• PNF and Movement
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• 제15권1호
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• pp.105-113
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• 2017

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

• 대한물리의학회지
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• 제7권1호
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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.

• The Journal of Korean Physical Therapy
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• 제33권2호
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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.

• 대한교통학회지
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• 제35권5호
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• pp.396-408
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• 2017

한국은 고령자가 폭발적으로 증가하고 있다. 또한 고령자의 경제활동과 고령자의 통행빈도 또한 증가 할 것으로 예상된다. 반면에 고령자의 보행 중 낙상 등의 사고는 꾸준히 증가하고 있으며, 고령자의 보행시설 만족도는 최하위이다. 본 논문에서는 이러한 결과의 이유들 중에 하나를 고령자들의 보행능력(일반인 대비 약 75%)을 고려하지 않은 보행 교통 시설물에서 찾았다. 이에 고령자들이 가장 불편함을 호소하는 계단 이용시 나타나는 고령자의 운동역학적인 보행특성을 동작분석시스템으로 알아보았다. 여러 보행변수들을 분석한 결과, 현재의 계단 높이로 규정되어 있는 18cm의 계단 높이는 고령자가 오름과 내림 보행 시 과도한 힘이 소요되며, 신체 중심이 흔들려 몸의 균형을 잡기에도 어려운 것으로 분석되었다. 이에 본 논문에서는 고령자 집단의 보행특성을 보여주는 보행변수들 간의 군집분석을 통하여 계단 챌면의 높이를 15cm 이하로 설정할 것 등의 계단 설계 기준을 제시하였다. 이는 일반인에게는 큰 변화는 아니지만 고령자에게는 통행빈도와 활동범위를 넓혀 보다 많은 사회경제 활동을 촉진 시킬 수 있을 것이다.

• PNF and Movement
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• 제8권2호
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• pp.57-67
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• 2010

Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

• 대한물리의학회지
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• 제3권2호
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• pp.113-119
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• 2008

Purpose : In this case report, we demonstrated the improvement of gait ability on the child who has mental retardation with incomplete gait pattern. Methods : The subject was a 4 years old boy with mental retardation. We applied the Bobath approach to the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis posterior-anterior movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. It was performed 24 sessions for 12 weeks. Results : With this treatment, he could accomplish dynamic standing stability and he could independent walk at the out door after 12 weeks. In gross motor function measure(GMFM), total motor function was improved to 85.6% from 75.7%. Conclusion : The gait ability of child with mental retardation was improved by using the bobath approach.

• PNF and Movement
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• 제12권3호
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• pp.143-150
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• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• 한국주거학회논문집
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• 제14권5호
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• pp.117-128
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• 2003

The purpose of this study is to investigate the effect of functional ability on relocation among the elderly. Longitudinal data from the Asset and Health Dynamics among the Oldest Old (1993, 1995) were analyzed for 6,225 respondents aged 70 or older. Among functional ability measures, difficulties in advanced activities of daily living (i. e., making telephone calls, taking medications, and managing money), lower body activities (i. e., walking several blocks, climbing one flight of stairs, pulling or pushing large objects, and carrying over 10 pounds), and household activities of daily living (i. e., preparing hot meals and shopping for groceries) were the predictors of increased residential move. Difficulties in basic activities of daily living (i. e., bathing, dressing, getting in and out, and using the toilet) were strongly related to increased entrance into an institutional care facility. Efforts to enhance the independent living of the elderly in the community setting should target the compensation of these functional difficulties.

• 한국전문물리치료학회지
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• 제22권3호
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• pp.33-40
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• 2015

The purpose of this study was to investigate the effect of multi joint-joint position sense (MJ-JPS) training on joint position sense, balance, and gait ability in stroke patients. A total of 18 stroke patients participated in the study. The subjects were allocated randomly into two groups: an experimental group and a control group. Participants in the experimental group received MJ-JPS training (10 min) and conventional treatment (20 min), but participants in the control group only received conventional treatment (30 min). Both groups received training for five times per week for six weeks. MJ-JPS is a training method used to increase proprioception in the lower extremities; as such, it is used, to position the lower extremities in a given space. MJ-JPS measurement was captured via video using a Image J program to calculate the error distance. Balance ability was measured using Timed Up and Go (TUG) and the Berg Balance Scale (BBS). Gait ability was measured with a 10 m walking test (10MWT) and by climbing four flights of stairs. The Shapiro-Wilk test was used to assess normalization. Within-group differences were analyzed using the paired t-test. Between-group differences were analyzed using the independent t-test. The experimental group showed a significant decrease in error distance (MJ-JPS) compared to the control group (p<.05). Both groups showed a significant difference in their BBS and 10MWT results (p<.05). The experimental group showed a significant decrease in their TUG and climbing results (p<.05), but the control group results for those two tasks were not found to be significant (p>.05). There was significant difference in MJ-JPS and by climbing four flights of stairs on variation of pre and post test in between groups (p<.05), but TUG and BBS and 10MWT was no significantly (p>.05). We suggest that the MJ-JPS training proposed in this study be used as an intervention to help improve the functional activity of the lower extremities in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.134-138
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• 2018

Objective: The aim of this research was to investigate the effects of functional electrical stimulation (FES) applied to the gluteus medius (Gm) and tibialis anterior (TA) during stair climbing in persons with stroke compared to FES applied to the TA only during stair climbing, and during stair climbing without FES in persons with stroke. Design: Cross-sectional study. Methods: Twenty subjects with stroke participated in this study. Subjects were included if: 1) they were diagnosed as stroke at least 6 months before; 2) had Mini Mental State Examination- Korean score of 24 or higher; 3) were able to climb a flight of 10 stairs independently (with or without walking aid). The patients walked 10 stairs 3 times with FES applied to the Gm and TA, only TA, or no FES. There was a 1-minute rest period between each bout. The assessments were made using the Timed Up & Down Test and the Wii Balance Board. Results: Stair climbing with FES applied to the Gm and TA was significantly faster than stair climbing with FES applied to the TA only and without FES (p<0.05). Stair climbing with FES applied to the Gm and TA exhibited significantly greater sway velocity than stair climbing without FES (p<0.05). However, maximal sway distances were not significantly different between groups. Conclusions: Stair climbing with FES applied to the Gm and TA can be an important component of a rehabilitation program for improving stair climbing ability in persons with stroke.