• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제29권5호
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• pp.246-254
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• 2017

Purpose: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis Methods: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). Results: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p<0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p<0.05). Conclusion: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.

• 대한물리의학회지
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• 제9권2호
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• pp.223-231
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• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.55-62
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• 2014

Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.

• Physical Therapy Rehabilitation Science
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• 제7권2호
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• pp.88-93
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• 2018

Objective: Elevated cholesterol levels contribute to changes of the arterial endothelial permeability. Hyperlipidemia promotes atherosclerosis and is associated with an increased risk of stroke incidence. The purpose of this study was to investigate the effects of having a history of hyperlipidemia prior to a stroke incidence on postural balance, anticipatory dynamic postural control, gait endurance and gait performance in individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Fifty-two adults who were diagnosed with stroke 6 months ago or more were enrolled in this study. They were divided into two different groups according to hyperlipidemia history before stroke. All participants were assessed with the Activities-specific into Balance Confidence (ABC) scale, Berg Balance scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go test (TUG), and the 6-minute walk test (6MWT). An independent t-test was used to analyze the difference between the hyperlipidemia group and non-hyperlipidemia group. Results: After analysis, the BBS, TUG, and 6MWT scores were significantly different between the hyperlipidemia and non-hyperlipidemia group, but not the ABC and DGI scores. Conclusions: The results of this study show that having a history of hyperlipidemia before stroke affects static and dynamic postural balance performance, anticipatory dynamic postural balance, and gait endurance in individuals with chronic hemiparetic stroke. Based on the results of this study, we also suggest treatment for hyperlipidemia should be implemented throughout the therapeutic interventions, such as pharmacological or exercise programs, in order to restore the physical function of stroke survivors.

• 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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• 제13권4호
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• pp.189-196
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• 2015

Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) upper and lower limb coordinated exercises on balance in elderly women. Methods: The study was conducted with 27 elderly women who were at least 65-year-old. The subjects were randomly assigned to a PNF upper and lower limb coordinated exercise group consisting of 14 subjects and an aero step balance exercise group consisting of 13 subjects, and the exercises were performed for 30 minutes, three times per week, for eight weeks. One Leg Stance Tests (OLST), Functional Reaching Tests (FRT), Four Square Step Tests (FSST), and Timed Up and Go (TUB) tests were conducted before and after the exercises to evaluate the subjects' static balance ability and dynamic balance ability. Among the collected data, the subjects' general characteristics were evaluated using descriptive statistics, the intra-group differences of the test results before and after the intervention were compared using paired sample t-tests, and the inter-group differences in the results before and after the intervention were evaluated using independent sample t-tests. The statistical significance level was set to 0.05. Results: Among the OLST, FRT, FSST, and TUG tests, the experimental group showed positive FSST results that were statistically significantly greater than the control group; the results of the other tests were also more positive for this group, but the differences between the groups were not statistically significant. The magnitude of the effects for both groups was clinically significant. Conclusion: Since inter-limb coordinated exercises for PNF applied to elderly women were found to produce good results for both static balance ability and dynamic balance ability, these exercises can be used in exercise programs to improve balance in elderly women.

• PNF and Movement
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• 제13권1호
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• pp.9-16
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• 2015

Purpose: This study aimed to examined the effects of upper and lower limb coordinated exercise of proprioceptive neuromuscular facilitation (PNF) on static and dynamic balance ability. Methods: The subjects of this study were 18 patients who had been diagnosed with a stroke and hospitalized and who had received rehabilitation treatment at D rehabilitation hospital located in J city. They were randomly and equally assigned to a PNF upper and lower limb coordinated exercise group and an ordinary central nervous system development and treatment group, and they conducted exercises for eight weeks. They carried out exercise three times per week, for 30 minutes per each time. After each four minutes of exercise, each participant was given a and rest for one minute after exercise for four minutes was given. In order to test the subjects' static and dynamic balance ability and their dynamic balance ability, frailty and injuries,: a cooperative studyies of intervention techniques (FICSIT-4) test, a four- step square test (FSST), a timed up and go test (TUG), and a TWT3M tests wasere conducted before and after the exercise. Descriptive statistics were taken for the general characteristics of the subjects, and an independent t-test was conducted both before and after the exercise in order to examine differences between the two groups before and after the exercise were conducted. The A statistical significance level was set at p= 0.05. Results: In all the tests (of FICSIT-4, FSST, TUG, and TWT3M), both the experimental group and the control group saw more improved results, but the experimental group's results were significantly higher than those of the control group, and the size of the effects was larger in the experimental group than in the control group, with statistically significant results. Conclusion: PNF upper and lower limb coordinated exercise applied to chronic stroke patients produced brought significant results in static and dynamic balance ability. PNF and is considered as an important intervention program to improve stroke patients' balance ability.

• PNF and Movement
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• 제13권3호
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• pp.127-134
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• 2015

Purpose: The current study seeks to examine the effect of coordinative pattern exercises of the upper and lower extremities using harnesses and walking rails on the walking and balance abilities of chronic stroke patients, and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 16 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=8), on which coordinative pattern exercises of the upper and lower extremities were conducted, and a comparison group (n=8) that received typical exercise therapy. The experimental group underwent 30 minutes of typical exercise therapy and 30 minutes of coordinative pattern exercises of the upper and lower extremities, while the comparison group underwent typical exercise therapy for 30 minutes twice a day, five days per week for a six-week period. To evaluate walking ability, 10-m walking tests (10MWT) and 6-m walking tests (6MWT) were conducted. To assess balance ability, timed up and go tests (TUG) were performed. Results: After the intervention, significant (p<0.05) differences were seen in the 10MWT, 6MWT, and TUG in both the experimental and comparison groups. As for the 10MWT, the experimental group showed more significant improvement than the comparison group (p<0.05). In terms of the 6MWT, no significant differences were found between the groups, while the experimental group showed more significant differences than the comparison group in the TUG (p<0.05). Conclusion: The results from the current research indicate that training programs that apply coordinative pattern exercises of the upper and lower extremities with harnesses are extremely effective for improving the walking and balance abilities of chronic stroke patients.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.356-366
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• 2021

Objective: This study aimed to compare gait ability through gait evaluations in indoor and outdoor environments according to the general characteristics and walking ability of stroke patients. Design: Crossed-sectional study. Methods: The subjects of this study were 57 hospitalized stroke patients.The study subjects were asked to select an indoor environment and an outdoor environment in random order, and the Timed Up and Go Test (TUG), 10-Meter Walk Test (10MWT), Figure-Eight Walk Test (F8WT) and the Functional Gait Assessment (FGA) were used to assess each environment. Results: The TUG, 10MWT, F8WT time and number of steps, and FGA showed a significant decrease in gait ability in the outdoor environment compared to the indoor environment (p<0.05). Although the TUG, 10MWT, and the time required for the F8WT were statistically higher in the outdoor compared to the indoor environment at points 2, 3, and 4, but not 5 of the functional ambulatory category (FAC), significant increases in the number of steps of the F8WT were found in the outdoor compared to the indoor environment for only points 2 and 3 of the FAC (p<0.05). In the FAC 3 and 4, there was a statistically significant decrease in the outdoor compared to the indoor environment only in the FGA (p<0.05). Conclusions: Therefore, it has been shown that the gait ability of stroke patients is reduced in the outdoor environment compared to the gait ability in the indoor environment.