• Physical Therapy Rehabilitation Science
• /
• v.5 no.4
• /
• pp.170-176
• /
• 2016

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

• Physical Therapy Rehabilitation Science
• /
• v.6 no.3
• /
• pp.120-126
• /
• 2017

Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on strength, proprioception, and walking ability in persons with stroke. Design: Randomized control trial. Methods: Twenty eight subjects participated in the study in which they were randomly assigned to either the underwater backward treadmill training (UBTT) group (n=13) or the BTT group (n=15). In both groups, forward gait training was performed for 20 minutes on the ground treadmill. The UBTT group performed backward gait on an underwater treadmill for 20 minutes while the BTT group performed backward gait on a ground treadmill for 20 minutes. The gait training in each group was performed twice a week for a total of six weeks. Muscle strength, proprioception, and gait ability was assessed using a digital power meter, joint angle recurrence method using the smartphone protractor application, the Figure-of-Eight walk test (F8W) and the functional gait assessment (FGA) respectively. Results: Both groups showed significant improvement in strength, F8W and FGA scores after training (p<0.05). However, there was no statistically significant difference between the two groups. Both groups showed significant improvement in proprioception after training (p<0.05). In the comparison between the two groups, there was a greater significant change in the UBTT group for joint proprioception (p<0.05). Conclusions: In this study, it was found that both backward treadmill gait training programs were effective on strength, proprioception, and gait ability, and that underwater training was particularly effective on proprioception compared to ground training.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.4
• /
• pp.411-421
• /
• 2012

PURPOSE: The purpose of this study was to investigate the effect of balance rehabilitation training with the visual cue deprivation on gait function in stroke patients in comparison with balance training without the visual cue deprivation. METHODS: Twenty two stroke patients participated in this study. Patients were randomly assigned to one of the two balance training program with and without the visual cue deprivation. Balance training session for each group lasted 50 minutes, 3 times a week for a total of 6 weeks. Gait function was measured with the Functional Gait Assessment (FGA), the self-selective comfortable gait speed (CGS), the maximal gait speed (MGS), and the Gait Analysis System. Temporal and spatial gait parameters of each evaluation were measured before and after the balance training program respectively. RESULTS: After the program, the visual cue deprivation group improved significantly in the FGA, the CGS, the gait velocity, the step time, the step length, the stride length, and the Functional Ambulation Performance (FAP) in comparison with the balance training group with the visual cue (p<.05). CONCLUSION: The gait function of the participants with the visual cue deprivation showed more improvement after the balance training program compared to the patients group without the visual cue deprivation, Therefore, the balance training program with the visual cue deprivation may be useful for rehabilitation of patients with chronic stroke.

• PNF and Movement
• /
• v.15 no.3
• /
• pp.361-371
• /
• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• The Journal of Korean Medicine
• /
• v.33 no.1
• /
• pp.148-159
• /
• 2012

Objectives: This study investigated the correlation among Postural Assessment Scale for Stroke (PASS), Timed "Up and Go" Test (TUG) and gait (velocity, cadence, step-length, stride-length and single-limb support). Methods: The 70 subjects were assessed on trunk control measured with the use of the PASS, dynamic balance (TUG) and gait function (by GAITRite). The data were analyzed using Pearson product correlation. Results: The PASS total scores were significantly correlated with PASS-M, PASS-C, and PASS-T (r =.80 ~ .88 p<.01). All items of the PASS were significantly correlated with TUG (r = -.63 ~ -.81 p<.01), velocity (r = .44~.58 p<.01), cadence (r =.38 ~.51. p<.01), affected side step length (r = .44 ~.56 p<.01) and affected side stride length (r = .45 ~.59 p<.01). But affected side single-limb support was lowly correlated with PASS-M, PASS-C, PASS-T and PASS-total (r = .25~.36 p<.05). Conclusions: Measures of trunk control were significantly related with values of dynamic balance and gait. Based on these results, trunk control is an essential core component of balance and gait. Trunk control training programs after stroke should be developed and emphasized.

• Journal of the Korean Society for Precision Engineering
• /
• v.22 no.5 s.170
• /
• pp.197-204
• /
• 2005

In this study, ground reaction force(GRF), absolute symmetry index(ASI) and coefficient of variation(CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated to show the biomechanical evaluation for above knee amputees. In the experiments, 37 normal male volunteers, two male and two female AK amputees were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle was superior to the other two ankle assemblies for the characteristic of forwarding and breaking forces. Multi-axis ankle was relatively superior to the other two ankle assemblies for gait balancing and movement of the center for mass. single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

• Physical Therapy Korea
• /
• v.5 no.1
• /
• pp.17-29
• /
• 1998

The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.89 and $r_s$=0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.82 and $r_s$=0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

• Physical Therapy Rehabilitation Science
• /
• v.6 no.3
• /
• pp.140-145
• /
• 2017

Objective: The purpose of this study was to investigate the effect of visual block with ankle joint fatigue on gait and dynamic balance ability. Design: Cross-sectional study. Methods: Thirty healthy young adults (men=15, women=15) between 22 to 25 years of age voluntarily participated in this study. All subjects performed the gait and dynamic balance test successively in two conditions: the visual block and the open eyes condition. Before the gait and dynamic balance test, muscle fatigue on the ankle joint was induced to all subjects by doing ankle dorsiflexion and plantarflexion alternately, and then gait parameters (step length, stride length, cadence, velocity, single limb support, and double limb support) were assessed by walking on the GAITRite system (CIR Systems Inc., USA). Subjects also performed the functional reach test (FRT) for assessment of dynamic balance. This study examined gait parameters and FRT scores in each visual block and open eyes condition. Results: The results showed that FRT scores with the visual block condition significantly decreased compared to without visual blocking (p<0.01). Step length, stride length, cadence, and velocity of gait parameters decreased significantly in the visual block condition (p<0.01) while there was no significant difference for single limb support. However, double limb support increased significantly in the visual block system (p<0.01). Conclusions: Therefore, blocking of visual information with muscle fatigue of the ankle joint can affect gait and balance ability of young adults and increase the risk of falls.

• The Journal of Korean Physical Therapy
• /
• v.32 no.1
• /
• pp.1-6
• /
• 2020

Purpose: This study examined the effects of action observational training to improve the gait function for patients with stroke. Methods: The participants were divided into two groups: right hemiplegia group (n=12) and left hemiplegia group (n=12). All groups received conventional therapy for five sessions for 30 minutes, each for three weeks. Left and right hemiplegia group practiced additional action observational training for five sessions for 20 minutes each for three weeks. They participated in three weeks of action observational training coupled with immediate physical practice (intervention), followed by a final assessment. The duration of each action observation video sequence was 10 minutes, followed immediately by practice of the observed motor skill (10 minutes). The gait velocity, cadence, swing time, step length, and BOS (base of support) were examined using the GAITRite system. Results: The results of this study showed significant improvement in the gait function. The outcomes of the gait abilities from gait velocity, cadence, swing time, step length of the affected side, and BOS (base of support) were improved significantly in the right hemiplegia group (p<0.05). In the left hemiplegia group, there was no significant improvement in the gait velocity, cadence, and BOS except for the swing time and step length of the affected side. The left and right group comparisons between the groups were not significant (p<0.05). Conclusion: Action observation training improves the gait function. These results suggest that action observational training is feasible and suitable for stroke patients.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.3
• /
• pp.293-302
• /
• 2012

Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.