• Physical Therapy Rehabilitation Science
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• v.2 no.1
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• pp.39-43
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• 2013

Objective: The objective of this study is to investigate the effect of treadmill gait trainig on dynamic balance and gait functions in stroke patients. Design: Randomized, double-blind, controlled pilot study. Methods: Four subjects following first stroke participated in this study. They were divided randomly into the treadmill gait trainig group (TM group) (n=2) and the control group (n=2). Subjects in both groups received general training five times per week. Subjects in the TM group practiced an additional treadmill gait trainig program that consisted of 60 minutes, three times per week, during a period of four weeks. Timed up and go test (dynamic balance) and the GAITRite test (gait function) were evaluated before and after the intervention. Results: In dynamic balance (timed up and go test), the TM group (-14.235 sec) showed a greater decrease than the control group (-13.585 sec). In gait functions, the TM group showed a greater increase in gait speed (12.8 cm/s vs. 10.15 cm/s), step-length (5.825 cm vs. 3.735 cm), and stride-length (5.005 cm vs. 1.55 cm) than the control group. Conclusions: The treadmill gait trainig improved dynamic balance and gait functions. Further research is needed in order to confirm the generalization of these findings and to identify which stroke patients might benefit from treadmill gait trainig.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.17-22
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• 2021

PURPOSE: This study examined the correlations between gait, static balance, and pelvic inclination in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The subjects participated in gait, static balance, and pelvic inclination tests. In the gait measurement, the cadence and gait velocity were measured, and the average of three trials was calculated and recorded. The static balance was measured using a force platform. The data was captured for ten seconds, and five successful trials were recorded. Pelvic inclination in the sagittal plane was measured using a palpation meter. For data processing, a KolmogorovSmirnov test was used to determine the type of distribution for all variables. Pearson's correlation coefficient was used for correlation analysis. The correlations among the gait, static balance, and pelvic inclination was calculated. The level of significance was .05. RESULTS: Significant negative correlations were observed between the gait variables (cadence, velocity) and static balance variables (COP path length, COP average velocity, and 95% confidence ellipse area) (p < .05). On the other hand, there was no significant correlation between pelvic inclination and gait or between the pelvic inclination and static balance variables. CONCLUSION: Significant correlations were observed between the gait function and static balance. On the other hand, there were no significant correlations between the pelvic inclination and gait and static balance. These results suggest that the pelvic inclination is not an important consideration for increasing the gait function and static balance.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.120-125
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• 2010

The purpose of this study was to compare the effects of treadmill walking in underwater and overground which affects gait and physical function of people who have had a stroke. Twenty people after a stroke who have become hemiplegic over 6 months were participated. Participants were divided into two groups: underwater treadmill group(UTG) and overground treadmill group(OTG). The intervention was done 4 times per weeks for 6 weeks and 1 session lasted for 30 minutes. Gait and physical function elements were measured at baseline, at the middle(3 weeks) and at the end of the intervention(6 weeks). For the elements of gait, walking velocity, affected stance phase, affected weight bearing were assessed. For the elements of physical function, Short Form 8(SF-8) health survey was used. The result of this study showed that both groups improved similarly in walking velocity. However participants in UTG improved more than those in OTG in affected stance phase(p<.05), affected weight bearing(p<.05) and emotional aspect(p<.001). Based on the results of this study, it can be suggested that treadmill walking both in underwater and on the ground can be effective in improving hemiplegic gait and physical function of people who have had a stroke. The result also suggest that the underwater treadmill exercise can be more effective than overground treadmill in restoration of gait in people after stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• Physical Therapy Korea
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• v.22 no.2
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• pp.30-40
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• 2015

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.55-65
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• 2020

Objective: The most important goal of hippotherapy is to improve function, gait, and balance. The purpose of this study was to investigate the effects of hippotherapy on function, gait, and balance of children with cerebral palsy (CP). Design: A systematic review and meta-analysis. Methods: We've searched the PubMed, EMBASE, and Cochrane Library CENTRAL databases for English experimental studies published up until September 2018. To analyze the effects of hippotherapy on the function, gait, and balance of children with cerebral palsy, the systematic review and meta-analysis were performed on Patient/Participants/Population Problem, Intervention, Comparison, Outcome with Timing, Setting Study Design. Papers retrieved from the database were removed from the literature management database. Methodological quality evaluation was evaluated using Cochrane's risk of bias. Data was analyzed using the Revman 5.3 program of the Cochrane library. Results: In this study, we found that the effect size of hippotherapy, denoted as d, was -3.82, and that hippotherapy had the most effect on gait, but no statistical significant difference was observed. We also found no significant difference in function and balance after hippotherapy. It was found from the funnel plot that there was no publication bias as the plot was symmetrically distributed around the dotted line. Conclusions: There are many unclear studies and a lack of randomized controlled trials (RCTs) in this research area. More RCTs on the effects of hippotherapy on children with CP should be conducted in the future.

• 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 Korean Physical Therapy Science
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• v.28 no.3
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• Physical Therapy Korea
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• v.26 no.2
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.25 no.4
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• pp.195-203
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• 2013

Purpose: The purpose of this study was to determine the effect of early Robot-assisted training on gait ability, function and ADL in patients with stroke. Methods: 26 patients with stroke were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 13 patients in each group. All subjects received a routine physical therapy. The robot-assisted training was for 30 min in the case of the EG subjects. The assessment tools of this study involved the gait ability, balance ability, function and ADL. The measurements were recorded before the intervention and after the intervention. Results: EG subjects and CG subjects, the variables measured after the intervention significantly differed from gait ability, balance ability, function and ADL without the FMA (p<0.05). The FMA was only effective experimental group after intervention. Also, there were significant differences in gait ability, balance ability, function and ADL without the FMA at post-test between the 2 groups (p<0.05). Conclusion: The findings indicate that early robot-assisted training exerts a positive effect on gait ability, balance ability, function and ADL in patients with stroke. This result indicates the possibility of application of the early Robot-assisted training to the management for stroke patients. Further studies are required to generalize the result for this study.