• The Journal of Korean Physical Therapy
• /
• v.17 no.3
• /
• pp.339-350
• /
• 2005

This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.1
• /
• pp.125-135
• /
• 2012

Purpose : This study is designed to demonstrate the effects of circuit obstacle group gait training on walking ability and emotion in stroke patients. Methods : Twenty one patients with stroke were participated in this study. The subjects were divided into control group(n=10) and experimental group(n=11). Circuit obstacle group gait training consisted of walking around obstacles, walking over obstacles, walking up and down slopes and walking up and down stairs. Circuit obstacle group gait training was conducted five times per week, 1 hour per session, for 6 consecutive weeks. At pre-test and post-test, subjects were tested with 10 m walking test, timed up and go test, up and down 4 stairs test, depression and self esteem. Results : After 6 weeks of research, the experimental group showed statistically significant difference in all items when comparing prior to training and after training (p<.05), but the control group showed statistically significant difference in items other than depression and self esteem(p<.05). In the comparison between the two groups, the experimental group showed higher improvement than the control group in the 10 m walking test, timed up and go test, and up and down 4 stairs test, and there was statistically significant difference in decrease of degree in depression between the experimental group and control group(p<.05). Conclusion : This study have shown that circuit obstacle group gait training improves walking ability and emotion in stroke patients.

• Journal of the Korean Society of Physical Medicine
• /
• v.16 no.4
• /
• pp.13-21
• /
• 2021

PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.

• Korean Journal of Applied Biomechanics
• /
• v.23 no.3
• /
• pp.271-278
• /
• 2013

The purpose of this study was to determine the effect of Pilates Reformer training on gait improvement of subjects with asymmetric pelvic rotation. The seven subjects with greater pelvic rotation in right swing were assessed twice, 4 weeks apart, during which there was submitted to a Pilates Reformer training (three 40 min session per week). The kinematic data consisted of pelvic rotation and flexion angle of hip and knee joint was measured during gait. In comparison between both leg swings, max, min and range values of pelvic rotation was not significantly difference. After training, range of pelvic rotation in right swing was significantly decreased, but in left swing was not. In comparison between both leg swings, the values of max of hip and knee joint angle was significantly difference. After training, max values of angle of knee joint in right swing was significantly increased, but in left swing was not. The result of this study revealed that Pilates Reformer training was effective in improving gait to symmetric pelvic rotation.

• Physical Therapy Korea
• /
• v.25 no.2
• /
• pp.53-61
• /
• 2018

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

• Physical Therapy Korea
• /
• v.2 no.2
• /
• pp.9-23
• /
• 1995

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

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

• PNF and Movement
• /
• v.10 no.2
• /
• pp.41-46
• /
• 2012

Purpose : This study investigated the effect of 4 weeks training of virtual reality game on balance and gait ability, depression of elderly people. Methods : The subjects of this study were 12 elderly people over 65 age. The subjects were treated by training using virtual reality gam (during 60 minutes, 3 times a week for 4 weeks). The results of the experiment were analyzed using paired T-test along with averages and standard deviations as the statistical methods for data analyses. Results : In comparison of depression, gait and balance ability between pre-test and post-test, there were statistically significant differences. Conclusion : Our study finding indicate that training using virtual reality game could improve balance and gait ability, depression in elderly people. According to our study, training using virtual reality game is judged to be used for elderly people with gait and balance problems, depression to prevent fall down.

• Physical Therapy Rehabilitation Science
• /
• v.11 no.4
• /
• pp.471-477
• /
• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• The Journal of Korean Physical Therapy
• /
• v.35 no.6
• /
• pp.200-205
• /
• 2023

Purpose: The purpose of this study is to find out how gait training with shoulder-back assistive device affects dynamic and static balance, gait of patients with stroke and to help improve body alignment, balance, and gait ability in stroke patients. Methods: Measurements were taken of the 20 subjects before intervention without shoulder-back assistive device, after intervention with device, and follow up after an hour compared. Berg balance scale used to evaluate dynamic balance; wii balance board was used to measure static balance; and gait ability were measured by timed up and go test and 10-meter walk test. To analyze the results, a one-way repeated measures analysis of variance was implemented to compare the measurements. Results: The results showed that, after wearing the shoulder-back assistive device, the subjects' dynamic balance statistically significantly improved; no statistically significant difference was observed in static balance, although their balance ability was enhanced; and their increase in gait ability was statistically significant. Conclusion: This study proved that gait training combined with a shoulder-back assistive device positively impacted dynamic and static balance, gait of patients with stroke.