• Physical Therapy Korea
• /
• v.23 no.3
• /
• pp.1-10
• /
• 2016

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

• Journal of the Korean Society of Physical Medicine
• /
• v.9 no.2
• /
• pp.201-211
• /
• 2014

PURPOSE: The purpose of this study was to investigate the inter-rater absolute reliability and the concurrent validity of the Tinetti-gait scale that was translated into Korean for chronic stroke patients. METHODS: Fifty-two patients with post-stroke participated in this study. Inter-rater reliability was analyzed by Intraclass Correlation Coefficient ($ICC_{3,1}$) and Kappa coefficient, and absolute reliability was analyzed by the Standard Error of Measurement (SEM), and the Minimal Detectable Change (MDC). Concurrent validity was analyzed by correlating between the Tinetti-gait scale and physical functions. The physical functions were measured by using the Dynamic Gait Index(DGI), 10m walking test(10WT), One Leg Standing Test of affected/non-affected side(OLST), Sit to Stand test(STS), (Fugl Meyer assessment of Lower Extremity(FM-LE). RESULTS: The inter-rater reliability of the Tinetti-gait scale was high; $ICC_{(3,1)}=.91$ (95% CI=.85~.95) (very reliable), the range of Kappa coefficient were .73~.92 (substantial~good). The inter-rater agreement of the each item in Tinetti-gait scale ranged from .74 to .92 (95 % CI=.59~.95) (reliable~very reliable). The SEM and MDC were .56 and 1.55, respectively. In the results of concurrent validity, there were moderate positive correlation between Tinetti-gait scale and DGI (r=.78), 10WT (r=.74), OLST (r=.65~.73), FM-LE (r=67). And there was moderate negative correlation between Tinetti-gait scale and STS (r=-79) (p<.01). CONCLUSION: The Tinetti-gait scale(Korean version) was a reliable and valid tool to measure gait ability in patients with chronic stroke. Thus, it could be a useful tool for examining a gait ability of post-stroke patients. Further study should be conducted to investigate the usability to predict fall risk of post-stroke patients of the Tinetti-gait scale.

• Physical Therapy Korea
• /
• v.14 no.3
• /
• pp.64-71
• /
• 2007

The purposes of this study were to determine correlations between the Berg Balance Test (BBS), Timed -UP & Go Test, Fugl Meyer-L/E, Balance, Sensory (FM-L/E, B, S), Motor Assessment Scale-Gait (MAS-G), Comfortable maximal Gait Speed (C MGS), and the Modified Barthel Index (MBI). The subjects were 40 stroke patients of the Korea National Rehabilitation Center in Seoul. Main outcome measures were Balance control (BBS, FM-B), Gait (TUG, C MGS, MAS-G), ADL (MBI) and Motor Function of Lower Extremities (FM-L/E, S). The data were analyzed using Pearson product correlation. FM scales between other clinical and instrumental indexes and multiple stepwise regression analyses were performed to identify prognostic factors for Balance, Gait and ADL Motor Function of Lower Extremity inclinations. The results of this study were as follows: The BBS, FM-L/E, balance, sensory and MBI showed positive correlation relations, but TUG and C MGS showed negative correlations. The sensory factor of the FM-scale showed the strongest variance in predicting BBS. However the FM-balance showed the strongest variance in predicting TUG, MAS-G and C MGS. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.28 no.1
• /
• pp.9-17
• /
• 2022

Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.

• The Journal of Korean Physical Therapy
• /
• v.32 no.2
• /
• pp.107-113
• /
• 2020

Purpose: This study compared the walking ability of chronic stroke patients following either treadmill training with knowledge of the result (KR group) or treadmill training with knowledge of the performance (KP group). Methods: Nineteen patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a KR group (10 patients) and a KP group (9 patients). They received 30 minutes of neuro-developmental therapy and treadmill training 30 minutes, five times a week for three weeks. The gait parameters were measured before and after training using the Optogait system. Results: After the training periods, the KR group showed significant improvement in gait speed, cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait assessment compared to the KP group (p<0.05). Conclusion: The results showed that treadmill training with KR was more effective in improving the gait speed and cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait ability than the treadmill training with KP. Therefore, to improve the walking ability of stroke patients, it is necessary to consider treadmill training with KR. If it can be combined with conventional neurological physiotherapy, it would be an effective rehabilitation for stroke patients.

• Journal of International Academy of Physical Therapy Research
• /
• v.11 no.2
• /
• pp.2028-2035
• /
• 2020

Background: Weakness of the trunk muscles decreases the trunk control ability of stroke patients, which is significantly related to balance and gait. Objectives: To compare the impact of diagonal pattern self-exercise on an unstable surface and a stable surface for trunk rehabilitation on trunk control, balance, and gait ability in stroke patients. Design: Nonequivalent control group design. Methods: Twenty four participants were randomized into the experimental group (diagonal pattern self-exercise while sitting on an unstable surface, n=12) and the control group (diagonal pattern self-exercise while sitting on a stable surface, n=12). All interventions were conducted for 30 minutes, three times a week for four weeks, and the trunk impairment scale (TIS), berg balance scale (BBS), functional gait assessment (FGA), and G-walk were measured. Results: All groups indicated significant increases in all variables (TIS, BBS, FGA, cadence, speed, stride length) after four weeks. The TIS, BBS, FGA, cadence, gait speed, and stride length group-by-time were significantly different between the two groups. Conclusion: We found that, in stroke patients, diagonal pattern self-exercise on an unstable surface is a more effective method for improving trunk control, balance, and gait ability than diagonal pattern self-exercise on a stable surface.

• PNF and Movement
• /
• v.17 no.3
• /
• pp.353-368
• /
• 2019

Purpose: This study investigated the effects of trunk exercise using less-affected extremities on gait and balance in chronic stroke patients. Methods: Thirty subjects with chronic stroke disease were divided into two groups: a trunk exercise group that used less-affected extremities (n=15) and a general trunk exercise group (n=15). All interventions were conducted 30 min a day, 6 times per week, for 3 weeks. Gait parameters were measured before and after the intervention using Zebris FDM-1.5. In addition, all subjects were evaluated using the Trunk Impairment Scale, the Berg Balance Scale, and the Functional Gait Assessment before and after the intervention. Results: Both groups showed improvements on all outcome measured pre- to post-intervention (p<0.05). The groups exhibited significant differences for TIS, BBS, FGA, gait speed, step length, and cadence at post-intervention (p<0.05). Conclusion: This study showed that trunk exercise using less-affected extremities has therapeutic benefits on gait and balance in individuals with chronic stroke disease.

• Physical Therapy Rehabilitation Science
• /
• v.10 no.3
• /
• pp.297-303
• /
• 2021

Objective: Stroke patients generally have problems with motor function, muscle weakness, and gait.This study was purposed toevaluate the effect of the treadmill training with kinesio taping of tibialis anterior (TKT) on muscle function, tibialis anterior, muscle strength, and gait ability in poststroke patients. Design: A randomized controlled design Methods: The participants were randomly divided in the TKT group (experimental group) and treadmill training with sham kinesio taping (control group), with 21 patients assigned to each group. Both groups receive treadmill training with kinesio taping and sham kinesio taping for 30 minutes per day, five days per week, for four weeks. The motor function was measured using the Fugl-Meyer assessment. A disital manual muscle test and G-walk were used to evaluate ankle dorsiflexor and gait ability.Evaluation was performed baseline and 4 weeks after the experiment. Results: Both groups showed significantly more improvement in muscle function, tibialis anterior muscle strength, cadence, gait velocity, and stridelength in pre-post intervention change(p<0.05).The experimental group showed significantly more improvement in motor function, muscle strength, cadence, gait velocity, and stridelength ability comparedto the control group(p<0.05). Conclusions: These finding show the benefits of treadmill training with kinesio taping for functional recovery in poststroke patients

• Physical Therapy Rehabilitation Science
• /
• v.6 no.2
• /
• pp.90-95
• /
• 2017

Objective: The purpose of this study was to investigate the physical therapists' perception of the use of gait measures, the frequency of the gait measures used, and also to identify the barriers that limit the use of these assessment tools. Design: Cross-sectional study. Methods: Physical therapists from the Seoul, Gyeonggi area from March to July 2016 were included in the study. Over the course of 18 weeks, a cross-sectional study was conducted with a self-report questionnaire. A total of 700 questionnaires were distributed and 350 questionnaires (50%) were collected, however with the exclusion of 140 questionnaires due to non-consent, a total of 210 questionnaires (30%) were analysed. Results: Out of the 10 standardized assessment tools, the therapists showed the highest perception for the timed up and go test (TUG [n=153, 72.9%]) and they also had high perception for the 10 meters walk test (10MWT [n=149, 71.0%]), and 6-minute walk test (6MWT [n=123, 58.6%]). The respondents answered that the TUG (n=116, 55.2%), 10MWT (n=100, 47.6%), and 6MWT (n=51, 24.3%) was used the most often. On the contrary, only four (1.9%) therapists have used the Chedoke-McMaster stroke assessment and the Rivermead Mobility Index. The lack of time was considered as the most important barrier to the use of assessment tools in clinical practice. Conclusions: Through this study, it has been shown that the domestic physical therapists used the TUG and the 10MWT mainly due to high recognition and evaluation status; however, the lack of time was the greatest impediment to the clinical application of the gait assessment tools.

• Journal of the Korean Society of Physical Medicine
• /
• v.17 no.1
• /
• pp.93-108
• /
• 2022

PURPOSE: This review sought to confirm the correlation between dual-task gait and cognitive function in cognitively impaired and healthy older adults. METHOD: We used four databases (DBs), Pubmed, Cochrane library, Kmbase, and Koreamed. Searches were carried out according to the PICOS method, P (participants) were the elderly (above 65 years) with cognitive decline, I (intervention) was walking with dual tasks, C (control group) comprised the elderly without cognitive decline, O (outcome) was the correlation between gait and cognitive function and S (study) was the cross-sectional study. For the methodological quality assessment of each study, we used the Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies provided by the National Institutes of Health (NIH). RESULTS: A total of 10 articles were included in this systematic review. For the components of gait, we used pace, rhythm, and variability and we observed that mild cognitive impairment mostly causes low gait performance while performing dual tasks. Among the 10 articles, 9 articles studied pace, of which 7 showed significant results. However, 2 were not significant. Also, 1 article that studied rhythm and 3 articles that studied variability showed significant results. The methodological quality of the 10 studies was fair. CONCLUSION: Gait pace was found to have a high correlation between memory, which is a cognitive ability, and overall cognitive function. It was observed that older adults with mild cognitive impairment have reduced gait pace in single-task walking, and further decrease in dual-task gait pace shows the correlation between memory and gait pace during walking.