• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.193-201
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• 2021

The aim of this study was to report the effect of Korean medicine treatment with scalp acupuncture of patient with lateropulsion, dizziness, headache caused by lateral medullary infarction. We treated the patient with scalp acupuncture, acupuncture, herbal medicine. Numeric rating scale (NRS), Korean version of berg balance scale (K-BBS), gait balance evaluation, dizziness handicap inventory (DHI), activities-specific balance confidence scale (ABC) and vestibular disorders activities of daily living scale (VADL) were used to evaluate symptoms. NRS of Lateropulsion, dizziness, headache were decreased. K-BBS score increased from 4 to 56, and in the gait balance evaluation, it returned to normal. DHI, VADL score were decreased and ABC score increased from 0 to 1,300. This case report shows that Korean medicine treatment with scalp acupuncture can be effective in lateral medullary infarction. However, further controlled studies are needed to confirm the effect of scalp acupuncture on such patients.

• Physical Therapy Korea
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• v.21 no.2
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• pp.37-47
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• 2014

Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

• Quality Improvement in Health Care
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• v.26 no.1
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• pp.2-10
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• 2020

Purpose: This study aimed to determine the effect of curved walking training on balance confidence and fall efficacy in early stroke patients. Methods: The study included 16 early stroke patients who were randomly allocated to a curved walking training group (experimental group, N=8) and a straight walking training group (control group, N=8). Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using the Activities-specific Balance Confidence (ABC) Scale, Fall Efficacy Scale (FES), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Results: After 3 weeks of training, both groups showed significantly improved ABC, FES, BBS, and TUG (p<.05 in both groups). However, the ABC, FES, BBS, and TUG scores in the experimental group were significantly better than those in the control group (p<.05). Conclusion: These findings indicate that curved walking training may be effective at improving balance confidence and decreasing fall risk in early stroke patients. Therefore, curved walking training can be used as a recommended walking method in early stroke patients.

• Clinical Pain
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• v.18 no.1
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• pp.16-23
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• 2019

Objective: To evaluate the effectiveness of dynamic balance exercise after intra-articular injection of hyaluronic acid (HA) therapy in elderly patients with unilateral knee osteoarthritis. Method: 30 patients with unilateral knee osteoarthritis were enrolled in this study. The patients were randomly divided into two groups: dynamic balance exercise after HA injection group (group A) and only HA injection group (group B). Both groups administered intra-articular HA injection and group A patients continued 20-session exercises for 4 weeks. The assessments were measured before injection and 4 weeks after treatment using the visual analog scale (VAS) for pain, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for physical function, Berg balance scale (BBS), and computerized dynamic posturography using SMART Balance Master system for balance function. Results: In both groups, significant improvements in VAS, WOMAC and balance function were observed. Compared between groups, group A showed significant improvements compared to group B in WOMAC and balance function. Conclusion: It is suggested that dynamic balance exercise may result in improved balance function and physical function in elderly patients with unilateral knee osteoarthritis.

• Physical Therapy Korea
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• v.17 no.4
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• pp.55-60
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• 2010

Clinical measures that Quantify falling risk factors are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the test-retest and interrater reliability of the dynamic gait index (DGI) for persons with Parkinson's disease (PD). A total of 22 idiopathic PD patients were recruited from rehabilitation hospital, Korea in this study. The DGI was assessed in two sessions that were, three days apart. We also measured Berg balance test (BBT) and geriatric depression scale (GDS) for concurrent validity with DGI. Intrarater and interrater reliability (.96 and .98 respectively) for DGI were high. indicating good agreement. The DGI was showed a good positive correlation with the BBS (r=.852). but not GDS (r=-.462). Intrarater and interrater reliability of DGI were high in people with PD. The DGI could be a reliable measure to evaluate functional postural control during gait activities in the PD population, and the ability of DGI to detect real change is acceptable in research and clinical settings.

• Physical Therapy Korea
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• v.18 no.4
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• pp.11-18
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• 2011

The aim of this study was to analyze the relationship between physical impairments and daily activities on the basis of the outcome measurements in stroke patients. Seventy-six stroke patients participated in this study. Two physical therapists evaluated 3 clinical common measurements, i.e., the Fugl-Meyer Assessment (FMA), the Berg Balance Scale (BBS), and the Functional Independence Measure (FIM). Multiple regression analysis was used, as the dependent variables were the BBS and FIM; the independent variables were post-stroke duration, FMA of Upper Extremity (FMU), and FMA of Lower Extremity (FML). In the regression equation of the BBS, the coefficient of determination ($R^2$) was .383, and the FML was found to be the most important variable for determining the BBS score. In the regression equation of the FIM, $R^2$ was .531, and the FML was found to be the most important variable for determining the FIM. These results suggest that there is a need to determine the function of activities on the basis of the physical impairments of stroke patients. More variable measurement tools on the levels of body function and structure, as well as activity limitations are required.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.102-108
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• 2018

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.67-76
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• 2010

Background: The purpose of this study was to evaluate the influence of ankle strategy exercise on balance ability in the women of octogenarians. Methods: Ankle strategy exercise group(n=14), leg strengthening exercise group(n=14) were measured an balance ability by Berg Balance Scale(BBS) scores and Balance Performance Monitor(BPM) at pre-intervention and post-intervention in 6weeks. Results: This study were summarized as follows : 1. The BBS scores, sway area, sway path length, sway maximum velocity of ankle strategy exercise group and leg strengthening exercise group were significantly different among the intervention period(p<.05). 2. The improvement of BBS scores, sway area, sway path length, sway maximum velocity were significantly different between ankle strategy exercise group and leg strengthening exercise group at in 6weeks(p<.05). Conclusion: Learned from the ankle strategy exercise could improve BBS scores, sway area, sway path length, sway maximum velocity and a balance for the women of octogenarians. Ankle strategy exercise need to be applied clinically for balance ability of the women of octogenarians.

• Physical Therapy Korea
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• v.23 no.2
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• pp.35-43
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• 2016

Background: The Functional Gait Assessment (FGA) was developed to measure of gait-related activities. The FGA was translated in Korean but only a few psychometric characteristics had been studied. Objects: The purpose of this study was to evaluate the validity and reliability of the Korean version of FGA scale using Rasch analysis. Methods: The study included 120 patients with stroke (age range=30~83 years; mean${\pm}$standard deviation=$58.3{\pm}11.1$). The FGA and Berg Balance Scale were performed, and were analysed for dimensionality of the scale, item difficulty, scale reliability and separation, and item-person map using Rasch analysis. Results: The 4 rating scale categories of FGA were satisfied with optimal rating scale criteria. The most items of the FGA showed sound item psychometric properties except 2 items ('gait with the horizontal head turns', and 'gait with narrow base of support'), and the 2 misfit items were excluded for all further analyses. The 8 items were arranged in order of difficulty. The most difficult item was 'gait with eyes closed', the middle difficult item was 'gait level surface', and the easiest item was 'gait with vertical head turns.' A person separation reliability was .93 and the person separation index was 3.57. Conclusion: This study suggests that the 8-item Korean FGA are valid measure of assess the gait-related balance performance, and to set the goal of rehabilitation plan in patient with stroke.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.2
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• pp.7-14
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• 2015

Purpose: The purpose of this study was to investigate the effects of falls prevention exercise program to balance, falls efficacy, blood pressure and blood lipids in the elderly females. Methods: A total of twenty-six elderly women participated in this study. All subjects participated in exercise program based on pelvic stabilization and balance training on two times a week for twelve weeks. They were measured about Berg balance scale (BBS), Time up and go (TUG), Functional reach test (FRT), Sit to stand (STS) for balance, falls efficacy scale-international (FES-I) for falls efficacy, systolic blood pressure (SBp), diastolic pressure (DSp) for blood pressure, and total cholesterol (TC), triglyseride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) for blood lipids. Results: There were significant improvements of BBS (p<.05), TUG (p<.001) FRT (p<.01), and STS (p<.001) in the balance after exercise program. There was significant improvements in FES-I (p<.001) in the falls efficacy, There were no statistical differences of SBp and DSp in the blood pressure. There were no statistical differences of TC, TG, HDL-C, and LDL-C in the blood lipids. Conclusions: Falls prevention exercise program was meaningful increasing balance ability and falls efficacy.