• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.1-12
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• 2006

Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.

• The Journal of Korean Physical Therapy
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• v.20 no.1
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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.

• Journal of Biomedical Engineering Research
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• v.28 no.2
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• pp.218-228
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• 2007

Modem concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. In this study, we developed an active gait training system for patients with gait disorder. This system provides joint movements to patients who cannot carry out an independent gait. It provides a normal stance-swing ratio of 60:40 using an eccentric configuration of two gears. Joint motions of the knee and the ankle were evaluated with using the 3D motion analysis system and compared with the results from the multi-body dynamics simulation. In addition, clinical investigations were also performed for low stroke patients during the 6-week gait training. Results from the dynamics simulation showed that joint movements of the knee and the ankle were affected by the gear size, the step length and the length of the foot plate, except the radius of curvature of the foot guide plate. Also, the 6-week gait training revealed relevant improvements of the gait ability in all low subjects. Functional ambulation category levels of subjects after training were 2 in three patients and 1 in a patient. The developed active gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke.

• Proceedings of the KIEE Conference
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• 2008.04a
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• pp.73-74
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• 2008

In this study, we developed a robotic gait trainer which induces the active gait training based on predefined continuous proper lower extremity joint movements. AC servo motors and linear actuators were used to control hip and knee joints of patients and the weight support system was used to support the patient's weight during the gait training. We also implemented a Gill program to set the gait training pattern with several training parameters and to confirm states of patients and the system through the visual feedback. The effectiveness of the gait training system will be determined by the long-term clinical experiments in the future. We expect that the developed robotic gait training system could be applied very practically to recover gait abilities for persons with gait disorder.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.7-12
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• 2014

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.67-71
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• 2013

Background: The purpose of this study was to investigate the effects of somatosensory stimulations with joints mobilization in foot on balance and gait speed in elderly women. Methods: This study included 2 female participants aged 72 years. Participants received somatosensory simulations with joints mobilization on both foot for 30 minutes a day, 3 days a week, during a 4 week period. All subjects were assessed using a BT(balance trainer)-4 balance measurement and timed up and go test (TUG), 10m walk test (10MWT). Results: It has been found that static length and static area were reduced and limits of stability was increased in 2 females. TUG test was improved but gait speed was not significantly difference. Conclusion: Those results indicate that somatosensory stimulations with joints mobilization is effective in elderly women to promoting a static and dynamic balance ability.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.62-71
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• 2023

Objective: Stroke patients need the training to adjust their posture and maintain balance is necessary to restore movement function, and unstable support training is one of the appropriate training. In this study, a systematic review and meta-analysis were conducted to find out the effects of unstable surface training on balance and gait in stroke patients. Design: Systematic review and meta-analysis Methods: After creating a search expression referring to MeSH and EMTREE, the literature from 1976 to February 2022 was searched in the databases of PubMed, EMBASE, and Cochrane Library CENTRAL. A total of 331 studies were searched from three databases, and 11 studies were finally selected according to the inclusion criteria. Unstable surface training included studies using balance trainer, Whole-body vibration, and sand surfaces. Results: The results were found to be d=2.28 (p=0.02) and the effect size was 0.36 (95% CI: 0.05, 0.67) on the Berg Balance Scale. In the Kinesthetic Ability Trainer static balance, d=2.59 (p=0.01) and the effect size was 1.01 (95% CI: 0.24, 1.78). Timed Up and Go test showed that d=2.18 (p=0.03) and the effect size was 0.38 (95% CI: 0.04, 0.72). At the gait speed, d=0.99 (p=0.32) and the effect size was 0.15 (95% CI: -0.15, 0.45). In the 6-minute walk test, d=0.14 (p=0.89) and the effect size was 0.04 (95% CI: -0.47, 0.55). Conclusions: In this study was found that training was effective in balance if it became unstable in standing posture. Therefore, unstable surface training can be used to improve the balance of stroke patients in clinical practice.

• 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.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Korean Journal of Applied Biomechanics
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• v.20 no.2
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• pp.129-137
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• 2010

The purpose of this study is to investigate the effect of a 12-week aquatic exercise on obstacle gait in older women. Originally, 20 healthy female elderly participated this study but 12 of them completed the program. All participants were trained in the aquatic exercise program by an authorized trainer. They had come to the authors' lab three times during training period(0, 6, 12 weeks) and performed obstacle gait with three different height(0, 30, and 50% of leg length). After performed 3-Dimensional motion analysis following results were found. (1) For the CV, MVHC, TC, HC, statistically significances were shown in obstacle height. Although significant training effects were not shown, all variables showed typical patterns and it was considered as efficient motion to overcome the height obstacles. (2) The anterior-posterior and vertical GRF of support leg during support phase were revealed in height effect but in training one. However, differences between Peak 1 and Peak 2 in vertical GRF increased as training period increased. (3) Knee and hip resultant joint moments were affected by training but ankle resultant moments remained unchanged.