• Journal of the Korean Society of Physical Medicine
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• v.19 no.3
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• pp.29-36
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• 2024

PURPOSE: To examine the effects of functional electrical stimulation during gait training on the gait, balance, and lower extremity function of chronic stroke patients. METHODS: A total of 20 subjects diagnosed with chronic stroke were randomly divided into experimental group that performed functional electrical stimulation during gait training, and a control group applied with only functional electrical stimulation, with 10 subjects in each group. RESULTS: In the Berg Balance Scale, the experimental group ranged from 19.80 ± 4.93 to 24.30 ± 6.63 and the control group ranged from 39.40 ± 12.72 to 40.10 ± 13.18, which showed significant differences (p < .05), and there was a significant difference between the groups (p < .05). In 10 Meter Walk Test, the experimental group ranged from 28.70 ± 4.03 to 26.42 ± 3.56, which showed significant differences (p < .05), and there was a significant difference between the groups (p > .05). In Fugl-Meyer Assessment Scale-Lower extremity, the experimental group ranged from 22.70 ± 4.49 to 25.30 ± 4.39 and the control group ranged from 21.10 ± 5.34 to 25.30 ± 4.49, which showed significant differences (p < .05), and there was no significant difference between the groups (p > .05). CONCLUSION: Functional electrical stimulation during gait training may be suggested as an effective program for improving gait, balance, and lower extremity function of stroke patients. Therefore, functional electrical stimulation during gait may be recommended as part of the rehabilitation program for chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.98-103
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• 2022

Purpose: New therapeutic approaches have emerged to improve gait ability in patients with brain damage, such as action observation learning (AOT), auditory cueing, motor imagery etc. We attempted to investigate the effects of AOT with auditory cueing (AOTAC) on gait function in patients with stroke. Methods: The eighteen stroke patients with a unilateral hemiparesis were randomly divided into three groups; the AOTAC, AOT, and control groups. The AOTAC group (n=8) received training via observing a video that showed normal gait with sound of footsteps as an auditory cue; the AOT group (n=6) receive action observation without auditory stimulation; the control group (n=5) observed the landscape video image. Intervention time of three groups was 30 minutes per day, five times a week, for four weeks. Gait parameters, such as cadence, velocity, stride length, stance phase, and swing phase were collected in all patients before and after each training session. Results: Significant differences were observed among the three groups with respect to the parameters, such as cadence, velocity, stride length, and stance/swing phase. Post-hoc analysis indicated that the AOTAC group had a greater significant change in all of parameters, compared with the AOT and control groups. Conclusion: Our findings suggest that AOTAC may be an effective therapeutic approach to improve gait symmetry and function in patients with stroke. We believe that this effect is attributable to the change of cortical excitability on motor related to cortical areas.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.351-360
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• 2013

PURPOSE: The purpose of this study was to investigate the effects of observed action gait training on stroke patients. METHODS: 22 subjects were randomized into two groups. The observed action gait training performed that watched a video of normal gait before gait training and the general gait training without watching it. The experimental group(n=11) performed observed action gait training and the control group(n=11) performed general gait training. Both group received gait training for 3 times per week during 8 weeks. RESULTS: The experimental group showed significant differences in the cadence, gait velocity, stride, step, single limb support, double limb support, stride length and step length(p<.05). The control group showed significant differences only in the stride(p<.05). CONCLUSION: The observed action gait training affected coordination and weight shift, as well as symmetry of the body. Plasticity of the brain was facilitated by repetitive visual and sensory stimulation. The observed action gait training promoted the normal gait by watching the normal gait pattern. In conclusion, motor learning through the sensory stimulation promotes brain plasticity that could improve motor function, and observed action gait training indirectly identified stimulated brain activities.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.364-368
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• 2015

Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.221-230
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• 2023

Purpose : This study was performed to evaluate the effects of virtual reality combined robot assist gait training (VRG) on improvement of balance and respiratory function in chronic stroke patients. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 35 chronic stroke patients. They were randomly allocated 2 groups; VRG group (n=18) and conservative treatment group (CG; n=17). The VRG group received 30 minutes robot assisted gait training combined virtual reality training, robot assisted gait training was conducted in parallel using a virtual reality device (2 sessions of 15 minutes in a 3D-recorded walking environment and 15 minutes in a downtown walking environment). In the conservative treatment group, neurodevelopmental therapy and exercise therapy were performed according to the function of stroke patients. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome balance and respiratory function were measured by a balance measurement system (BioRescue, Marseille, France), Berg balance scale, functional reach test for balance, Spirometry (Cosmed Micro Quark, Cosmed, Italy) for respiratory function Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximum expiratory volume (PEF) were measured according to the protocol. The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in balance and respiratory function during intervention period. VRG revealed significant differences in balance and respiratory function as compared to the CG groups (p<.05). Our results showed that VRG was more effective on balance and respiratory function in patients with chronic stroke. Conclusion : Our findings indicate that VRG can improve balance and respiratory function, highlight the benefits of VRG. This study will be able to be used as an intervention data for recovering balance and respiratory function in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.47-54
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• 2020

PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.

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

• The Korean Journal of Rehabilitation Nursing
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• v.19 no.2
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• pp.108-117
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• 2016

Purpose: This study aimed to prove the effects of the net-step exercise (NSE) on gait ability, depression, cognitive function and activities of daily living (ADL) in older adults. Methods: The study employed a non-equivalent control group non-synchronized design. A total of 64 community-dwelling older adults were recruited and divided equally into two groups; 32 subjects for an experimental group and 32 subjects for a control group. In the experimental group, the NSE was applied to an hour, two times per week for 4 weeks. The level of gait ability, depression, cognitive function and ADL were measured before and after NSE. The study conducted from July to August, 2016. Data were analyzed with descriptive statistics, $x^2$ test, Fisher's exact test, t-test, ANCOVA, and Pearson correlation coefficients using SPSS/WIN 22.0 version. Results: Gait ability, depression, cognitive function were significantly better in the experimental group than the control group. However, the difference in ADL was not significant between the two groups. Conclusion: These findings in this study showed that the NSE was an efficient intervention for older adults. Nurses could apply non-pharmacological interventions to avoid pharmacological side-effects.

• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.17-28
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• 2003

The aim of this study was to investigate the effects of treadmill gait training on the functional characteristics and the temporal-distance parameters of gait in hemiplegic patients, as compared with conventional gait training. The subjects of this study were 32 hemiplegic patients who had been admitted or were visited out-patients at Kangdong Sacred Heart Hospital, Hallym University, from March 3 through April 25, 2003. These subjects were randomly divided into treadmill gait training group or conventional gait training group. We evaluated the gait ability, motor functions, muscle strength, spasticity, physiological cost index, and temporal-distance parameters. We analyzed the changes between pre and post training in each groups, and the difference between two groups. Temporal-distance parameters were obtained using the ink footprint method and then energy consumption using physiological cost index. The results were as follows: 1. After a six-week training, treadmill gait training group significantly improved, as. compared to pre-training, in gait ability, motor functions for the leg and trunk and gross function, muscle strength of the lower limb, gait speed, cadence, step length both on the affected and on the unaffected side, step length symmetry, and energy consumption(p<0.05). 2. After a six-week training, conventional gait training group significantly improved, as compared to pretraining, in gait ability, motor functions for the leg and trunk, muscle strength of the lower limb, spasticity the upper limb, gait speed, cadence, step length both on the affected and on the unaffected side, and energy consumption(p<0.05). 3. After a six-week training, the treadmill gait training group significantly improved, as compared to the conventional gait, training, in gait speed and step length on the unaffected side. These results show that treadmill gait training was improved gait speed and step length on the unaffected side of hemiplegic patients, as compared with conventional gait training. Further research is needed to confirm the generalization of these findings and to identify which hemiplegic patients might benefit from treadmill gait training.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.247-253
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• 2012

The purpose of this study was to evaluate the effects of a visual flow speed's modulation-based VR(virtual reality) program on gait function in stroke patients. Thirty one stroke patients were randomly selected at Dep. of Rehabilitation medicine of M hospital in Seoul. We carried out the gait analysis by dividing them with four conditions : one condition had applied without the visual flow modulation-based VR and another had done three visual flow speed's modulation-based VR(0.25, 1, 2 times). The gait analysis was used with GaitRite system. The data were collected using gait velocity, cadence, stride length, step length, single support time, and double support time during treatment. The results were as follows. First, the slow visual flow(0.25 times)-based VR program on the condition was significant decrease gait velocity, cadence, stride length, step length and increase single support time, double support time(p<.05). Second, the fast visual flow(2 times)-based VR program on the condition was significant increase gait velocity, cadence, stride length, step length, single support time on paretic lower limb and decrease single support time on non-paretic lower limb, double support time(p<.05). Third, the normal visual flow(1 times)-based VR program on the condition was not significant differ gait velocity, cadence, stride length, step length, single support time, double support time. In conclusion, the visual flow speed's modulation-based VR program improves gait function in chronic stroke patients.