• PNF and Movement
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• 제15권3호
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• pp.317-331
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• 2017

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• PNF and Movement
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• 제14권2호
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• pp.131-137
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• 2016

Purpose: The purpose of this study was to compare muscle activities in the frontal plane and scapular plane of the middle fiber and lower fiber of the trapezius muscle at different shoulder abduction angles. Methods: Twenty male and female students in their 20s participated in this study. Each subject maintained shoulder abduction at $75^{\circ}$, $90^{\circ}$, $125^{\circ}$, and $160^{\circ}$ in a standing position and repeated motions three times each in the frontal plane and the scapular plane. While maintaining the motions for 10 seconds in each posture, surface electromyography (EMG) was used to measure muscle activity of the middle fiber and lower fiber of the trapezius muscle. The collected EMG data were normalized using maximal voluntary isometric contraction (MVIC). Differences in muscle activity of the middle fiber and lower fiber of the trapezius muscles according to the angles at each plane were statistically processed using repeated measured analysis of variance, and an independent t-test was used to examine the differences between the two planes at each angle. Results: Muscle activity of the middle and lower trapezius during shoulder abduction in the frontal plane and scapular plane significantly increased as the angles increased (p<.05). However, muscle activity of the middle trapezius was significantly lower in the scapular plane than in the frontal plane for all shoulder abduction angles (p<.05). Conclusion: The results of this study suggest that during shoulder abduction, angles should be different according to the goals, and for training during an acute phase or early phase for functional recovery, it is more efficient to perform the training in the scapular plane than in the frontal plane.

• PNF and Movement
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• 제5권2호
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• pp.63-71
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• 2007

Objective : Respiratory muscle weakness and decreased chest mobility has been suggested to result from the deconditioning that accompanied activity level in chronic elderly stokes. The benefits of respiratory exercise programmes on exercise capacity and muscle strength in hemiplegia. This study aimed to determine the effects of selective inspiratory and expiratory muscles training and chest mobility exercise on patients with strokes to establish if an improved exercise capacity can be obtained in patients that are not limited in their daily activities. Methods & Intervention : Twelve patients were assigned to the intensive respiratory exercise group participated in a measures design that evaluated the subjects with pre-treatment and post-treatment. Thirteen subjects who were assigned to a control group received training with breathing exercise and resistance exercise of skeletal muscles. The subjects performed spirometry then undertook a 6-week programme of respiratory muscle and chest mobility training. Training for the two groups was carried out 2 times a week for 6 weeks. Measurements and Results : Spirometry(Forced Vital Capacity: FVC and Closed Circuit Spiromety: CCS) and thoracic mobility were measured before and after the 6 weeks. The experimental group improved significantly compared to control group in FVC, $FEV_1$, MVV, IRV and ERV, and upper chest wall expansion(p<0.05). No significant improvement was seen in thoracic mobility or lung function in control group(p>0.05). Conclusion : The major findings in this study were that a intensive 6week exercise programme of resistive breathing and chest mobility in patients with hemiplegia led to an increase in lung capacity. The resistive breathing exercise programme used here resulted in a significant increase in the chest excursion during breathing.

• PNF and Movement
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• 제7권4호
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• pp.31-36
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• 2009

Many daily activities require people to complete a motor task while walking. Substantial gait decrements during simultaneous attention to a variety of cognitive tasks have been shown by a group of severely injured neurological patients of mixed etiology. And previous studies have shown that the attentional load of a walking-associated task increased with its level of difficulty. The purpose of this study was to analyze subjects' gait changes are affected by the effects of arithmetic task difficulty and performance level. Participants performed a walking task alone, three different Arithmetic tasks while seated, and among them, two kinds of the simillar Arithmetic tasks in combination with walking. Reaction time and accuracy were recorded for two of the Arithmetic tasks. The mean values of the gait were measured using a Timed Up and Go test among 11 with post-stroke patients while walking with and without forward counting (WFC) and backward counting(WBC).There was significant Arithmetic Task Difficulty level between the 10-forward counting task condition(FC) and the 10-backward counting task condition(BC)(p=0.008). The mean values of T.U.G time were significantly higher under backward counting dual-task condition than during a simple walking task(p=0.009) and WFC(p=0.009). The change in T.U.G time during WFC was higher when compared with the change during a simple walking, but there was no significant difference (p=0.246). This study suggesting that a high interference could be linked with a high level of difficulty, whereas adaptive task enabled participants to perfectly share their attention between two concurrent tasks. Future research should determine whether dual task training can reduce gait decrements in dual task situations in people after stroke. And the dual-task-based exercise program is feasible and beneficial for improving walking ability in subjects with stroke.

• PNF and Movement
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• 제15권1호
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• pp.77-84
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• 2017

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

• PNF and Movement
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• 제18권1호
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.

• PNF and Movement
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• 제12권3호
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• pp.167-171
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• 2014

Purpose: The purpose of this study was to show the effects of voluntary change of weight bearing on the vastus medialis oblique and the vastus lateralis ratio during squat exercise. Methods: Twenty-four healthy adults were recruited for this study. The subjects performed squat exercise with median weight bearing, lateral weight bearing and non-changed weight bearing. The muscle activities of the vastus medialis oblique and the vastus lateralis were measured during the squat for all three conditions. The measured data were analyzed using one-way ANOVA to investigate the effect of muscle activation on the each condition. The statistical analyses were performed using SPSS ver. 17.0, and a p-value of less than 0.05 was considered significant for all cases. A post-hoc test was performed using Tukey's test. Results: The study showed that the vastus medialis oblique and the vastus lateralis ratio significantly changed according to the voluntary change of weight bearing during a squat. The vastus medialis oblique and the vastus lateralis ratio significantly decreased under the condition of voluntary lateral weight bearing. Conclusion: We suggest squat exercise on median weight bearing to increase the vastus medialis oblique and the vastus lateralis ratio. If your patient has.

• PNF and Movement
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• 제10권3호
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• pp.7-18
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• 2012

Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

• PNF and Movement
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• 제20권3호
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• pp.341-349
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• 2022

Purpose: The purpose of this study is to compare the muscle activity of the hip abductors and the ratio between the hip abductor muscle group according to the range of hip abduction during the clam exercise. Methods: This study was conducted on 18 healthy men in their aged 20 to 29 who had not been diagnosed with spine-related diseases. The subjects performed a clam exercise without rotation of the pelvis in a state of 60° hip flexion and 90° knee joint flexion in the side-lying position. Using Myomotion equipment and EMG, the muscle activity of the hip abductor muscles and the activity ratio between the hip abductor muscle group were measured during the clam exercise by dividing the range into initial, mid-range, and terminal sections. Repeated measures analysis of variants was employed to compare the activity and use of hip abductor muscles according to range of motion during the clam exercise. Results: Gluteus medius muscle activation was significantly increased in the comparison of muscle activity in the initial, mid-range, and terminal sections of hip abduction. Tensor fasciae latae muscle activation was significantly increased in the comparison of muscle activity in all range of motion sections as well. The gluteus medius-tensor fasciae latae muscle activation ratio was significantly increased in the terminal section compared to the initial section. Conclusion: The gluteus medius and tensor fasciae latae had higher muscle activities as they approached the terminal section during the clam exercise, and the hip abduction activity ratio of the gluteus medius and tensor fasciae latae was higher as the range of motion approached the terminal section.