• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.399-404
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• 2013

Purpose: To investigate the effects of initiation side on gait symmetry in the chronic stroke patients. Methods: Twenty one patients with independent gait after stroke were divided into the paretic-leg gait initiation group (PLI) and the nonparetic-leg gait initiation group (NPLI). The symmetry ratio (SR) was calculated from of the spatiotemoral and kinematic parameter which measured by 3D motion analysis. Results: In the spatiotemporal variables, SR-step length and SR-velocity was significantly different between groups (p<0.05). In the kinematic variables, SR-TOAA and SR-SwPAA of the hip joint was significantly different between groups (p<0.05). Conclusion: We suggest that the initiating leg may influence on the gait symmetry of stroke patient These results will be a helpful reference in hemiplegic gait training or intervention.

• The Journal of Korean Physical Therapy
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• v.24 no.4
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• pp.247-252
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• 2012

Purpose: The purpose of this study was to investigate the change of muscle activities during level walking, stairs and ramp climbing in hemiplegic patients. Methods: Eight hemiplegic patients were recruited and agreed to participate in this study. Muscle activity was measured by MP100 system (BIOPAC System Inc., Santa Barbara, CA, USA). Statistical analysis was used as a one-way repeated measure of ANOVA to know the difference according to the gait conditions (level walking, stairs and ramp ascending). Results: In the swing phase, muscle activity of rectus femoris muscle, with the side lower extremities affected, were generally significantly different in the stair and ramp ascending. In addition, biceps femoris muscle with unaffected side lower extremity was generally significantly different in the ramp ascending. In the swing phase, muscle activity of tibialis anterior muscle with unaffected side lower extremities was generally showed a significant difference in the ramp ascending. In the stance phase, climbing stairs and ramps showed an increase in the muscle activities. Further, climbing the stairs increased muscle activities of the gastrocnemius muscle. Conclusion: These findings indicate that compared with the level walking climbing stairs, ramps and muscle activities of lower extremity during each showed different results. It can be seen that in accordance with the terms of gait are different muscles group recruitment.

• Physical Therapy Rehabilitation Science
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• v.8 no.3
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• pp.141-145
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• 2019

Objective: The purpose of this study was to compare walking conditions (straight line and curved path) on walking patterns in persons who had experienced hemiplegic stroke and to determine whether if they adapt their walking pattern and performances according to changes in environmental conditions. Design: Cross-sectional study. Methods: Forty-four hemiplegic stroke survivors participated in this study. This study measured walking performance in three different walking conditions, such as straight walking, the more-affected leg in the inner curve walking, and less-affected leg in the inner curve walking conditions, and a 2-dimentional gait analysis system was used as a primary measurement. This study also measured secondary clinical factors including the Timed Up-and-Go Test, the Trunk Impairment Scale, and the Dynamic Gait Index. Results: After analyzing, cadence and step length of the less-affected side, stride length in the more-affected side, and stride length in less-affected side were significantly different among the three different walking conditions in this study (p<0.05), but other temporospatial parameters were not significant. Cadence was the largest in the straight walking condition. Step length in the less-affected side, stride length in the more-affected side, and stride length in less-affected side were also the longest in the straight walking condition. Conclusions: The results of the study suggest that hemiplegic stroke survivors show walking adaptability according to changes in walking demands and conditions, and moreover, cadence and step and stride lengths were significantly different between straight and curved walking conditions.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.364-368
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• 2015

Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.

• Physical Therapy Korea
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• v.17 no.3
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• pp.11-19
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• 2010

The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.49-55
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• 2000

The purpose of this study was to identify the characteristics oi gait patterns and to find the effects of the gait function on the P.N.F. pelvic pattern. The subjects of this study were 40 hemiplegic patients who either hospitalized in or out patients at department physical therapy, Tae-Bong hospital and Masan college health education center. The study on these patient were done from July 20.1999 through May 10,2000. Method of gait pattern assessment used ink foot print record. The results were as follows: 1. There were significiant difference in cadence and stride length(p<0.05). 2. There were significiant difference in gait velocity (p<0.05).

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.181-188
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• 2022

Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.1
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• pp.1-9
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• 2013

Purpose : The purpose of this study is to investigate the impact on the ability to walk, balance after side walking training of hemiplegic patients caused by stroke. Method : The subjects were training before stroke onset whether more than one year elapsed 15 patients with chronic stroke patients, and Berg balance scale(BBS) and Timed up and go test(TUG), Functional reaching test(FRT), 20m walking time 200m walking time were measured and recorded. Training period, a total of three weeks, and training frequency circuit training times 10 minutes per training, 5-minute break, the 10-minute training total 25-minute training was conducted. Gait line of 3m to be based on the patient's side walking, and the risk of falling compared to the presence of the experimenter trained under was carried out. Result : 1. TUG, 2. 20m walking time, 3. 200m walking time 4. FRT, 5. All showed significant improvement in BBS. Judging from the results, the side walking training conducted three weeks due to chronic stroke hemiplegic patient's ability to balance and showed a positive effect on the improvement of walking ability. Conclusion : Accordingly, it was more effective to train hemiplegic patients with chronic stroke on side walking.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.125-134
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• 2007

Purpose : This study is to determine effects of cane-shape which influenced on the change of muscle activation, gait component in hemiplegic patients caused by cerebrovascular accident. Methods : Twenty one stroke patients using T-shape cane(TCG) and twenty one stroke patients using I-shape cane(ICG) participated in this study. Surface electromyography(SEMG) of erector spinae, transvers abdominis, tibialis anterior, soleus of both side were measured during walking without cane and walking with cane. Results : The activation of tibialis anterior was significantly increased in affected side of ICG. The activation of tibialis anterior was significantly decreased in affected side of TCG. The activation of soleus was significantly increased in affected side of ICG. The activation of soleus was significantly decreased in affected side of TCG. The activation of erector spinae was significantly increased in nonaffected side of ICG and TCG. The activation of transvers abdominis was significantly increased in nonaffected side of ICG and TCG. Conclusion : From the finding of this study, it was suggested that I-shape cane increase weight bearing of affected side in hemiplegic patient. Therefore, I-shape cane can be applied to improve gait asymmetry of hemiplegic patients.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.49-56
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• 2011

Purpose: The purpose of this study was to investigate the kinematic characteristics and muscle activities during the following two conditions: transition from half-kneel to standing on the affected leg and non-affected leg. Methods: Twenty-one hemiplegic patients participated in the study. A motion analysis system was used to record the range of motion and angle velocity of the hip, knee and ankle from the half-kneel to the standing position. Electromyography was used to record the activity of 4 muscles. Results: The statistical analysis showed that the minimum ROM of the hip joint was less on the affected leg during transition from half-kneel to standing. However, the minimum ROM of the knee and ankle joints was less on the non-affected leg during transition from half-kneel to standing. The angle velocity of the knee and ankle joints was less during transition from half kneeling to standing on the non-affected leg. Muscle activity of the rectus femoris and tibialis anterior was less while moving from half-kneel to the standing position on the affected leg. Conclusion: These results show that greater active ROM of the knee and ankle was required on the affected leg for transition from half-kneel to the standing position than for normal gait. Muscle activity of the rectus femoris and tibialis anterior is normally required for movement from the half-kneel to the standing position during normal gait. Further studies are needed to investigate the antigravity movement in healthy subjects and hemiplegic patients in order to completely understand the normal and abnormal movement from the half-kneel to the standing position.