• PNF and Movement
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• 제16권3호
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• pp.405-414
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• 2018

Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.

• 대한물리의학회지
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• 제13권4호
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• pp.95-103
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• 2018

PURPOSE: The present study was conducted to investigate the effects of functional electrical stimulation gait training with rhythmic auditory stimulation on balance and gait ability in stroke patients. METHODS: In this blinded randomized controlled study, 26 stroke patients were assigned to either experimental group (n=13) consisting of 30 min of gait training 5 days per week for 4 weeks while performing functional electrical stimulation gait training with rhythmic auditory simulation, or a control group (n=13) performing the same gait training program, also consisting of 30 minutes 5 days a week and lasting for 4 weeks, but without functional electrical stimulation and rhythmic auditory stimulation. At baseline and after the 4 week intervention, balance was measured using the timed up and go test (TUG). Gait velocity was measured using the 10-meter walk test (10 MWT) and gait ability was assessed using the functional gait assessment (FGA). RESULTS: After the intervention, the experimental group showed statistically significant differences in gait velocity and ability (10 MWT, FGA) (p<.05). Between-group differences were statistically significant in gait velocity and ability (10 MWT, FGA) (p<.05). CONCLUSION: The findings suggest that functional electrical stimulation gait training with a rhythmic auditory stimulation gait training program may help improve gait ability in stroke patients.

• 한국전문물리치료학회지
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• 제26권1호
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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.

• 대한물리의학회지
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• 제14권1호
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• pp.75-89
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• 2019

PURPOSE: This study measured the impact of a 12-week fall-prevention exercise program on balance, ambulatory ability, lower limb strength, and psychosocial characteristics in older adults diagnosed with dementia. METHODS: The participants comprised 31 older adults (9 men, 22 women) diagnosed with Alzheimer's or vascular dementia at a long-term care hospital located in Gunsan City. A fall-prevention exercise program was provided to the experimental group, while the control group was only provided with instruction and materials related to the fall-prevention exercise program. The participants were evaluated before the intervention, 6 weeks after the intervention, and 12 weeks after the intervention on static and dynamic balance abilities (using Timed Up and Go test: TUG, Tinetti-balance scale, one-leg standing test: OLS), gait (Tinetti-balance scale, 6-minute walk test: 6MWT), lower limb strength (sit to stand test; STS), and psychosocial characteristics (Short Form 36 Health Survey-Korean version, Korean Mini-Mental State Exam). RESULTS: An independent samples t-test and repeated measures analysis of variance were used for the statistical analysis. There were statistically significant improvements after the intervention (p<.05) in dynamic balance abilities (TUG and OLS using the left foot), gait (6MWT), and lower limb strength (STS) for the experimental group, but not for the control group. No difference was seen in psychosocial characteristics. CONCLUSION: Older adults with dementia who participated in the fall-prevention exercise program showed significant improvements in their static and dynamic balance abilities, lower limb strength, and ambulatory ability after the intervention.

• 대한물리의학회지
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• 제14권1호
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• pp.139-150
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• 2019

PURPOSE: This study was conducted to determine the effects of treadmill gait training with obstacle-crossing on the static and dynamic balance ability of patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into three groups as: treadmill gait training with obstacle-crossing (TOG, n=7), treadmill gait training without obstacle-crossing (TGG, n=7) and a control (CON, n=7). TOG and TGG performed exercise for 20 minutes, three times a week for 8 weeks. Static balance ability (stability typical, ST; weight distribution index, WDI; fourier harmony index, FHI; and fall index, FI) and dynamic balance ability (berg balance scale, BBS and timed up and go test, TUG) were measured before and after 8 -weeks in each exercise group. Statistical analyses were conducted using two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Tukey's HSD. RESULTS: FHI and BBS were significantly increased at TOG (p<.01) and TGG (p<.05) after 8-weeks compared to before treadmill gait training with obstacle-crossing. FHI and BBS were significantly increased at TOG compared with CON and TGG (p<.05). CONCLUSION: Treadmill gait training with obstacle-crossing was more effective than that without obstacle-crossing to improve posture control and independent daily life performance of hemiplegia patients.

• PNF and Movement
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• 제17권2호
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• pp.245-252
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• 2019

Purpose: The purpose of this study was to determine the effects of action observation training on lower limb muscle activity and dynamic balance in chronic stroke patients. Methods: This study evaluated 20 chronic stroke patients who were divided randomly into a control and an experimental group comprising 10 patients each. Both the experimental group and the control group performed the general exercise therapy provided by the hospital, but the experimental group also performed action observation training. Lower limb muscle activity was measured with a surface electromyograph, and dynamic balance was measured with the Timed Up and Go test and the 10-meter walk test. The paired t-test was used to compare the groups before and after the experiment. Furthermore, the independent t-test was used to assess differences in the degree of change between the two groups before and after the experiment. Results: The within-group comparisons for both the experimental group and the control group showed significant differences in muscle activity and dynamic balance (p<0.05). In a comparison between the groups, the differences in the muscle activity and dynamic balance of the experimental group appeared significant compared with those of the control group (p<0.05). Conclusion: The study results indicate that action observation training is effective in improving the muscle activity and dynamic balance of chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.205-210
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• 2018

Purpose: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. Methods: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: $0^{\circ}$ treadmill gait training (n=14), $5^{\circ}$ treadmill gait training (n=15), and $10^{\circ}$ treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. Results: This study showed that gait training on a treadmill at controlled inclinations of $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ positively influenced the stroke patients' standing balance. The $5^{\circ}$ and $10^{\circ}$ inclination gait training groups showed significantly more improvement than the $0^{\circ}$ inclination group. Conclusion: Gait training on a treadmill with inclinations of $0^{\circ}$, $5^{\circ}$, or $10^{\circ}$ can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, $5^{\circ}$ and $10^{\circ}$ inclination gait training offered more significant improvement than the $0^{\circ}$ inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.

• PNF and Movement
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• 제17권1호
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• pp.129-136
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• 2019

Purpose: This study is a comparison of spatiotemporal parameters between straight and curved walking in individuals with chronic hemiparetic stroke, investigating whether those patients can adapt their walking according to task demands and environmental changes. Methods: Twenty-eight patients who diagnosed with their first stroke at least six months prior to this study were recruited. They were measured for spatiotemporal parameters in three different walking conditions: straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. This study also measured secondary clinical factors, such as the timed up-and-go test, the trunk impairment scale, and the dynamic gait index. The statistical methods for the three different walking conditions, using the averaged value of each condition, was repeated measures ANOVA. Results: The difference in cadence was statistically significant when comparing straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. Swing duration (%) was also a statistically significant difference between straight walking and walking with an inner curve to the more-affected leg. However, differences in other spatiotemporal parameters were not statistically significant among the three conditions. Conclusion: The results of this study suggest that stroke survivors could adapt their walking according to straight and curved walking conditions, although cadence and swing duration were different between straight and curved walking groups.

• PNF and Movement
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• 제17권1호
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.55-67
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• 2021

Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.