• Title/Summary/Keyword: Gait scale

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The effects of water-based exercise on postural control in children with spastic cerebral palsy

  • Kim, Kyung Ho;Shin, Hwa Kyung
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.77-82
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    • 2017
  • Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

A Case Report of Miller-Fisher Syndrome with Bilateral Abducens Nerve Palsy (밀러-피셔 증후군 환자의 양안 외전신경마비 치험 1례)

  • Yoon, Seok-Yeong;Roh, Min-Yeong;Kam, Eun-Young;Kang, Eun-Jeong;Kim, Jong-Han;Choi, Jeong-Hwa;Park, Soo-Yeon;Jung, Min-Yeong;Lee, Ji-Hyun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.133-144
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    • 2020
  • Objectives : The purpose of this study is to report the effect of Korean medicine treatment on limitation of eye movement in Miller-Fisher Syndrome. Methods : A patient was treated with herbal medicines, acupuncture(including electropuncture, phamacopuncture), Moxibustion and cupping therapy. To evaluate the result of this treatment, we used photographs of eye movement, Scott and Kraft score of both eye, length of eyeball movement and visual analogue scale(VAS) for subjective symptoms. Results : After treatment, the limitation of eye movement and diplopia were remarkably improved. Also, other symptoms such as dizziness, gait disturbance, facial nerve disorder were disappeared. Conclusions : This study suggests that Korean medicine treatments are effective for patient with limitation of eye movement in Miller-Fisher Syndrome.

The Reliability and Validity of Figure-of-8 Walk Test in Patients with Stroke (뇌졸중 환자에서 Figure-of-8 walk test의 신뢰도와 타당도)

  • Kim, Yang-Ho;Lim, Jae-Heon
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.10 no.1
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    • pp.29-37
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    • 2012
  • Purpose : The purpose of this study was to establish intra-rater, inter-rater, test-retest reliability, and concurrent validity of figure-of-8 walk test in people with stroke. Methods : The subjects of this study were 17 patients who were diagnosed with a stroke. Subjects were tested twice by the same raters, with 1 day between tests. Subjects were assessed by two physical therapists. Test-retest reliability was calculated using intraclass correlation coefficients (ICC). The concurrent validity was demonstrated by spearman correlation of F8WT with 10m walking test (10MWT), timed up and go test (TUG), Berg balance scale (BBS), dynamic gait index (DGI) and four square step test (FSST). Results : Intra-rater, inter-rater, test- retest of F8WT time, showed high reliability. Intra-rater, inter-rater, test-retest of F8WT steps demonstrated high reliability. Intra-rater, inter-rater, test-retest of F8WT total smoothness score showed below moderate reliability. There was a significant positive correlation of F8WT time with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT time with DGI, BBS. There was a significant positive correlation of F8WT steps with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT steps with DGI. There was a significant positive correlation of F8WT test total smoothness score with BBS. Conclusion : The time, and number of steps in F8WT show high inter, intra-rater, test-retest reliability. The F8WT smoothness shows below moderate reliability. The F8WT shows high concurrent validity with other comparable balance, and walking tests. The F8WT is a valid and reliable measure for assessing walking function in patients with a stroke.

A Case Report of Wallenberg Syndrome due to Lateral Medullary and Cerebellar Infarction Treated with Korean Medicine Treatment (외측 연수경색 및 소뇌경색에 의한 Wallenberg 증후군 환자의 한방 치험 1례)

  • Nam, Hyun-seo;Han, Seung-hee;Baek, Tae-hyun;Kim, Mikyung;Sun, Seung-ho;Jeong, Ui-min;Han, In-sik
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.768-775
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    • 2019
  • Objective: The aim of this study was to report a case in which Korean medicine treatment with Gami-daebo-tang and acupuncture improved the clinical symptoms in a patient with Wallenberg syndrome. Methods: The patient was treated for 53 days with a Korean medicine treatment consisting of Gami-daebo-tang and acupuncture. We measured dysesthesia based on the number of affected dermatomes. Gait ataxia was estimated with the Korean version of the Berg Balance Scale (K-BBS) and the number of times that the patient had stumbled per day. Dizziness was measured with a numerical rating score (NRS). Results: After treatment, the number of affected dermatomes was decreased. The K-BBS score was improved from 52 to 56, and the frequency of stumbling decreased from 20 to 0 times per day. The NRS score of dizziness decreased from 8 to 0. Conclusion: This case showed that Korean medicine treatment might be helpful for improving the symptoms of patients with Wallenberg syndrome.

A Case Report of a Proprioceptive Neuromuscular Facilitation Intervention Strategy Applied with an ICF Tool in a Patient with Anterior Cruciate Ligament Reconstruction (ICF 도구를 적용한 앞십자인대 재건술 환자의 고유수용성신경근촉진법 중재전략의 증례)

  • Song, Myung-Soo;Kim, Beom-Ryong;Kim, Chang-Heon;Noh, Hyun-Jeong;Kang, Mi-Gyeong
    • PNF and Movement
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    • v.15 no.1
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    • pp.1-11
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    • 2017
  • Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

Clinical features and risk factors for missed stroke team activation in cases of acute ischemic stroke in the emergency department

  • Byun, Young-Hoon;Hong, Sung-Youp;Woo, Seon-Hee;Kim, Hyun-Jeong;Jeong, Si-Kyoung
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.437-448
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    • 2018
  • Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

Effects of Calcaneus Fixation Taping on Quadriceps Angle and Lower Limb Muscles During Stairway Gait of a Patient with Patellofemoral Pain (무릎넙다리통증증후군 환자의 계단보행 시 발뒤꿈치뼈 교정 테이핑이 슬개대퇴각과 하지근육에 미치는 영향)

  • Oh, Kang-O;Lee, Sang-Yeol
    • PNF and Movement
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    • v.17 no.2
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    • pp.311-319
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    • 2019
  • Purpose: This study was conducted to determine the structural change in knees caused by quadriceps angle and the muscle activity in lower limbs. Indirect intervention was provided by using taping for stability in the ankle joints, which affected patellofemoral pain. Methods: The subjects in this study were 20 patients with patellofemoral pain who visited ${\bigcirc}{\bigcirc}{\bigcirc} $ Hospital in Busan. The visual analogue scale measured the dynamic quadriceps angle and the degree of pain felt by the patients while walking down stairs, which was a known factor of patellofemoral pain. In addition, muscle activities in the rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, peroneus longus, and biceps femoris, which affect the knees and ankles, were measured using surface electromyography. The muscle activities were converted into %RVC for this study. The data obtained in this study were analyzed with the Wilcoxon signed-rank test using the SPSS Ver. 25.0 statistical program. The significance level ${\alpha}$ was 0.05. Results: The study results showed that the pain and dynamic quadriceps angle were significantly reduced statistically when applying the calcaneus fixation taping (p<0.05). Muscle activity in the lower limbs was significantly decreased in the vastus medialis, vastus lateralis, and tibialis anterior (p<0.05). Conclusion: The summary of the study results verified that the calcaneus fixation taping reduced the pain and dynamic quadriceps angle by providing stability in the ankle joints. It also produced efficient movement due to the difference in lower-limb muscle activity.

Comparison of Spatiotemporal Parameters during Straight and Curve Walking for Patients with Stroke (뇌졸중 환자의 직선보행과 곡선보행 시 시공간적 변수의 비교)

  • Choi, Bo-Ra;Woo, Young-Keun;Hwang, Su-Jin
    • PNF and Movement
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    • v.17 no.1
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    • pp.129-136
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    • 2019
  • Purpose: This study is a comparison of spatiotemporal parameters between straight and curved walking in individuals with chronic hemiparetic stroke, investigating whether those patients can adapt their walking according to task demands and environmental changes. Methods: Twenty-eight patients who diagnosed with their first stroke at least six months prior to this study were recruited. They were measured for spatiotemporal parameters in three different walking conditions: straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. This study also measured secondary clinical factors, such as the timed up-and-go test, the trunk impairment scale, and the dynamic gait index. The statistical methods for the three different walking conditions, using the averaged value of each condition, was repeated measures ANOVA. Results: The difference in cadence was statistically significant when comparing straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. Swing duration (%) was also a statistically significant difference between straight walking and walking with an inner curve to the more-affected leg. However, differences in other spatiotemporal parameters were not statistically significant among the three conditions. Conclusion: The results of this study suggest that stroke survivors could adapt their walking according to straight and curved walking conditions, although cadence and swing duration were different between straight and curved walking groups.

Two Case Reports of Patients Diagnosed with Avascular Necrosis of the Femoral Head Treated with Korean Medicine Treatment Including Chuna Manual Therapy, Pharmacopuncture and Acupuncture (추나 요법 및 약침, 침치료를 비롯한 한방치료로 증상이 호전된 대퇴골두 무혈성 괴사 환자 2예 보고)

  • Kim, Da-hye;Kim, Eun-jung;Jo, Myeong-jae
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.195-204
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    • 2021
  • Objectives The purpose of this study is to report the effects of Korean medicine treatments including Chuna manual therapy, pharmacopuncture and acupuncture for two patients who have pain in hip joint diagnosed with avascular necrosis of the femoral head. Methods The treatment effect was evaluated with a numeric rating scale (NRS), range of motion (ROM), physical examination (Patrick test), and score of Harris hip score (HHS). Results After treatment, symptoms of the two patients such as hip joint pain and gait dysfunction were improved. The NRS decreased from 8 (right [Rt.]), 7 (left [Lt.]) to 4 (Rt.), 3 (Lt.) in case 1 and from 9 to 2 in case 2. Also the patients showed improvement in ROM and score of HHS increased from 55.5 to 88.5 in case 1 and from 63.5 to 85.5 in case 2. In addition, positive Patrick test improved to negative. Conclusions Korean medicine treatments including Chuna manual therapy, pharmacopuncture and acupuncture can be effective in relieving pain and recovering the fucnction of hip joint associated with avascular necrosis of the femoral head, even when surgery is recommended. Although further study such as controlled studies is needed.

The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement

  • Kim, San-Han;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.16-23
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    • 2022
  • Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.