. Conclusion: In conclusion, therapeutic exercise was effective in improving gait speed.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.270-277
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• 2021

Objective: The purpose of this study is to compare the effect of static balance, lower extremity function, and gait ability between a lower extremity restrain robot gait training and a general robot gait training in subacute stroke subjects. Design: Two-group pretest-posttest design. Methods: A total of 12 subacute stroke patients were randomly divided into an Experimental group (n=6) and a control group (n=6). Both groups were performed for four weeks, three times a week, for 20 minutes. To compare the Static balance function, the center of pressure (COP) path-length and COP velocity were measured. The Fugl-Meyer assessment lower extremity (FMA-LE) were evaluated to compare the Lower Extremity function. 2D Dartfish Program and 10 Meter Walking Test (10 MWT) on Gait ability were evaluated to compare the gait function. Results: In the intra-group comparison, Experimental groups showed significant improvement in COP path-length, velocity, Lower Extremity Function, 10 MWT, Cadence, by comparing the parameters before and after the intervention (p<0.05). Comparison of the amount of change between groups revealed significant improvement for parameters in the COP path-length, velocity, Lower extremity function, 10 MWT by comparing the parameters before and after the intervention (p<0.01). Conclusions: The Experimental group showed enhanced efficacy for variables such as COP path-length, velocity, Lower extremity function, 10 MWT as compared to the control group.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

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.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.13-19
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• 2014

Objective: The purpose of this study was to determine the effects of Augmented Reality-based Postural Control (ARPC) training on balance and gait function in patients with stroke. Design: Single-blind randomized controlled trial. Methods: Twenty participants who experienced a stroke were enrolled in the study and randomly assigned to the ARPC (n=10) or control group (n=10). Subjects in both groups received conventional physical therapy for 60 min per session, 5 days per week, for 4 weeks. In addition, subjects in the ARPC group received ARPC training for 30 min per day, 3 days per week, for 4 weeks. The participants watched established normal postural control patterns on a head-mounted display and repeated the movements in ARPC training. Outcome measurements were assessed using the Berg Balance Scale (BBS) and 10-Meter Walk Test (10MWT) before and after 4 weeks of training. Results: Of the 20 randomized participants, only 18 completed the 4-week training program. The ARPC group showed significant improvement in the BBS and 10MWT after training (p<0.05). Meanwhile, the control group did not exhibit improvement in either variable. In addition, the ARPC group showed significantly greater improvement than the control group in the 10MWT (p<0.05), whereas no significant difference was observed between the groups for the BBS. Conclusions: The results of this study confirmed the benefits of ARPC training on dynamic balance and functional gait ability. Additionally, this study may provide evidence supporting the use of an ARPC training program for improving balance and gait ability in patients after a chronic stroke.

• Journal of Power System Engineering
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• v.20 no.4
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• pp.19-25
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• 2016

It is needed to use the gait training system for the rehabilitation of the disabled and old people. In this study, a gait training system of turn roller type is proposed for the purpose of helping the rehabilitation. A driving mechanism with the turn roller is designed by using the RecurDyn which is the dynamic analysis program. RecurDyn is used to analyze the dynamic behavior of the gait training system. The static load analysis is carried out to investigate the safety of this system. From the operating test of this system, it is noted that the driving error is little and the load capacity is 130 kgf.