• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• 한국산학기술학회논문지
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• 제13권3호
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• pp.1153-1160
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• 2012

본 연구는 뇌졸중 환자의 보행수행을 저하시키는 발목 등쪽 굽힘근의 약화에 대해 발목 근력 강화 훈련과 정적 근육 신장 훈련을 이용하여 등쪽 굽힘을 시행한 훈련이 뇌졸중 환자의 족저압 및 보행에 미치는 영향을 알아보고자 하였다. 연구는 편마비 뇌졸중 환자 36명을 대상으로 뇌졸중 환자의 보행변수인 10m 걷기를 측정하고, 발바닥의 각 영역별 최대 족저압의 측정은 F-scan system을 사용하여 자료를 수집하여 연구하였다. 본 연구에서 각 훈련 전과 훈련 후의 보행의 변화 연구에서 발목 근력 강화 훈련군과 정적 근육 신장 훈련군은 10m 보행속도검사에서 보행속도가 감소하여 뇌졸중 환자의 보행에 좋은 영향을 미친다고 할 수 있겠다. 뇌졸중 환자 발의 압력측정에서 발목 근력 강화 훈련군 에서는 다른 그룹에 비해서 무지부, 족지부, 제1중족골두에서 최대 족저압이 증가 하였다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 춘계학술대회
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• pp.576-579
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• 2018

본 연구는 만성뇌졸중 환자에게 적용한 동작관찰 과제지향 훈련이 균형 및 보행능력에 미치는 영향을 알아보고자 하였다. 연구에 동의한 만성 뇌졸중환자 30명중 동작관찰 과제지향훈련을 시행한 실험군 15명과 일반 과제지향훈련을 시행한 대조군 15명에게 총 6주간 하루 30분씩 훈련하였다. 훈련효과를 알아보기 위해 훈련전 균형은 BT4로 검사를 시행하였고 보행능력은 10M검사를 실시하였다. 이에 동작관찰 과제지향 훈련군이 일반과제 지향훈련군에 비해 균형과 보행능력에서 유의미한 차이를 보였다. 이에 동작관찰 과제지향훈련이 만성뇌졸중환자의 균형 및 보행능력에 효과적인 프로그램임을 알 수 있다.

• PNF and Movement
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• 제15권1호
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• pp.57-65
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• 2017

Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.

• 대한물리의학회지
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• 제8권4호
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• pp.489-496
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• 2013

PURPOSE: The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk test, 6minute walk test) between pre and post in the experimental group. In comparison of two group, experimental group was significant different pulmonary function(FVC, FEV1, MVV) and gait ability(6minute walk test) than control group. but, There was no significant difference of the gait ability(10m walk test). CONCLUSION: This study showed experimental group can be used to improve pulmonary function and gait ability than control group. These findings suggest that the respiratory muscle strengthening training effect on pulmonary function and gait ability for rehabilitation in patients with subacute stroke.

• 대한통합의학회지
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• 제8권2호
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• pp.169-185
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• 2020

Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

• The Journal of Korean Physical Therapy
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• 제27권2호
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• pp.112-117
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• 2015

Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

• 대한물리치료과학회지
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• 제10권1호
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• pp.7-17
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• 2003

The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

• 한국산학기술학회논문지
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• 제12권5호
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• pp.2187-2196
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• 2011

본 연구는 리듬청각자극을 이용한 보행훈련이 뇌졸중 환자의 보행의 대칭성에 미치는 효과를 알아보고자 하였다. 6개월이 지난 만성 뇌졸중환자 40명을 대상으로 중재 방법에 따라 4군으로 나누었다. A군은 편안한속도로 마비측에 청각자극을 주고 B군은 편안한속도로 비마비측에 청각자극을 주고 C군은 10%증가된 속도로 마비측에 청각자극을 주고 D군은 10%증가시킨 속도로 비마비측에 청각자극을 주었다. 각 군의 환자에게 5분동안 청각자극을 주며 보행훈련을 시행하였다. 보행분석 시스템을 이용하여 보행의 시간적인 변수를 측정하였으며 계산공식을 이용하여 보행의 대칭성을 구하였다. 보시간은 A군을 제외한 모든 군에서 유의하게 감소하였고(p<.05), 보행대칭성도 A군을 제외한 모든 군에서 유의하게 개선되었다(p<.05). 분속수는 A군을 제외한 모든 군에서 유의하게 증가하였고(p<.05), 속도는 모든 군에서 증가하지 않았다. 이 결과를 통해 리듬청각자극이 보행의 대칭성을 개선하는데 효과적임을 확인하였으며 뇌졸중 환자의 보행훈련에 효과적인 방법으로 적용할 수 있으리라 생각한다.

• 대한물리의학회지
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• 제5권3호
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• pp.435-443
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• 2010

Purpose : The goal of this study was to identify the effects of treadmill walking training (TW) and ergometer bicycle training (EB) on gait and balance in stroke patients. Methods : The subjects consisted of 42 stroke patients. They were randomly divided to two groups: TW(n=20) and EB(n=22). Each group trained along with the conventional physical therapy, three times a week for six weeks. The ability of gait was assessed by the 10m walk test and Timed Up and Go test(TUG). The ability of balance was assessed by Berg Balance Scale(BBS) and Balance Performance Monitor(BPM). Results : There was no significant difference between the 10m walking test and TUG groups, but there was a statistical difference between before and after the training for all groups. The result of BBS that assessed balance showed a significant reduction between before and after the training for all groups, but there was no difference between the two groups. While the two groups showed no difference in the BPM assessment, only the EB showed a significant improvement of before and after the training in each group. Conclusion : The outcomes suggest that stroke patients can improve their gait and balance performance through the TW and EB trainings. Although dynamic mean balance showed significance from EB, no significant difference was found between two groups. Even though it cannot be determined through this study which training group is more effective among the above mentioned two, it could be suggested that each training is effective to gait ability and the ability of balance of stroke patients.