• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.29-34
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• 2018

Purpose: This study aimed to systematically analyze the reliability and validity of Korean versions of mobility and gait assessment tools for patients with stroke. Methods: Two reviewers conducted an independent literature search and systematically reviewed the literature. Literature published until June of 2017 was searched using search engines for electronic databases. The 2 reviewers reviewed the title and abstract of each article. Among the articles examined, we read the full text of those judged to be suitable for our study. We classified the selected data into research methods and results. The determination was made through mutual agreement. Results: The reviewers selected 5 articles related to the purpose of this study. The DGI was found to be moderately associated with BBS, 10MWT, and TUG in intra-rater reliability (ICC=0.92), inter-rater reliability (ICC=0.88), and concurrent validity tests. The FGA demonstrated a high level of reliability with intra-rater (ICC=0.92-0.95) and inter-rater reliability (ICC=0.91, 0.95). The intra-rater reliability of the RMI was high at ICC=0.98. Its concurrent validity showed a high association with STREAM and BI. The intra-rater reliability of the MAS was ICC=0.75-0.99. Its inter-rater reliability was very high, exceeding 0.99. The inter-rater reliability of the Tinetti-gait Scale was ICC=0.91, and its concurrent validity was moderately associated with the DGI, 10WMT, OLST, FM-L/E, and STS. Conclusion: The results of this study revealed that the reliability and validity of the Korean versions of the mobility and gait assessment tools were high.

• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.64-70
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• 2023

Purpose: This study investigated the influence of attention-demanding tasks on gait and measured differences in the temporal, spatial and kinematic characteristics between young healthy adults and elderly healthy adults. Methods: We recruited 16 healthy young adults and 15 healthy elderly adults in this study. All participants performed two cognitive tasks: a subtraction dual-task (SDT) and working memory dual-task (WMDT) during gait plus one normal gait. Using the LEGSys+ system, knee and hip-joint kinematic data during stance and swing phase and spatiotemporal parameter data were assessed in this study. Results: In the elderly adult group, attention-demanding tasks with gait showed a significant decrease in hip-joint motion during the stance phase, compared to the normal gait. Step length, stride length and stride velocity of the elderly adult group were significantly decreased in WMDT gait compared to normal gait (p<0.05). In the young adult group, kinematic data did not show any significant difference. However, stride velocity and cadence during SDT and WMDT gaits were significantly decreased compared to those of normal gait (p<0.05). Conclusion: We determined that attention-demanding tasks during gait in elderly adults can induce decreased hip-joint motion during stance phase and decreased gait speed and stride length to maintain balance and prevent risk of falling. We believe that understanding the changes during gait in older ages, particularly during attention-demanding tasks, would be helpful for intervention strategies and improved risk assessment.

• Physical Therapy Korea
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• v.23 no.3
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• pp.40-47
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• 2016

Background: Assessments of Sit-to-Stand (STS) and gait functions are essential procedures in evaluating level of independence for the patients after stroke. In a previous study, we developed the software to analyze center of pressure (COP) in standing position on Wii Balance Board (WBB). Objects: This purpose of this study is to measure test-retest reliability of ground reaction forces, COP and time using WBB on STS and gait in healthy adults. Methods: Fifteen healthy participants performed three trials of STS and gait on WBB. The time (s), vertical peak (%) and COP path-length (cm) were measured on both tasks. Additionally, counter (%), different peak (%), symmetry ratio, COP x-range and COP y-range were analyzed on STS, 1st peak (%), 2nd peak (%) of weight were analyzed on gait. Intra-class correlation coefficient (ICC), standard error measurement (SEM) and smallest real difference (SRD) were analyzed for test-retest reliability. Results: ICC of all variables except COP path-length appeared to .676~.946 on STS, and to .723~.901 on gait. SEM and SRD of all variables excepting COP path-length appeared .227~8.886, .033~24.575 on STS. SEM and SRD excepting COP path-length appeared about .019~3.933, .054~11.879 on gait. Conclusion: WBB is not only cheaper than force plate, but also easier to use clinically. WBB is considered as an adequate equipment for measuring changes of weight bearing during balance, STS and gait test which are normally used for functional assessment in patients with neurological problems and elderly. The further study is needed concurrent validity on neurological patients, elderly patients using force plate and WBB.

• The Journal of the Korea Contents Association
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• v.20 no.6
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• pp.114-123
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• 2020

The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.285-291
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• 2014

PURPOSE: The purpose of this study was to propose clinical criteria to differentiate patients who are able to perform the step-through-step gait pattern in chronic stroke patients. METHODS: Sixty patients with chronic stroke patients participated this study. To differentiate patients who could perform the step-through-step gait pattern, age, gender, and causes of stroke were noted, a Chedoke-McMaster (CM) damage list, Fugl-Meyer (FM) assessment scales and the Berg Balance Scale (BBS) were determined. A 10 meter gait test and Timed Up and Go (TUG) test were conducted to determine the differences in gait speed and dynamic balance between patients walking with or without canes in the step-through-step gait pattern group. RESULTS: There was no significant statistical difference in age, gender, and stroke type between all subjects. There were significant differences in the CM scale for postural and lower extremities, and FM scale for lower extremities and BBS. The dynamic balance ability and gait speed showed significant differences between the subjects in the step-through-step gait pattern with or without a cane during gait. CONCLUSION: CM and FM scales for the lower extremities and postural control, as well as BBS scales, can be used as criteria to differentiate patients who are able to perform the step-through-step gait pattern. These results can also be used to provide beneficial information to patients that are walking with canes.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.655-666
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• 2010

Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.129-136
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• 2017

PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.471-477
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• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• The Journal of Korean Physical Therapy
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• v.31 no.6
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• pp.346-350
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• 2019

Purpose: The purpose of this study was to investigate the effects of calf tightness on gait, plantar pressure, and balance in adults. Methods: A total of 60 participants were divided into a normal group of 30 subjects with normal dorsiflexion angle (20-25 degrees) and an experimental group of 30 subjects with limited dorsiflexion angle (0-15 degrees) due to calf tightness. Gait ability and foot pressure of the subjects was measured with a treadmill, and the balance ability was measured by PROKIN system. Results: A significant difference in COP length, loading response, and single limb support was observed between groups. The COP length and single limb support ratio in the normal group was greater than in the experimental group, but the experimental group showed a higher ratio for loading response in the gait ratio. Conclusion: Our results indicated that calf tightness was negative effects on balance and gait ability, so assessment of the muscle tightness should be considered during exercise and treatment.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.49-55
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• 2000

The purpose of this study was to identify the characteristics oi gait patterns and to find the effects of the gait function on the P.N.F. pelvic pattern. The subjects of this study were 40 hemiplegic patients who either hospitalized in or out patients at department physical therapy, Tae-Bong hospital and Masan college health education center. The study on these patient were done from July 20.1999 through May 10,2000. Method of gait pattern assessment used ink foot print record. The results were as follows: 1. There were significiant difference in cadence and stride length(p<0.05). 2. There were significiant difference in gait velocity (p<0.05).