• The Journal of Korean Physical Therapy
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• 제32권5호
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• pp.312-318
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• 2020

Purpose: This study aimed to investigate the evidence that therapeutic horseback riding can improve balance, muscle, ADL, equivalenc, GMFM, gait, emotion with developmental disabilities and neural patients. Methods: To conduct meta-analysis, the search focused on studies that employed therapeutic horseback riding for developmental disabilities and neural patients for which eight databases (KIS, RISS, DBpia, National Assembly Library, Pubmed, Embase, Google scholar and Cochrane Library) were used to extract literature published from 2002 to September 2019. The data were analyzed the RevMan 3.5.3 program. Results: As a result of meta-analysis, therapeutic horseback riding total effect size is 0.552 for children with developmental disabilities and neural patients. And effect size result of according to assessment type variable first, balance effect size is 0.594. Second, muscle activities effect size is 0.425. Third, ADL effect size is 0.430. Fourth, equivalance effect size is 0.640. Fifth, GMFM effect size is 0.482. Sixth, gait effect size is 0.400 and seventh emotion effect size is 0.876. Conclusion: These findings is horseback riding is effective The effect size by outcome was observed to be the effective for children with developmental disabilities and neural patients. and also the horseback riding provided the positive effects of balance, muscle activities, ADL, equivalance, GMFM, gait, emotion for children with developmental disabilities and neural patients. It is hoped that this study will contribute to the development of effective treatments for children with developmental disabilities and neural patients therapeutic horseback riding and the development of study.

• 대한물리의학회지
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• 제12권2호
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• pp.75-82
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• 2017

PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

• 한국전문물리치료학회지
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• 제26권1호
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• pp.1-7
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• 2019

Background: The Microsoft Kinect which is a low-cost gaming device has been studied as a promise clinical gait analysis tool having satisfactory reliability and validity. However, its accuracy is only guaranteed when it is properly positioned in front of a subject. Objects: The purpose of this study was to identify the error when the Kinect was positioned at a $45^{\circ}$ angle to the longitudinal walking plane compare with those when the Kinect was positioned in front of a subject. Methods: Sixteen healthy adults performed two testing sessions consisting of walking toward and $45^{\circ}$ obliquely the Kinect. Spatiotemporal outcome measures related to stride length, stride time, step length, step time and walking speed were examined. To assess the error between Kinect and 3D motion analysis systems, mean absolute errors (MAE) were determined and compared. Results: MAE of stride length, stride time, step time and walking speed when the Kinect set in front of subjects were investigated as .36, .04, .20 and .32 respectively. MAE of those when the Kinect placed obliquely were investigated as .67, .09, .37, and .58 respectively. There were significant differences in spatiotemporal outcomes between the two conditions. Conclusion: Based on our study experience, positioning the Kinect directly in front of the person walking towards it provides the optimal spatiotemporal data. Therefore, we concluded that the Kinect should be placed carefully and adequately in clinical settings.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.77-83
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• 2021

Background: Although symmetry of spatio-temporal parameter and center of pressure (COP) shift during walking is associated with knee adduction moment, research on clinical association with knee osteoarthritis (OA)-related knee pain and functional scores is lacking. Objects: The aims were 1) to compare symmetry of gait parameters and COP-shift in patients with unilateral knee OA and pain and matched controls, and 2) to investigate the relationship between symmetry of gait parameters and COP-shift, and clinical measures. Methods: Female subjects (n = 16) had with unilateral radiological knee OA and pain. Healthy controls (n = 15) were age-matched to OA group. Symmetry of foot rotation, step length, stance and swing phase, lateral symmetry of COP and anterior/posterior symmetry of COP during walking was assessed. To assess the clinical variables, pain intensity, pain duration and function using Knee Osteoarthritis Outcome Survey (KOOS) subscales were collected. We compared symmetry between groups using Mann-Whitney U-test or independent t-test. Relationships between clinical measures and symmetry index measured using Spearman's correlation test. Statistical significance was set at α = 0.05. Results: Knee OA group showed significantly greater values of only lateral symmetry of COP (p < 0.01) than healthy group. Values of lateral symmetry of COP had moderate or strong correlation significantly with the intensity of knee pain, pain duration, and scores of all KOOS subscales (p < 0.01). Conclusion: Patients with unilateral knee OA and pain showed more asymmetry of lateral COP-shift during walking compared with matched healthy controls. In addition, larger asymmetry of lateral COP-shift has the moderate or strong association with worse of knee pain, worse in KOOS scores and longer duration of knee pain. Asymmetry of lateral COP-shift during walking may be one of the characteristics of unilateral knee OA as the compensatory strategy response to unilateral OA of the knee.

• 대한화상학회지
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• 제23권2호
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• pp.31-36
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• 2020

Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR^® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1^st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• 재활복지공학회논문지
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• 제10권2호
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• pp.107-112
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• 2016

본 연구는 수중 경사로 보행 훈련이 제2형 척수성근위축증(spinal muscular atrophy type II) 아동의 넙다리네갈래근 활성화와 보행 및 일상생활동작에 미치는 영향을 알아보고자 하였다. 본 연구의 대상자는 만 5세의 제2형 척수성근위축증으로 진단받은 아동이었다. 본 연구는 단일 대상자 반전 연구 설계(A-B-A)를 이용하여 일주일에 3번 12회기 실행하였고 기초선 설정기간(A), 실험 적용기간(B), 관찰기간(A)으로 나누어 진행하였다. 기초선 설정기간, 관찰기간에서는 일반적인 수중 치료가 적용되었고 실험 적용기간에는 일반적인 수중 치료와 수중 경사로 보행훈련(60m 경사로 걷기)이 추가되었다. 제2형 척수성근위축증 환자의 보행에 큰 영향을 끼치는 넙다리네갈래근 활성화 측정을 위해 표면 근전도 검사가 실시되었고, 동적인 기능평가를 위해 일어나 걷기 검사와 일상생활 기능평가(ACTIVLIM)를 실시하였다. 그 결과 기초선 설정기간에 비해 실험 적용기간에서 넙다리네갈래근의 활성화가 감소하였고 보행 시간도 감소하였다. 일상생활 기능은 변화가 나타나지 않았다. 하지만, 관찰기간동안 다시 넙다리네갈래근의 활성화 증가, 보행시간 증가, 일상생활 기능 감소가 나타난 것으로 보아 수중 경사로 보행 훈련이 본 아동에게 기능적으로 영향을 끼쳤음을 알 수 있었다.

• 디지털융복합연구
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• 제13권10호
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• pp.541-548
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• 2015

본 연구의 목적은 뇌졸중 환자를 대상으로 측방보행 훈련이 균형(기능적 보행 검사, 일어나 걸어가기 검사) 및 보행(10 미터 보행검사)에 미치는 영향을 알아보고자 하였다. 28명의 뇌졸중 환자를 대상으로 실험군(측방 보행군)과 대조군(전방 보행군)에 각각 14명씩 무작위로 배정하였다. 두 그룹 모두 재활 물리치료를 4주 동안 실시하였다. 실험군에는 4주 동안 1회당 20분씩 주 3회 측방보행 훈련을 실시하였고, 대조군에도 4주 동안 1회당 20분씩 주 3회 전방보행 훈련을 실시하였다. 측방보행 후 기능적 보행평가를 측정한 결과 실험군에서 16.86점에서 18.64점으로 유의하게 향상되었고(p<.05). 일어나 걸어가기 검사에서도 26.03초에서 22.43초로 감소하여 유의하게 향상되었다(p<.05). 10미터 보행검사에 있어서도 실험군에서 21.90초에서 19.10초 감소하여 유의하게 향상되었다(p<.05). 따라서 측방보행 훈련이 뇌졸중 환자의 균형 및 보행을 증진시키는데 유용한 훈련으로 제안할 수 있을 것이다.

• 한국산학기술학회논문지
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• 제11권1호
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• pp.368-374
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• 2010

본 연구는 가정용 게임기를 이용한 재활 운동을 적용하여 뇌졸중 환자의 보행능력에 효과가 있는가를 알아보고자 하였다. 뇌졸중으로 6개월 이상 장애를 가진 32명이 연구에 참여하였고 게임운동군 16명과 대조군 16명으로 나누었다. 게임운동군은 가정용 게임기(PS2, sony)를 이용하여 1시간씩 주 3회를 6주간 실시하였다. 대조군은 운동의 적용없이 평상시 생활을 유지하도록 하였다. 운동 전과 후에 보행능력을 측정하여 효과를 비교하였다. 통계처리 방법으로 전.후 차이를 검증하기 위하여 Wilcoxon rank 검정을 실시하였고 대조군과의 차이 검증을 위하여 Mann.Whitney U 검정을 실시하였다. 모든 통계적 유의수준은 0.05로 하였다. 본 연구의 결과 보행능력에서 10 m 보행속도가 유의하게 증가하였고(p<.05), 6분 보행거리도 유의하게 증가하였다(p<.05). 결론적으로 가정용 게임기를 이용한 재활운동이 뇌졸중 환자의 보행능력에 효과가 있는 것으로 나타났다. 향후 뇌졸중 환자에게 흥미를 유발하고 기능회복의 효과를 가진 게임형태의 재활운동이 다양하게 개발되어 적용하는 연구가 필요하다고 생각한다.

• 디지털융복합연구
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• 제13권1호
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• pp.367-373
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• 2015

본 연구의 목적은 뇌졸중 환자를 대상으로 후방보행 훈련이 균형능력(기능적 보행 검사, 일어나 걸어가기 검사) 및 보행(10 미터 보행검사)에 미치는 영향을 알아보고자 하였다. 이를 위해 18명의 뇌졸중 환자를 대상으로 실험군과 대조군에 각각 9명씩 무작위로 배정하였다. 두 그룹 모두 일반적인 신경학적 재활 물리치료를 1회 45분씩 주당 5회 4주 동안 실시하였으며, 실험군에는 후방보행 훈련을 4주 동안 1회당 20분씩 주당 3회를 추가하여 실시하였다. 후방보행 훈련 후 균형능력을 평가한 결과 기능적 보행평가는 $17.67{\pm}1.00$점에서 $19.22{\pm}1.10$점으로 상승하였고(p<.05), 일어나 걸어가기 검사에서는 $26.45{\pm}1.37$초에서 $23.28{\pm}1.35$초로 감소하여 유의하게 향상되었다(p<.05). 후방보행 훈련 후 10 미터 보행검사에서도 $21.74{\pm}1.35$초에서 $18.33{\pm}1.10$초 감소하여 유의하게 향상되었다(p<.05). 따라서 뇌졸중 환자에게 후방보행 훈련을 적용하면 균형능력(기능적 보행평가, 일어나 걸어가기 검사) 및 보행(10 미터 보행 검사)에 향상을 가져옴으로 유용한 운동치료의 프로그램으로 제안할 수 있을 것이다.