Jung, Ju Yeon;Jung, Jin-Hwa;Hahm, Suk-Chan;Jung, Kyoungsim;Kim, Sung-Jin;Suh, Hye Rim;Cho, Hwi-young
Physical Therapy Rehabilitation Science
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제6권2호
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pp.59-64
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2017
Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.
Objectives : The aim of this study was to report the effectiveness of Combined Korean Medicine treatment on a intracerebral hemorrhage patient with hemiplegia and gait disturbance. Methods : A 56-year-old, female patient with hemiplegia and gait disturbance was treated by Korean Medicine including acupuncture, moxibustion and herbal medicine. The effect of the treatment was evaluated by Manual Muscle Test(MMT), Modified Rankin Scale(MRS), Korean version of Modified Barthel Index(K-MBI). The gait of the patient was evaluated by 10m walk test, Timed Up&Go Test(TUG), Functional Ambulatory Category(FAC), GAITRite and Symmetry Criterion(SC). Results : After treatment, MMT, MRS, K-MBI, gait parameters and gait symmetry were improved. Conclusions : This study suggests that Combined Korean Medicine treatment might be effective for a intracerebral hemorrhage patient with hemiplegia and gait disturbance.
Purpose : The purpose of this study was to investigate the effects of proprioceptive exercise (PE) using a trampoline and a balance board on a balance ability after stroke. Method : Sixteen chronic stroke patients participated. Participants were randomly assigned to the PE group or control group (8 experimental, 8 control). All of participants were in-patients at local rehabilitation centre and had been receiving a traditional rehabilitation program, five days a week. The PE group have additionally undergone for four weeks, three days a week, the PE using a trampoline and a balance board under supervision by a physical therapist but control group was not received any additional program except the traditional rehabilitation program. The position sense test used to assess a proprioceptive sense at a knee joint. The Berg Balance Scale (BBS) and the Timed Up & Go (TUG) test to measure the balance ability were carried out before and after the training. Result : After the training the error of position sense at knee joint of PE group significantly decreased compared to the control group. The PE group demonstrated a significant improvement in the scores of the BBS and TUG. Conclusion : The present study suggests that the PE program using a trampoline and balance board may become a useful tool for enhancing a balance ability in chronic stroke patients through the ennced proprioceptive position senses.
Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) exercise on the range of motion (ROM), pain, and functional activity of patients who received total knee arthroplasty (TKA). The purpose of this study was to provide fundamental data regarding the use of PNF exercise among patients with musculoskeletal disease. Methods: Fourteen patients who received TKA were randomly divided into an experimental group (n=7) that took part in PNF exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 2 weeks. For the measurement of ROM, the range of knee flexion was measured using a clinometer smartphone application. A visual analogue scale (VAS) was used for the measurement of the level of pain. The timed up and go test (TUG) was conducted to measure functional activity. A paired t-test was performed to compare within-group changes before and after the PNF exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in VAS and TUG scores in the experimental group and control group (p<0.01). There was also a significant between-group difference in VAS and TUG scores after the intervention (p<0.05). Conclusion: General rehabilitation exercise is commonly applied as a treatment for TKA patients and is relatively effective. The application of PNF exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.
Purpose: The aim of this study was to investigate the effect of goal-oriented side walking training on balance and gait in chronic stroke patients. Methods: This study involved 18 chronic stroke patients who were divided into an experimental group (n=9) and a control group (n=9). The experimental group performed goal-oriented side walking training, and the control group performed general side walking training. The walking variables assessed were walking speed, stride length, and 10-m walking time. The balance variables assessed were foot pressure, timed up and go test (TUG), and Berg balance scale (BBS). These variables were measured before and after the exercise. Wilcoxon's signed-rank test was used to compare the participants' performances before and after the intervention in both groups. The Mann-Whitney U test was conducted for between-group comparisons after the intervention. Statistical significance was set at ${\alpha}=0.05$ Results: Walking speed, stride length, 10-m walking time, TUG, and foot pressure were significantly improved in both groups after the exercise (p<0.05). The between-group comparison showed a significant improvement in the goal-oriented side walking group (p<0.05). However, there were no significant between-group differences in 10-m walking times (p>0.05) and BBS (p=0.05). Conclusion: The results revealed that goal-oriented side walking training was effective in improving the balancing and walking ability of chronic stroke patients.
Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.
Kim, Yang Rae;Kim, Jae Ic;Kim, Yong Youn;Kang, Kwon Young;Kim, Bo Kyoung;Park, Joo Hyun;An, Ho Jung;Min, Kyung Ok
국제물리치료학회지
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제3권2호
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pp.446-452
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2012
This study aims to examine the effects of taping of the ankle joint on the static and dynamic balance and gait ability of stroke patients. Twenty-six stroke patients receiving physical therapy at a hospital located in Gyeonggi-do were divided equally into a group that had taping in physical therapy and an ordinary physical therapy group. They exercised for 30 minutes each, 3 times per week for 8 weeks from June to August 2011. Romberg's eye open and eye closed tests, limits of stability(LOS), forward and back test, timed up and go test(TUG) and 10-meter gait velocity test were performed to evaluate static balance, dynamic balance, and gait ability, respectively, prior to and 8 weeks after the intervention. Differences within each group in relation to the lapse of time were compared by a paired t-test. Differences between the two groups were compared by an independent t-test. Regarding comparison of differences within each group, all tests resulted in significant changes in both groups after the intervention (p<.05). Comparison of differences between the two groups showed that taping in the physical therapy group had significantly better test results than the ordinary physical therapy group in all measured items(p<.05). The after effects of ankle taping on stroke patients are more efficient and effective than ordinary physical therapy alone in improving balance and gait ability.
Purpose : The purpose of this study was to establish intra-rater, inter-rater, test-retest reliability, and concurrent validity of figure-of-8 walk test in people with stroke. Methods : The subjects of this study were 17 patients who were diagnosed with a stroke. Subjects were tested twice by the same raters, with 1 day between tests. Subjects were assessed by two physical therapists. Test-retest reliability was calculated using intraclass correlation coefficients (ICC). The concurrent validity was demonstrated by spearman correlation of F8WT with 10m walking test (10MWT), timed up and go test (TUG), Berg balance scale (BBS), dynamic gait index (DGI) and four square step test (FSST). Results : Intra-rater, inter-rater, test- retest of F8WT time, showed high reliability. Intra-rater, inter-rater, test-retest of F8WT steps demonstrated high reliability. Intra-rater, inter-rater, test-retest of F8WT total smoothness score showed below moderate reliability. There was a significant positive correlation of F8WT time with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT time with DGI, BBS. There was a significant positive correlation of F8WT steps with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT steps with DGI. There was a significant positive correlation of F8WT test total smoothness score with BBS. Conclusion : The time, and number of steps in F8WT show high inter, intra-rater, test-retest reliability. The F8WT smoothness shows below moderate reliability. The F8WT shows high concurrent validity with other comparable balance, and walking tests. The F8WT is a valid and reliable measure for assessing walking function in patients with a stroke.
Background: The elderly are likely to fall due to physical and mental atrophies, and experiencing falls may result in fear of falls and lack of self-confidence, which also leads to hesitation to physical activities and changes in walk and balance, the major variables in independent daily life. Methods: In three senior citizen centers located in D city, 22 elderly women aged 65 or older were chosen, and they filled in the questionnaire which included their agreement to voluntarily participate in the survey and medical histories. As to whether they had falls experience, the medical history items in the questionnaire asked them if they had falling down or falls once a year, twice for the three years. The objects were divided to NFE (non-falls experience) and FE (falls experience). Results: 1. As to walking abilities, significant difference was found between NFE and FE regarding walk width, stepping with two feet, and stride length while there was no significant different in terms of cadence. 2. As to balancing abilities, was significant difference between NFE and FE in terms of the physical body center area. As to the sit-to-stand, tandom gait test, no significant difference was found, and neither in the timed up and go test. Conclusions: The elderly with falls experience has inferior walking and balancing abilities to those without falls experience, and thus they are more exposed to the risks of falls.
Purpose The purpose of this study was to compare the effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Methods Ten patients with stroke were randomly allocated to either a closed kinetic chain exercise (CKC) group(n=5) or an open kinetic chain exercise(OKC) group(n=5). The subjects of each group followed the exercise regimen of their respective groups, and each exercise was performed for 50 mins per day, 3 days per week, for 4 weeks. Assessment was made using Berg Balance Scale (BBS), One Leg Standing(OLS) test, and Timed up and go(TUG) test. The 2 groups were assessed twice: before and after the intervention. Results The TUG test score was significantly different in the CKC group between before and after intervention (p<.05); however, there was no such deference in the OKC group (p>.05). Further, the scores of the BBS and OLS tests were not significantly different for the 2 groups between before and after intervention (p>.05). The hanges in these BBS and OLS score were not significantly different(p>.05); however, there was a significant difference in the change in the TUG scores (p<.05). Conclusion On the basis of the results of this study, we found that the closed kinetic chain exercise is more effective in improving the walking ability and dynamic balance in patients with stroke. Future studies are warranted in this regard.
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