• Physical Therapy Korea
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• v.14 no.1
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• pp.64-73
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• 2007

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 Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.23-28
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• 2013

Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.4
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• pp.301-308
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• 2015

The purpose of this study was to compare core muscle activity and thickness in the abdomen (internal Oblique, IO; External Oblique, EO; Transverse Abdominis, TrA) according to walking training methods. Tests were performed on 20 healthy men who randomly assigned to two groups, divided by Nordic walking (n=10) or Power walking group (n=10). They were performed Nordic walking or Power walking training for 2 weeks that is consistent with each of the assigned groups. Results demonstrated that Nordic walking was more effective than Power walking in improving IO and EO activities. Nordic walking is believed to be useful method for a variety of therapeutic exercise as a stable balance with the stick in addition to normal gait and trunk stability.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1873-1878
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• 2019

Background: Walking is a complex activity. The main components of walking include balance, coordination, and symmetrical posture. The characteristics of walking patterns of stroke patients include slow walking, measured by gait cycle and walking speed. This is an important factor that reflects post-stroke quality of life and walking ability. Objective: This study aimed to examine the effect of deep lumbar muscle stabilization exercise on the spatiotemporal walking ability of stroke patients. Design: Quasi-experial study Methods: The experiment was conducted 5 times per week for 4 weeks, with 30 minutes per session, on 10 subjects in the experimental group who performed the deep lumbar muscle stabilization exercise and 10 subjects in the control group who performed a regular exercise. Variables that represent the spatiotemporal walking ability (step length, stride length, step rate, and walking speed) were measured using GAITRrite before and after the experiment and were analyzed. Results: There was a significant difference in the pre- and post-exercise spatiotemporal walking ability between the two groups (p<.05). Furthermore, there was a significant difference in the step rate and walking speed between the two groups (p<.05). Conclusions: Deep lumbar muscle stabilization exercise is effective in improving the walking ability of stroke patients. Therefore, its application will help improve the spatiotemporal walking ability of stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.471-480
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• 2012

PURPOSE: The object of the present study is to investigate the effects of the insole supporting medial longitudinal arch while walking in spastic cerebral palsy with pes planus. METHODS: Ten spastic bilateral cerebral palsy children with pes planus participated in this study. The insole were custom-made for the individual child. Muscle activity was measured by surface EMGs attached on tibialis anterior (TA), gastrocnemius (GA), vastus medialis oblique (VMO), biceps femoris long head (BF). temporal-spatial parameters such as velocity, step length, stride length, stance time, toe angle were collected while the subjects walked on the GAITRite system. RESULTS: The results of the present study were summarized as follows: 1. Muscle activities in mean EMGs while walking: Left VMO, Right TA, Left BF and GA revealed significant reductions after applying insole. 2. Muscle activities in peak EMGs while walking: Left TA and BF demonstrated reductions significantly after applying insole. 3. There were improvements in temporal-spatial gait parameters with insole: velocity, both step length, Right stride length and Right toe angle were increased(p<.05). CONCLUSION: Therefore the current study demonstrated that insole supporting the medial longitudinal arch would be effective on gait of the spastic cerebral palsy with pes planus.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.139-148
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• 2018

PURPOSE: This study compared the effects of indoor and outdoor environmental changes on the activity of the major lower limb muscles and walking factors in people 40-50 years and those aged older than 70 years. METHODS: Ten middle-aged people in their forties (age:$44.2{\pm}2.7$, BMI:$21.8{\pm}1.8$) and 10 elderly aged more than 70 years (age:$76.4{\pm}5.9$, BMI:$22.2{\pm}1.9$) with a normal walking ability were included. The participants walked 100 m both indoors and outdoors at their own speed. Using a 3D motion analyzer and EMG, the walking speed, angle of the ankle and activity changes of the lower limb muscles were compared. RESULTS: Significant differences in walking speed and peak-plantar flexion angle were observed between the two groups (p<.05). The muscular activity of the gastrocnemius muscle (GCM) was significantly different outdoors in the swing phase between the two groups (p<.05). In the people aged in their forties, the muscular activity of the rectus femoris (RF) was significantly higher outdoors than indoors (p<.05). In the elderly, however, the muscular activity of the RF was lower outdoors than indoors (p<.05). When compared to those in there forties, the muscular activity of the outdoor RF significantly decreased in the elderly group (P<.05). The muscular activity of the biceps femoris (BF) in the elderly decreased significantly outdoors compared to indoors (p<.05). CONCLUSION: For the elderly, increasing the exposure to the new environments or focusing on the performance of repeated movements for gradual speed control and precise movements is required to maintain normal gaits and movements that are less affected by environmental changes.

• Journal of Korean Physical Therapy Science
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• v.11 no.2
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• pp.27-37
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• 2004

The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.370-377
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• 2012

This study examines the effects of different environments on the application of hemiplegia patients circuit balance training. Group 1 performed circuit balance training without any auditory intervention Group 2 performed training in noiseless environments and Group 3 performed training in white noise environments. First, among lower extremity muscular strength evaluation items, maximum activity time(MAT) was not significantly different(p>.05). Maximum muscle strength(MMS) increased significantly in Group 3(p<.01), there was no significant difference in MMS among the groups. Average muscle strength(AMS) indexes also significantly increased in Group 3(p<.01), there was no significant difference in AMS among the groups. Second, among balancing ability evaluation items, Berg's balance scale(BBS) scores significantly increased in all groups(p<.05), BBS scores were significantly difference among the groups. Based on the results, Group 1, 2 and Group 1, 3 showed significant increases (p<.05). Functional reach test(FRT) values significantly increased in Group 2, 3(p<.05), and there was no significant difference in FRT values among the groups. Timed up and go(TUG) test values significantly decreased in Group 2, 3(p<.05), and there was no significant difference in TUG test values among the groups. Third, among walking speed evaluation items, the time required to walk 10m significantly decreased in all groups(p<.05), and there was no significant difference in the values among the groups. Average walking speeds showed significant increases in Group 1, 3(p<.05), and there was no significant difference in the values among the groups. Based on the results of this study, noise environments should be improved by either considering auditory interventions and noiseless environments, or by ensuring that white noise environments facilitate the enhancement of balancing ability.

• Korean Journal of Applied Biomechanics
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• v.25 no.3
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• pp.323-333
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• 2015

Objective : The purpose of this study was to investigate the changes of gait patterns and muscle activations with increased loads during stair walking. Also, it can be used as descriptive data about continuous stair walking in a real life setting. Method : Twelve sedentary young male adults(Age: $27.0{\pm}1.8yrs$, Weight: $65.8{\pm}9.9kg$) without any lower extremity injuries participated in this study. Participants performed stair walking up 7 floors and their ascending and descending motion on each floor was analyzed. A wireless electromyography(EMG) were attached on the Rectus Femoris(RF), Biceps Femoris(BF), Gastrocnemius(GN), Tibialis Anterior(TA) muscle to calculate integrated EMG(iEMG), median frequency(MDF) and co-contraction index(CI). Chest and left heel accelerometer signal were recorded by wireless accelerometer and those were used to calculate approximate entropy(ApEn) for analyzing gait pattern. All analyses were performed with SPSS 21.0 and for repeated measured ANOVA and Post-hoc was LSD. Results : During ascending stairs, there were a statistically significant difference in Walking time between 1-2nd and other floors(p=.000), GN iEMG between 2-3th and 6-7th(p=.043) floor, TA MDF between 1-2nd and 5-6th(p=.030), 6-7th(p=.015) floor and TA/GN CI between 2-3th and 6-7th(p=.038) floor and ApEn between 1-2nd and 6-7th(x: p=.003, y: p=.005, z: p=.006) floor. During descending stairs, there were a statistically significant difference in TA iEMG between the 6-5th and 3-2nd(p=.026) floor, and for the ApEn between the 1-2nd and 6-7th(x: p=.037, y: p=.000, z: p=.000) floor. Conclusion : Subjects showed more regular pattern and muscle activation response caused by regularity during ascending stairs. Regularity during the first part of stair-descending could be a sign of adaptation; however, complexity during the second part could be a strategy to decrease the impact.

• Korean Journal of Applied Biomechanics
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• v.24 no.2
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• pp.167-172
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• 2014

The purpose of this study was to investigate walking standard time and joint powers of the lower extremities on the changes of illuminations in the elderly women. Ten older women ($70.90{\pm}3.28$ years, $154.70{\pm}3.47$ cm, $53.80{\pm}5.39$ kg) with normal vision and no gait disabilities participated in this study. All the experiments were performed on a level walkway from low to high lighting (six conditions). A 3-dimensional motion capturing system, force-plate, and EMG were used to acquire and analyze walking motion, force, and muscle activity data; the sampling frequency was 100 Hz, 1000 Hz and 1000 Hz respectively. To test the differences on walking standard time and joint powers of the lower extremities between the six lighting conditions, one-way repeated ANOVAs were evaluated. The following results were drawn: First, mean standard time was about 1.3 sec/stride, and velocities were smaller with lighting increasing except 100 Lx. Second, the joint power patterns of ankle and knee were not consistent, but only hip joint power was a greatest in 6 Lx and a smallest in 400 Lx. Third, standard times(100 Lx<300 Lx, 400 Lx) were statistically significant, and hip joint max powers (100 Lx>others) were also statistically significant. But ankle and knee joint max power were not statistically significant. These results showed that standard times from low to high lighting were not consistent, and hip joint of 100 Lx has a greatest rotational torque. We suggested that gait strategies of them as to changing illuminations were not consistent and findings may represent a lack of adaptability in the elderly women.