• 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.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• Korean Journal of Applied Biomechanics
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• v.24 no.2
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• pp.95-101
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• 2014

The purpose of this study was to investigate the training and detraining effects of a 8-week water exercise on lower extremities coordination during obstacle gait in the female elderly. Eight elderly participants (age: $76.58{\pm}4.97$ yrs, height: $148.88{\pm}7.19$ cm, body mass: $56.62{\pm}6.82$ kg, and leg length: $82.36{\pm}2.98$ cm), who stayed at the Seoul K welfare center, were recruited for this study. All participants had no history of orthopedic abnormality within the past 1 year and completed the aquatic exercise program which lasted for 8 weeks. To identify the training and detraining effect of 8 weeks of water exercise, a 3-D motion analysis with 7 infrared cameras and one force plate sampling frequency set at 100 Hz and 1,000 Hz, respectively, was performed. A two-way ANOVA was performed to find training and detraining effects among diferent obstacle heights. In this study significant level was set at .05. Significant training effects of LTS (lead foot thigh and shank) coordination in all obstacle height were found (p<.05). It is also found that the training effect of LTS remained 37%, 58%, and 25% in obstacle height of 30%, 40%, and 50%, respectively. Lead foot showed the greater detraining effect of coordination compared with trail foot, and SF (shank and foot) coordination revealed better detraining effects of coordination compare with TS (thigh and shank) in both feet. Based on the findings, a 8 week water exercise give an positive effects to the elderly in terms of segment cooperation which potentially helps reducing their accident falls. The magnitude of detraining may also help the elderly to find the retraining moment.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.33-42
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• 2017

Purpose: This study examined the effects of the fumanet exercise program on the cognitive function and fall down-related physical fitness factor in elderly people. Method: The study period was May 2-June 24, 2016. The participants included 20 elderly persons (control group 10, experimental group 10) who registered at the day-care Center in G. City. Descriptive statistics were used for the analysis of the control and experimental groups' general characteristics. The chi-square and Mann-Whitney U tests were conducted to identify the two groups' general characteristics' and dependent variables' homogeneity. The Wilcoxon signed-rank test was used to compare the pre-and post-intervention cognitive function and fall down-related physical fitness factor, and a Mann-Whitney U test was used to analyze the rate of cognitive function and fall down-related physical fitness factor changes between the groups after the intervention. Result: The participants' fall down-related physical fitness factors (balance, gait, leg strength) increased and memory in the cognitive function sub-area improved in the participants who participated in the fumanet exercise program. The amount of change in gait was significantly different between the control and experimental groups. Conclusion: The fumanet exercise program included gait training using the learn, remember and repeat phased steps. Therefore, this study proposes using the fumanet exercise program to improve the elderly's cognitive function and physical fitness factor.

• 한국노년학
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• v.29 no.4
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• pp.1261-1275
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• 2009

Age related decrease of muscle strength, balance, and gait abilities bring about physical inactivity in the elderly. Virtual reality (VR) training has been used successfully to rehabilitate functional balance and mobility in elderly subjects. This study was aimed at determining the effect of VR-based exercise programs by using a video game on the muscle strength, balance, and gait abilities in the elderly. 48 old people were randomly divided into two groups; VR-group (men: 11, women: 14, age: 68.42yrs) and control group (men: 10, women: 13, age: 67.58yrs). VR-group performed an exercise program twice a week for 8 weeks and control group had no intervention. The VR-based exercise program was composed of warm up(10 mins), VR-program(40 mins), and cool down(10mins). It was performed by playstation eyetoy play that provided visual and auditory feedback as well as movements of the upper and lower extremities. Muscle strengths of the knee and ankle were measured using manual muscle tester. Static balance was estimated using computerized posturography. Dynamic balance was measured by Timed up and go test (TUG), Functional reach test (FRT). 10m walk test and 6-min walk test were used to assess gait abilities. After the completion of the VR-exercise program, muscle strength, balance, and gait abilities were improved significantly (p<0.05). In conclusion, the VR-based exercise program showed improvement on the muscle strength, balance, and gait ability in the elderly. This exercise program is both effective and interesting for this age group.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.11-20
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• 2017

Purpose: The purpose of this study was to determine the effects of rotation direction during curved walking on gait parameters in stroke patients. Methods: A group of thirty subjects with stroke (Berg Balance Scale score${\geq}41$ were fifteen, Berg Balance Scale score${\leq}40$ were fifteen) were enrolled in this study. Testing indications included two directions for rotation in each subject. These indications were for rotation toward the affected and unaffected side in stroke patients. The gait speed, affected side single support duration, affected side double support duration were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 40 points of Berg Balance Scale score. Results: There was significant increase affected side single support duration was turned the affected side in stroke patients that presented a Berg Balance Scale score${\geq}41$ (p<.05). There were significant increase gait speed, affected side single support duration, and significant decrease affected side double support duration while subjects were turned the affected side in stroke patients that presented a Berg Balance Scale score${\leq}40$ (p<.05). Conclusion: This result may be effective to rotate in the paralyzed direction to improve the ability of the paralyzed lower limb to gain weight during gait training for stroke patients with a Berg Balance Scale score<40. Therefore, walking training program for hemiplegic patient needs to be suggested in the direction of turning for suitable balance ability.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.9
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• pp.3834-3842
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• 2011

The purpose of this study is to analyze the kinematic characteristics of children with Down syndrome got congenitally joint laxity and muscle hypotonic. The subjects are boys with Down syndrome and don't have the other disabilities. We got three dimensional position data and then calculated spatiotemporal and kinematic variables during walking on treadmill used increasingly for gait analysis and training. In result, in order to overcome their gait instability due to their musculoskeletal characteristics they walked with hip, knee and ankle joints more flexed than the typical gait pattern, and on the propulsion phase they extend the lower limb joints less than the typical, result in propel the body less than. The reason is that the more is the propulsion by extending the joints, the greater is the reaction force from the ground on heel contact. This result is expected to be used to develop the training program for intensification of musculoskeletal system aim to improve the other musculoskeletal disabilities as well as Down syndrome.

• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.63-79
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• 2020

Background: A physical therapy is required to restore motor function of stroke patients, especially gait function improvement is very important to them. Design: Systemic review. Methods: The purpose of this study is to provide objective evidence for the effectiveness of the treadmill training method applied to stroke patients. The literature search for a systematic review was performed on domestic data published from 2010 to 2020 at KISS, RISS, and DBpia. Results: 40 papers meeting the inclusion/exclusion criteria were finally selected. Data analysis was performed according to the research type, intervention method and process, measurement variables, and the risk of bias assessment was conducted as quality evaluation. Conclusion: Various training methods have been suggested and proved that treadmill intervention is an effective method for improving gait and balance. As the goal of rehabilitation for stroke patients is to improve walking and balance, we expect continuous clinical research to continue to establish a more systematic training program and present a new paradigm.

• Journal of the Korean Applied Science and Technology
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• v.37 no.6
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• pp.1669-1677
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• 2020

The purpose of this study was to evaluate the effects of a 14-week proprioceptive resistance exercise on muscle endurance strength, dynamic balance and gait ability of elderly women in a social welfare facility. Thirty community dwelling elderly subjects (mean age 70.84±3.33) divided into experimental (n=15) and control (n=15) groups. The participants performed the muscle endurance strength(30sec hair stand), dynamic balance (3m up and go) and low extremity performance (10m walking, 400m walking) pre and after the training program. The exercise groups were submitted to 14 weeks proprioceptive training with a Swiss ball three times a week. As a results were as follow. Significantly improvements were observed in low extremity strength and dynamic balance. And there have significantly improvements in 10m walking, 400m walking. Conclusionly, the improvement of dynamic balance and gait ability by proprioceptive resistance training will reduce the possibility in female elderly people.

• Physical Therapy Korea
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• v.14 no.4
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• pp.75-83
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• 2007

The purpose of this study was to investigate the effect of balance training with upper extremity exercise on the improvement of balance performance in people who have had a stroke. Eighteen candidates who have all experienced a stroke, were living in Dong-Gu, Ulsan and were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 7 consecutive weeks. Subjects were tested with 7 m and 100 m Timed Gait Test (sec), Timed Get Up and Go Test (sec), Functional Reach Test (cm) and 5 items of Berg's Balance Test at pre-training and post-training. Total balance index and balance ratios were measured by K.A.T. 3000. The balance training program performed by sitting on a chair and gymnastic ball and standing on stable and unstable surfaces during upper extremity exercises such as Proprioceptive Neuromuscular Facilitation (PNF) upper extremity pattern, picking a ball up from floor, throwing and catching it. After seven weekends of balance training, subjects showed a significant difference in balance test results. The exceptions were three items of Berg's Balance Test (p<.05). Balance index score and affected and unaffected side balance ratio had a larger improvement than pre-training (p<.05). The result of this study showed that intervention of this balance training program could improve the balance performance in people who have had a stroke.