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The Effect of Visual Bio-feedback Training on Balance and Postural Control in Stroke Patients (시지각 바이오피드백 훈련이 뇌졸중 환자의 균형 및 자세조절에 미치는 영향)

  • Lim, Soo-Jeong;Lee, Jong-Soo;Kim, Na-Ra;Kim, Seong-Sik;Lee, Byoung-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.1
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    • pp.137-148
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    • 2011
  • Objectives : This study was to investigate the visual bio-feedback training for 5 weeks on balance and postural control for patients with stroke. Methods : The 26 subjects were randomly selected from the patients of the E hospital in the S city who met the study conditions. They were divided into a visual bio-feedback training group of 13 patients and a self-resistance exercise group of 13 patients. The visual bio-feedback training group received visual bio-feedback and general physiotherapy for five weeks and the self-resistance exercise group received cycling and general physiotherapy for the same period. The subjects were measured and compared for stability index, weight distribution index, fall down index, functional reach test and timed up and go test before and after the program. Results : The visual bio-feedback training group showed significant changes after the experiment in stability index, weight distribution index, functional reach test and timed up and go test(p<0.05), and the self-resistance exercise group also showed significant differences(p<0.05). The changes between prior to and after the experiment show that the visual bio-feedback training group had more significant effects than the self-resistance exercise group(p<0.05). Conclusions : The visual bio-feedback training for five weeks had effects in the improvement of the balance and posture control of stroke patients. Based on these results, more effective training programs should be developed and propagated.

Effect of Action Observation Physical Training for Chronic Stroke Patients on the Stairs Walking Ability and Self-Efficacy

  • Park, Geun-hong;Lee, Hyun-min
    • The Journal of Korean Physical Therapy
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    • v.33 no.2
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    • pp.53-61
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    • 2021
  • Purpose: This study examined the impacts of action observational physical training related to stair walking on the stair walking ability and self-efficacy of chronic stroke patients. Methods: This study was conducted on 24 chronic stroke patients, who were assigned randomly to an action observational physical training group (12 persons) and a landscape observation physical training group (12 persons). To the action-observational physical training group, five videos related to stair walking were presented, and after observing them, physical training was carried out. The landscape observation physical training group observed the videos consisting of landscape, where there were no humans and animals, and then underwent physical training. This study measured the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius to examine the muscle activity of the lower limb. A timed up and go and step test was performed to examine the balance ability, and a timed stair test was conducted to examine their stair walking ability. A self-efficacy scale was measured to examine the degree of their confidence of performing stair walking. The assessment was conducted three times in total: pre-, post-, and follow-up surveys. Results: As a result of this study, the action observational physical training group significant improvement after the intervention than in the landscape observation physical training group. Moreover, the follow-up study four weeks after the intervention showed significant improvements in the action observational physical training group (p<0.05). Conclusion: These results show that the action observational physical training had a positive impact on the stair walking ability and self-efficacy of chronic stroke patients.

The Immediate Effect of Thoracic Self-Mobilization on Balance and Gait of Acute Stroke Patients (자가 흉추관절가동술이 급성기 뇌졸중 환자의 균형과 보행에 미치는 즉각적 영향)

  • Park, Si-hyun;Jeong, Eui-young
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.2
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    • pp.11-20
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    • 2019
  • Background: The purpose of this study was to investigate the immediate effect of thoracic self mobilization on balance and gait of acute stroke patients. Methods: Patients (n=10) with acute stroke applied to thoracic self mobilization. There are two thoracic self mobilization of both extension and rotation. Each thoracic self mobilization was performed ten times per direction in a total of three sets and the total time required for two thoracic self mobilization was twenty minutes. The break time between sets was one minute. Balance ability was measured using the timed up and go test and the five times sit to stand test for patients. The 10 meter walk test and the functional gait assessment were used for measurement of gait ability for patients. Results: Significant improvements were observed on balance ability (p<.05) and gait ability (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.

Effects of Functional Electrical Stimulation (FES) on the Temporal-spatial Gait Parameters and Activities of Daily Living in Hemiplegic Stroke Patients

  • Oh, Dong-Gun;Yoo, Kyung-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.3
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    • pp.37-44
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    • 2021
  • PURPOSE: This study examined the effects of functional electrical stimulation (FES) on temporal-spatial gait and the activities of daily living in hemiplegic stroke patients. METHODS: The subjects were 29 hemiplegic stroke patients (57.7 ± 10.3). The patients walked at a self-controlled speed in four states: (1) walking without FES (non-FES), (2) walking with FES on the gluteus medius in the stance phase (GM), (3) walking with FES on the common peroneal nerve and tibialis anterior in the swing phase (PT), (4) walking with both GM and PT. A GAITRite system, Timed-Functional Movements battery, and Timed UP and Go test were used to measure the variables. RESULTS: Significant improvements were observed in all variables of the GM+PT, GM, and PT states compared to the non-FES state (p < .05). There were significant improvements in the GM+PT state compared to GM and PT states (p < .05). Moreover, significant improvements were noted in the single support time on the affected side, backward walking 10ft, and side stepping 10ft on the affected side of the GM state compared to the PT state (p < .05). There were significant improvements in the stride length on the affected side and side stepping 10ft on the unaffected side of the PT state compared to the GM state (p < .05). CONCLUSION: FES is effective in improving the temporal-spatial gait and activities of daily living in hemiplegic stroke patients.

The Effects of Circuit Obstacle Group Gait Training on Gait and Emotion in Stroke Patients (순환식 장애물 집단 보행 훈련이 뇌졸중 환자의 보행 능력과 정서에 미치는 효과)

  • Kim, Chul-Min;Lee, Ho-Jung;Choi, Myeong-Su;Song, Ju-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.1
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    • pp.125-135
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    • 2012
  • Purpose : This study is designed to demonstrate the effects of circuit obstacle group gait training on walking ability and emotion in stroke patients. Methods : Twenty one patients with stroke were participated in this study. The subjects were divided into control group(n=10) and experimental group(n=11). Circuit obstacle group gait training consisted of walking around obstacles, walking over obstacles, walking up and down slopes and walking up and down stairs. Circuit obstacle group gait training was conducted five times per week, 1 hour per session, for 6 consecutive weeks. At pre-test and post-test, subjects were tested with 10 m walking test, timed up and go test, up and down 4 stairs test, depression and self esteem. Results : After 6 weeks of research, the experimental group showed statistically significant difference in all items when comparing prior to training and after training (p<.05), but the control group showed statistically significant difference in items other than depression and self esteem(p<.05). In the comparison between the two groups, the experimental group showed higher improvement than the control group in the 10 m walking test, timed up and go test, and up and down 4 stairs test, and there was statistically significant difference in decrease of degree in depression between the experimental group and control group(p<.05). Conclusion : This study have shown that circuit obstacle group gait training improves walking ability and emotion in stroke patients.

Frailty and its Related Factors in the Vulnerable Elderly Woman by Urinary Incontinence (지역사회 거주 여성노인의 요실금 유무에 따른 허약정도와 허약 영향요인)

  • Park, Jin Kyoung
    • 한국노년학
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    • v.37 no.4
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    • pp.893-907
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    • 2017
  • This study aimed to investigate factors affecting frailty by urinary incontinence groups among the vulnerable elderly woman in Korea. In this secondary analysis, data were collected from records for 3,251 elders registered in the Visiting Health Management program of Public Health Centers in 2012. body mass index, waist circumference, timed up & go, depression, self rated helath, walking exercise, flexibility exercise, strengh exercise and frailty were assessed. Data were analyzed using $x^2$-test, t-test, ANOVA, Pearson's correlation and stepwise regression to determine the associated factors of frailty by urinary incontinence. Depression, walking exercise, timed up & go and age were found to be factors significantly associated with frailty among the elders with incontinence(F=38.321, p<.001). Age, depression, walking exercise, self rated health and tined up & go were found to be factors associated with frailty in the elders without incontinence(F=265.666 p<.001). The findings show that frailty of elders and associated factors were different by urinary incontinence, and common factors affecting frailty were depression, walking exercise, timed up & go, age. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to urinary incontinence.

Effect of Action Observation by Subject Type on the Balance and the Gait of Stroke Patients

  • Lee, Jong-Su;Kim, Kyoung;Kim, Young-Mi
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.7-14
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    • 2019
  • PURPOSE: This study examined the effects of observing a self-video or a video of another person performing balance and gait training, followed by actual performance of the observed movements on the balance and walking ability of chronic stroke patients. METHODS: Thirty patients, who had experienced a stroke and were admitted to S rehabilitation hospital for treatment, were selected randomly and divided into three groups with 10 patients each: self-action observation (SAO) group, other-action observation (OAO) group, and treadmill walking training (TWT) group. The training program was conducted five times per week for four weeks. The GAITRite system, 10 m walking test, and timed up and go test were performed to measure the subjects' gait and balance ability. RESULTS: The velocity, cadence, double support, and stride length were increased significantly in the SAO and OAO groups (p<.05) but the T group showed no significant changes; no significant difference was observed among the groups (p >.05). The 10MWT decreased significantly in the OAO group (p<.05), but there were no significant changes in the SAO and T groups, and no significant difference was observed among the groups (p>.05). The TUG decreased significantly in the SAO and OAO groups (p<.05), but there were no significant changes in the T group, and no significant difference was observed among the groups (p>.05). CONCLUSION: The self or other action observation training helps improve the balance and gait ability.

Effect of Non-paralyzed side and Paralyzed side of Elastic Band Combined with Proprioceptive Neuromuscular Facilitation Lower Extremity Patterns on Balance in Chronic Stroke Patients (비 마비 측과 마비 측에 적용한 탄력밴드를 결합한 고유수용성 신경근 촉진법 하지패턴이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Lee, Young-Min;Ham, Min-Sik;Kim, Taek-Soo
    • PNF and Movement
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    • v.13 no.4
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    • pp.181-188
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    • 2015
  • Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

Effects of the Customized Self-Exercise Program on Muscle Strength and Walking Function in Stroke Patients (보행기능에 맞춘 자가운동 프로그램이 뇌졸중 환자의 근력 및 보행기능에 미치는 영향)

  • Kim, Jeong-soo;Lee, Kye-beom;Song, In-ui
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.37-50
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    • 2019
  • Background: Stroke is one of the most common diseases responsible for physical disabilities. In addition to their physical and occupational therapy, the self-exercise programs were developed for patients with hemiplegia to increase the intensity of their therapeutic exercise. Objects: The purpose of this study was to assess the effect of a customized self-exercise program (CSP) to walking function on improving stroke survivors' muscle strength and ambulation function. Method: To test the effect of the self-exercise program, the following tests were conducted: The functional ambulation category (FAC), Tinetti performance-oriented mobility assessment gait part (POMA-G), timed up and go (TUG), 10-meter walk, and 2-minute walk. The study included 161 consenting stroke patients (FAC score>1) from a randomized, screened sample of 217. The CSP group participated in a 30-minute CSP each day for 10 weeks in addition to completing a routine rehabilitation program. The control group received only a routine rehabilitation program. All the subjects were monitored by a therapist once a week and had to submit an exercise checklist at the end of each session. Result: The strength of the participants' upper and lower extremity muscles showed no significant differences between the CSP group and the control group. The FAC score and POMA-G also showed no significant differences. However, there were significant differences in the TUG, 10-meter walk test, and 2-minute walk test (p<.05). Conclusion: The findings of this study suggest that a CSP may improve gait-related function in stroke survivors.

Discriminative validity of the timed up and go test for community ambulation in persons with chronic stroke

  • An, Seung Heon;Park, Dae-Sung;Lim, Ji Young
    • Physical Therapy Rehabilitation Science
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    • v.6 no.4
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    • pp.176-181
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    • 2017
  • Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.