• The Journal of Korean Physical Therapy
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• 제20권1호
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• 한국전문물리치료학회지
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• 제5권1호
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• pp.17-29
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• 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.

• 대한통합의학회지
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• 제11권3호
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• pp.147-157
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• 2023

Purpose : Stroke patients exhibit considerable variations in gait patterns. Stroke patients generally show abnormal muscle tone and gait. This study was performed to evaluate the effects of treadmill gait training combined with muscle tone control technique (TM) on gait ability in patient with chronic stroke. Methods : A single-blind, randomized controlled trial was conducted with 36 patient with chronic stroke. They were randomly allocated 2 groups; treadmill gait training combined with muscle tone control technique group (TM group; n=18) and conservative treatment group (CG group; n=18). The TM group received 15 minutes muscle tone control technique and 15 minute treadmill gait training. In the conservative treatment group received 30 minutes conservative physical therapy. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome gait ability were measured by gait measurement system (Optogait, Microgate, Italy) and 10 m walking test (10MWT). An independent t-test was used to statistically analyze the pre-test and pos-ttest gait ability results. Results : Both groups demonstrated significant improvement of outcome in gait ability during intervention period. TM group showed significant differences in gait ability as compared to the CG groups (p<.05). TM group showed significant differences in 10MWT as compared to the CG groups (p<.05). Our results showed that TM was more effective on gait ability in patients with chronic stroke. Conclusion : Our findings of this study confirmed that the treadmill gait training combined with muscle tone control technique provided significant improvements on gait ability in patient with chronic stroke. Therefore treadmill gait training combined with muscle tone control technique may positive influenced gait ability. This study will be able to be used as an intervention data for recovering gait ability in patients with chronic stroke.

• 대한물리치료과학회지
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• 제28권3호
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• pp.88-97
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• 2021

Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.

• 국제물리치료학회지
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• 제2권1호
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• pp.207-213
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• 2011

In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

• 대한물리의학회지
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• 제17권1호
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• PNF and Movement
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• 제11권1호
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• pp.63-68
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• 2013

Purpose : The purpose of this study was to examine changes in spatiotemporal gait parameters(STGPs) in healthy adults before and after a immediate intervention of a Mulligan taping program(MTP). Methods : A total of 12 healthy adults(mean age, 20.82 years; age range, 19-24 years) participated in the study. performance was assessed by recording changes in the STGPs using GaitRite. comparisons of changes in the STGPs at pre-intervention and at dischange were analyzed using the Wilcox signed rank test and Mann-Whithney U test. Results : There was a significant improvement in the outcome measures of STGPs(stride length, velocity) after immediate of MTP(p<0.05). However, no significant different pre-test and post-test step width, toe angle(p>0.05). Conclusion : Participants in a MTP improves STGPs, thereby increasing the ability of healthy adults to maintain gait. MTP appears to be a safe and efficacious, noninvasive treatment modality for patients with knee joint disease.

• 대한물리치료과학회지
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• 제18권3호
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• pp.33-39
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• 2011

Background : The purpose of this study was to apply cervical orthosis for temporal parameters of gait was to evaluate the effect. Methods : Seven normal adults participated in this study. Before and after applying a cervical orthosis compared to gait. Outcome measure were: general characteristics, temporal parameters of gait. General chacteristics included age, gender, height, weight. Temporal parameters included the Velocity cycle, Stride length, Step length, Cadence cycle, Initial double support time. Temporal parameters of gait, using the motion analysis system for cervical orthosis were evaluated before and after applying. The data was analyzed using SPSS 12.0 software and the Wilcoxon's signed-ranks test. Results : Velocity cycle and Step length were no significant differences(p>0.05). But Stride length, Cadence cycle, Initial double support time were significant(p<0.05). After apply Cervical orthosis in gait, Stride length and Initial double support time was decreased and Cadence cycle was increased. Conclusion : Changes in temporal of temporal parameters of gait was apply a cervical orthosis with the limitations of vision due to take effect. Therefore, Cervical orthosis does not interfere with the normal gait pattern by limiting the Range of Motion so that we consider to apply.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.112-123
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• 2019

Objective: Based on the results of previous studies, it is necessary to analyze gait and discuss and present the effects of aquatic exercise for chronic stroke. The purpose of this study was to present objective data on the effect of aquatic exercise on the gait of persons with stroke by performing a meta-analysis. Design: A systematic review and meta-analysis. Methods: We performed a meta-analysis of 23 studies that investigated the effects of aquatic exercise performed between 2006 and 2017. The studies were searched on the basis of the participants, intervention, comparison, outcomes standard. The quality of the research method was assessed using a tool that can assess the risks posed by each study design. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publication bias. Results: The mean effect size of the patients' gait was 0.65 (p<0.05). The largest effect size by outcome was observed at the 6-m walk test, followed by the 6-minutes walk test, 10-m walk test, and the walking equipment test (p<0.05). The meta-regression analysis showed that the effect size increased with increased duration, number, and length of sessions. Conclusions: Aquatic exercise appears to show a moderate effect on the gait of chronic stroke survivors. Meta-analyses on the effects of aquatic exercise in other patient populations are needed. This study suggests standard criteria establishments for the effect of aquatic exercise on the walking ability of persons with chronic stroke.

• PNF and Movement
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• 제13권4호
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• pp.203-213
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• 2015

Purpose: Deficits in lower-extremity function and trunk control ability have a negative impact on individuals with hemiplegia. This case report aimed to describe the effect of trunk stability exercises using proprioceptive neuromuscular facilitation (PNF) on trunk control ability, balance, and gait in a patient with hemiplegia. Methods: A 77-year-old man with hemiplegia and trunk and lower extremity impairment participated in this four-week training intervention. Results: The patient demonstrated improvements in trunk control ability, balance, and gait performance. Outcome measures (Fugl-Meyer Assessment Lower Extremity (FMA-LE), Trunk Control Test, Berg Balance Scale, Timed Up and Go test, 10 Meter Walk test) were measured before and after the training program. Conclusion: The results of this case suggest that a trunk stability exercise using a PNF program may improve trunk control ability, balance, and gait in a patient with hemiplegia.