• Physical Therapy Korea
• /
• v.19 no.1
• /
• pp.86-93
• /
• 2012

The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.

• Physical Therapy Korea
• /
• v.19 no.1
• /
• pp.76-85
• /
• 2012

The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.

• Physical Therapy Korea
• /
• v.22 no.2
• /
• pp.70-80
• /
• 2015

The spinal cord is highly complex, consisting of a specialized neural network that comprised both neuronal and non-neuronal cells. Any kind of injury and/or insult to the spinal cord leads to a series of damaging events resulting in motor and/or sensory deficits below the level of injury. As a result, muscle paralysis (or paresis) leading to muscle atrophy or shrinking of the muscle along with changes in muscle fiber type, and contractile properties have been observed. Traditionally, histology had been used as a gold standard to characterize spinal cord injury (SCI)-induced adaptation in spinal cord and skeletal muscle. However, histology measurements is invasive and cannot be used for longitudinal analysis. Therefore, the use of conventional magnetic resonance imaging (MRI) is promoted to be used as an alternative non-invasive method, which allows the repeated measurements over time and secures the safety against radiation by using radiofrequency pulse. Currently, many of pathological changes and adaptations occurring after SCI can be measured by MRI methods, specifically 3-dimensional MRI with the advanced diffusion tensor imaging technique. Both techniques have shown to be sensitive in measuring morphological and structural changes in skeletal muscle and the spinal cord.

• Physical Therapy Korea
• /
• v.22 no.2
• /
• pp.52-58
• /
• 2015

Balance control deficits have been indicated to be a primary problem among cerebral palsy (CP) patients. Fabric ankle foot orthosis (AFO) can allow more efficient balance control by facilitating proprioception. The purpose of this study was to investigate the immediate effect of fabric AFO on balance, compared to a barefoot condition in children with unilateral CP. Twelve children with unilateral CP participated in this study. Their balance ability was evaluated using pediatric balance scale and bubble test. Both pediatric balance scale and bubble test showed significant improvement with the use of the fabirc AFO (p<.05). The fabric AFO could improve functional balance ability, and promote better balance among children with unilateral CP. We demonstrated that fabric AFO contributed to improving balance among children with unilateral CP, classified as Gross Motor Function Classification System level I and II. Consequently, fabric AFO might be an assistive device leading to the improvement of balance instead of the typical AFOs.

• Physical Therapy Korea
• /
• v.22 no.2
• /
• pp.30-40
• /
• 2015

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

• Physical Therapy Korea
• /
• v.22 no.2
• /
• pp.11-20
• /
• 2015

The purpose of this study was to evaluate the effect of dual-task training with cognitive effort on the walking and balance functions of chronic stroke patients. The study included 14 chronic stroke patients, who were randomly divided into the experimental group (EG) and control group (CG), each with 7 patients. The EG performed the dual-task training with cognitive effort 3 times a week, 30 minutes for 4 weeks, where as the CG performed single-task training three times a week, for 30 minutes for 4 weeks. Outcome assessments were made with 10 m walk test, timed up and go test, 6 minutes walk test, and Berg balance scale. In within-group comparison, subjects from the EG showed significant differences in all variables (p<.05), while subjects from the CG showed only significant differences in 6 minutes walk test, and Berg balance scale (p<.05). Further, there was significant difference in the improvement rate of 10 m walk test. The findings suggest that the dual-task with cognitive effort may be beneficial for improving walking and balance functions of patients with chronic stroke.

• Physical Therapy Korea
• /
• v.21 no.2
• /
• pp.28-36
• /
• 2014

The purpose of this study was to evaluate the changes in the electromyographic (EMG) activity of the trunk and the lower limb muscles during quiet standing on an unstable surface while wearing low-heeled shoes (3 cm), high-heeled shoes (7 cm) and without footwear (0 cm) in 20 young healthy women. The subjects stood on an unstable surface for 30 seconds. We examined the differences in the EMG data of the erector spinae, rectus abdominis, biceps femoris, rectus femoris, tibialis anterior, and the gastrocnemius medialis muscle. A one-way repeated analysis of variance was used to compare the effects of shoe heel height on the EMG activity with the level of significance set at ${\alpha}=.05$. The EMG activity of the erector spinae and the rectus femoris were significantly increased (p<.05) in the subjects who wore elevated heel height, while the tibialis anterior and the gastrocnemius medialis were significantly decreased (p<.05). However, the rectus abdominis and the biceps femoris exhibited no significant difference among the three conditions. The above results indicate that wearing high-heeled shoes may change the postural strategy. The findings of this study suggest that excessive heel height could contribute to an increased fall risk during quiet standing.

• Physical Therapy Korea
• /
• v.21 no.2
• /
• pp.18-27
• /
• 2014

The purpose of this study was to examine the effects of dual-task training (cognitive and exercise tasks) on the balance and gait performance of chronic stroke patients. Eighteen subjects with chronic stroke were divided equally into two groups, an experimental group and a control group. Subjects in both groups participated in an exercise program, performing the same tasks, for 45 minutes per day, three times per week for four weeks. The experimental group also performed additional cognitive task. The experimental group showed a more significant improvement than the control group on the Berg Balance Scale, the Timed Up and Go Test, the Korean Activities-Specific Balance Confidence Scale, and the Functional Gait Assessment (p<.05). The cognitive task error rates in the final week were significantly less than in the first week in the experimental group (p<.01). These results suggest that dual-task training for chronic stroke patients is effective in improving balance, gait, and cognitive abilities.

• Physical Therapy Korea
• /
• v.21 no.2
• /
• pp.74-81
• /
• 2014

The versions of the Oswestry disability questionnaire (ODQ) is regarded as one of the most extensively used condition-specific instruments measuring disability resulting from low back pain. It has been shown to have adequate psychometrics, reliability, validity, and responsiveness as a whole, yet the summated total score of the instrument often provide little information to rehabilitation clinicians. A keyform analysis based on Rasch measurement model is an innovative way of illustrating the specific test items that an individual may or may not perform. By applying the keyform of the Rasch measurement model to the ODQ, rehabilitation clinicians may able to select more challenging ODQ items matching an individual's ability and document them as attainable treatment goals. The results demonstrated how a keyform analysis assist to setting possible goals for the treatment of individuals with low back pain. Forty-two individuals with low back pain were recruited from rehabilitation clinics in Gainesville, Florida. A series of Rasch analyses on the 10 items of the ODQ were performed using Winsteps software. The performance of two individuals on those 10 items was illustrated on the keyform. The keyform analysis of the Rasch measurement model may be translated into a useful tool for making clinical judgements.

• Physical Therapy Korea
• /
• v.20 no.3
• /
• pp.74-80
• /
• 2013

The purpose of this study was to determine the reliability of distance measurements from the medial border of the scapula to the spinous process of the thoracic vertebrae when obtained using tape and photography measurements. The study included 20 healthy subjects (10 males, 10 females); for a total of 40 scapula measurements. The distance measurements made using tape or photography methods were conducted with the subject in a standing position. Repeated tape and photography measurements were conducted in two sessions on different days by two examiners to assess the inter-rater and intra-rater reliability of the two methods. The reliability of scapular distance measured using tape and photography methods was tested using intraclass correlation coefficients (ICC(3,1)) and the standard error of measurement (SEM). The inter-rater reliability of the tape measurement method was excellent (ICC=.77) and the intra-rater reliability was fair to good (ICC=.74). The inter-rater and intra-rater reliabilities of the photography measurement method were excellent (ICC=.76 and .76 respectively). Our results suggest that photography measurement is an objective and qualitative measurement tool for scapular distance measurements.