• 대한물리의학회지
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• 제12권1호
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• pp.121-129
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• 2017

PURPOSE: This study was conducted to determine the effect of dual-task training (based on the International Classification of Functioning, Disability, and Health; ICF) on walking ability and self-efficacy in individuals with chronic stroke. METHODS: 22 chronic stroke patients participated in this study. Participants were randomly allocated into either the single-task group (n=11) or the dual-task group (n=11). Both groups had physical training three a week for 4 weeks, and at a three-week follow-up. Outcome measures included the 10m walking test (10MWT), figure of 8 walk test (F8WT), dynamic gait index (DGI), and Self-efficacy scale. All data were analyzed using SPSS 18.0 for Windows. Between-group and within-group comparison were analyzed by using the Mann-Whitney U test and Wilcoxon singed-rank test respectively. RESULTS: In the dual-task group, the 10MWT, time and steps of F8WT, DGI, and self-efficacy showed significant differences between pre- and post-test (p<.05). The Changes between the pre- and post-test values of 10MWT (p<.05), DGI (p<.05), and self-efficacy scale (p<.05) showed significant differences between the dual-task group and single-task group. CONCLUSION: Participants reported improved walking ability and self-efficacy, suggesting that dual-task training holds promise in the rehabilitation of walking in chronic stroke patients. This study showed that ICF-based on a dual-task protocol contiributes to motor learning after chronic stroke.

• 대한물리의학회지
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• 제10권3호
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• pp.19-27
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• 2015

PURPOSE: This study aimed to investigate the effects of pressure sense perception training (PSPT) on various surfaces on the somatosensory system, balance, and walking ability in chronic stroke patients. METHODS: Thirty patients with stroke participated in this study and were randomly assigned to one of three groups; group 1 received the general physical therapy and the PSPT on a stable surface, group 2 received the general physical therapy and the PSPT on an unstable surface, and group 3 received the general physical therapy alone. Participants in group 1 and group 2 underwent 30 min/session, 3 days per week, for 4 weeks. Pressure error (PE) was used to evaluate changes of proprioception. The Balancia, Functional reach test (FRT), and Timed Up and Go (TUG) were used to assess the balance ability, and the 10m Walking Test (10-MWT) was used to assess walking ability. RESULTS: Experimental groups (group 1 and group 2) showed significant differences in PE, FRT, TUG, and 10-MWT compared to the control group (p <0.05). Group 2 (PSPT on an unstable surface) was significantly different in PE, FRT, and 10-MWT from group 1 (p <0.05). No significant differences were observed for other measures. CONCLUSION: Pressure sense perception training on an unstable surface might be a significantly more effective method for improving somatosensory function, balance, and walking ability, than PSPT on a stable surface.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.30-40
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• 2017

Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제35권5호
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

• 한국운동역학회지
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• 제21권3호
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• pp.383-390
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• 2011

In this study, 26 normal subjects were studied to compare the biomechanical Analysis of Lower Limbs on Speed of Nordic Walking. The biomechanical variables were determined by performing three-dimensional gait analysis, and the measurements items were spatial and temporal parameters; vertical ground reaction force; and moments of the hip, knee, and ankle joints. The purpose of this study based on the speed of Nordic Walking to the vertical ground reaction force and joint moments of each were analyzed. Nordic Walking with poles while being whether this weight is reduced to load, not the improvement of muscle activity by identify Nordic walking is to allow efficient. The results of the analysis were follows. The spatial parameters of step length, stride length significantly increased with increase in velocity(p<0.001). The temporal parameters of step time, stride time, the duration of double support use, and the duration of single support use also significantly decreased with increase in velocity(p<0.001), but cadence significantly increased(p<0.01). Analysis of the changes in ground reaction force revealed that vertical ground reaction force significantly increased at the initial contact and the terminal stance and decreased at the mid stance with increase in velocity(p<0.001). Moments of the hip and knee joints significantly in creased with increase in velocity whereas that of the ankle joint did not. Gait analysis revealed that weight-bearing decreased and moments of the hip and knee joints increased with increase in velocity(p<0.01). The results of this study may help people perform Nordic walking efficiently and Nordic walking can be used in the gait training of people with an abnormal gait.

• 한국운동역학회지
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• 제12권2호
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• pp.1-16
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• 2002

본 연구의 목적은 다운증후군 보행에 영향을 주는 근력 훈련이 성장기에 있는 다운증후군 아동의 지면반력의 변화에 미치는 효과를 살펴보는 것이다. 본 연구의 대상자는 삼염색체 다운증후군을 가진 남자 아동(11세~13세) 8명이며, 근력훈련 전에 지면반력 변인(수직력, 전후력, 좌우력, 총압력중심)을 측정하였으며 근력훈련 후에도 동일한 방법으로 지면반력 변인을 측정하였다. 지면반력 변인의 측정은 2대의 AMTI 지면반력기를 사용하였으며, 초당 100Hz로 데이터를 수집하여 분석하였다. 근력 훈련은 하지 근육 강화 훈련 4종목(스쿼트, 레그 컬, 레그 익스텐션, 토 레이즈)과 복근 및 척추기립근 강화 훈련 2종목(하이퍼 익스텐션, 윗몸 일으키기)으로 구성하여 8주간 주당 3회, 1회 운동 시 10~15RM${\times}$3세트로 점증부하 원리에 의거하여 실시하였다. 본 연구를 통한 결론은 다음과 같다. 근력 훈련 전후의 수직력, 전후력, 좌우력의 변화패턴은 다운증후군 아동별로 다양하게 나타났으며, 근력훈련으로 정상인과 비슷한 패턴으로 향상되었다. 또한, 훈련 전 후의 총압력중심의 이동궤적은 연구대상자별로 다양한 이동궤적이 나타나서 명확한 설명을 하기가 어려우며, 이에 대한 보다 종합적인 후속 연구가 필요할 것으로 사료된다. 본 연구를 통하여 다운증후군 아동들의 보행의 운동역학적 기전의 이해와 운동학적 결과의 해석을 돕고 향후 병적 보행의 평가에 대한 기초자료를 제시할 수 있을 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제32권3호
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• pp.137-145
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• 2020

Purpose: The purpose of this study is to examine the effect of various bridge exercises on walking ability. Method: The subjects were 30 stroke patients. They were divided into a bridge exercise group on a stable support surface (Group I), a bridge exercise group on an unstable support surface (Group II), and a bridge exercise group combined with whole body vibrations (Group III). 10 subjects were randomly assigned into each group. The subjects of this study had 30 minutes of nervous system physical therapy including gait training and strength training. In addition, each group underwent a 30 minutes session five times a week for eight weeks. Before intervention, LUKOtronic was used to measure step width and step length, time was measured with a 10 m walking test, and time and number of steps were measured with the figure 8 walking test. After the intervention, remeasured and analysis was performed for each group. Results: As a result of comparing and analyzing the change of walking ability between groups, there was a statistically significant difference. As a result of the post hoc analysis according to the change of walking ability among groups, the change of walking ability was larger in Group III than in Group I and Group II. Conclusion: Based on these results, it is confirmed that the bridge exercise combined with whole body vibration was more effective for walking ability. Based on these findings, this study proposes an effective program for elite athletes as well as stroke patients.

• 생명과학회지
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• 제20권11호
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• pp.1704-1710
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• 2010

본 연구는 뇌졸중 발병 후 재활운동에 참가하는 환자들을 대상으로 재활운동 3개월이 지난 시점에서 1차 실험을 하였고, 6개월이 지난 시점에서 2차 실험을 하여 운동역학적 비교분석을 하였다. 실험에 사용된 장비는 영상분석기, 족저압분석기, 근전도분석기를 사용하였다. 대상자는 7명으로 하였으며 통계방법은 t-test분석 이용하였다. 결과는 엉덩관절의 최대신전 피크 값과 최대신전 피크 모멘트 값에서 통계적으로 유의한 차이를 나타내었다(p<0.05). 족저압의 비교에서는 환측 다리의 족저압에서 일반적인 걷기 동작시에 족저압의 중심이동거리에서 통계적으로 유의한 차이를 나타내었다(p<0.05). 근전도 분석에서는 대퇴사두근 중의 대퇴직근과 외측광근의 근력에서 통계적으로 유의한 차이를 나타내었다(p<0.05).

• Journal of Korean Biological Nursing Science
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• 제15권2호
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• pp.65-73
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• 2013

Purpose: The purpose of this study was to review the literature on music intervention for neurological patients in Korea and to explore the effect of music intervention on functional rehabilitation of neurological patients. Methods: This systematic review examined literature from 2005 to 2010. The existing literature was searched in the electronic databases of RISS and KISS using the following keywords: music, rhythmic movement, stroke, brain injury, dementia, Parkinson, spinal cord injury. Seventy-seven studies were founded through the database. After The exclusion of duplicates, case studies, literature review, and irrelevant studies, nine studies were included for analysis. Results: They included nine quasi-experimental studies. The medical diagnoses of the study participants were stroke, dementia, brain injury, and spinal cord injury. Among nine studies, only two studies were conducted in the nursing area. Eight studies used comprehensive music programs composed of health education, gait training, vocal training, or relaxation therapy, and these comprehensive programs were effective in the areas of physical and psychosocial treatment. Seventeen sessions were provided on average throughout intervention, and the average duration of each session was 49.4 minutes. Conclusion: Comprehensive music intervention can be implemented in nursing care for patients with neurological problem.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.222-229
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• 2020

Objective: The purpose of this study was to investigate the effect of treadmill exercise on the posture and walking speed of chronic stroke survivors with an ankle-foot orthosis. Design: Randomized controlled trial. Methods: Twenty-four chronic persons with chronic stroke admitted to Bobath Memorial Hospital in Seongnam city were divided into two groups by random blind method. Treadmill exercise with an elastic ankle-foot orthosis was performed in the experimental group and treadmill exercise was performed in the control group. The experiment was carried out for 6 weeks, and the experiment was carried out three times a week for 20 minutes per session. To measure the effect, static balance was measured using the MTD system before and after training, and the Berg Balance Scale (BBS) was used to measure functional balance. Results: There was a statistically significant difference between the 2 groups in the BBS measurement results for confirming the functional balance (p<0.05). Also, there was a significant difference between the 2 groups in single limb support time, step time and step length (p<0.05). Conclusions: In this study, it was found that treadmill exercise with an elastic ankle-foot orthosis in persons with chronic stroke was effective in maintaining functional balance, walking ability, step length, and step time. Therefore, it is necessary to use a flexible ankle-foot orthosis with proper treadmill exercise as a method of improving balance and walking speed of chronic stroke survivors.