• Physical Therapy Rehabilitation Science
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• v.2 no.2
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• pp.104-110
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• 2013

Objective: The purpose of this study was to investigate the effects of intensive gait training with body weight support treadmill training on gait and balance in stroke disability patients. Design: Randomized controlled trial. Methods: Twenty-six stroke patients (20 men and 6 women) participated in this study. All subjects were hospitalized patients. They were randomly divided into two groups: the experimental group (body weight supported treadmill training group, n=14) and control group (treadmill group, n=12). The mean ages were 52.07 years (experimental group) and 53.83 years (control group). Subjects in both groups received conventional training 10 times/wk. Subjects in the experimental group practiced body weight supported treadmill training for 30 minutes a day, 3 day/wk. Subjects in the control group practiced treadmill training for 30 minutes. The Berg Balance Scale (BBS) and GAITRite were used to evaluate balance and gait parameters (step length, cadence and gait speed) before and after the intervention. Results: BBS scores in the experimental group showed significantly greater improvement ($4.33{\pm}1.54$), compared with the control group (p<0.05). Significantly greater improvement in the gait speed ($24.13{\pm}4.53$ cm/s), affected side step length ($10.40{\pm}3.42$ cm), sound side step length ($11.97{\pm}3.29$ cm), and cadence ($23.88{\pm}5.52$ step/min), compared with the control group (p<0.05). Conclusions: Intensive gait training with Body Weight Support Treadmill Training may improve gait and balance in subacute stroke.

• Physical Therapy Korea
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• v.21 no.1
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• pp.20-28
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• 2014

The purpose of this study was to investigate the effects of visual cue deprivation during sideways treadmill training in individuals with stroke. Twenty-eight stroke patients were divided into two groups, and each group participated in a sideways treadmill training session for 20 minutes, three times per week for 4 weeks. The eyes close group (15 subjects) performed this treadmill training with visual cue deprivation, while the eyes open group (13 subjects) performed it without visual cue deprivation. Gait function was measured in both groups before and after the training sessions with the Biodex Gait Trainer 2, which determined walking speed, distance, step length, and time on each foot. Balance was measured before and after each training period in both groups using the Five-Times Sit-to-Stand Test (FTSST), the Timed Up and Go test (TUG), and the seven-item Berg Balance Scale-3P (7-item BBS-3P). The eyes close group showed significantly improved gait function, walking speed, distance, step length, and time on each foot after training (p<.05). The eyes close group showed improved balance ability, FTSST, TUG, and 7-item BBS-3P test after training (p<.05). The findings indicated that sideways treadmill training with visual cue deprivation positively affects gait ability of stroke patients. Therefore, sideways treadmill training with visual cue deprivation may be useful for the recovery of gait ability of stroke patients.

• Physical Therapy Korea
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• v.25 no.2
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• pp.53-61
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• 2018

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.120-126
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• 2017

Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on strength, proprioception, and walking ability in persons with stroke. Design: Randomized control trial. Methods: Twenty eight subjects participated in the study in which they were randomly assigned to either the underwater backward treadmill training (UBTT) group (n=13) or the BTT group (n=15). In both groups, forward gait training was performed for 20 minutes on the ground treadmill. The UBTT group performed backward gait on an underwater treadmill for 20 minutes while the BTT group performed backward gait on a ground treadmill for 20 minutes. The gait training in each group was performed twice a week for a total of six weeks. Muscle strength, proprioception, and gait ability was assessed using a digital power meter, joint angle recurrence method using the smartphone protractor application, the Figure-of-Eight walk test (F8W) and the functional gait assessment (FGA) respectively. Results: Both groups showed significant improvement in strength, F8W and FGA scores after training (p<0.05). However, there was no statistically significant difference between the two groups. Both groups showed significant improvement in proprioception after training (p<0.05). In the comparison between the two groups, there was a greater significant change in the UBTT group for joint proprioception (p<0.05). Conclusions: In this study, it was found that both backward treadmill gait training programs were effective on strength, proprioception, and gait ability, and that underwater training was particularly effective on proprioception compared to ground training.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.35-42
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• 2017

PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.39-48
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• 2020

PURPOSE: This study examined the effects of integrating transcutaneous electrical nerve stimulation into treadmill gait training by applying functional electrical stimulation on the spasticity, balance, and gait ability of chronic stroke patients METHODS: Twenty participants were assigned randomly to two groups: the treadmill gait training group with applied functional electrical stimulation (FES) with integrated transcutaneous electricalstimulation (TENS) (experimental group, EG, n = 10) and the treadmill gait training group with FES (control group, CG, n = 10). Both groups received treadmill gait training with FES for 30 minutes a time, four times a week, during five weeks. The experimental group received additional TENS on their L3, L5, and S2 dermatome for 30 minutes before the interventions. The spasticity, balance, and gait ability were evaluated before and after the training to compare the intergroup and intragroup changes. RESULTS: Both groups showed significant improvements in the static, dynamic balance, and gait ability (p < .05), but did not show any significant changes in the muscle tone. The EG showed significant improvements in the static balance ability and gait cycle compared to the CG (p < .05). CONCLUSION: Treadmill gait training combined with FES with integrated TENS is an effective method for improving the static balance and gait cycle. On the other hand, the effects of treadmill gait training with FES on spasticity need to be studied further.

• Physical Therapy Korea
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• v.14 no.4
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• pp.84-90
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• 2007

The purpose of this study was to assess the test-retest reliability of heart rate (HR) and velocity measurements during peak effort and free treadmill walking tests in older patients with gait-impaired chronic hemiparetic stroke and control group. Twenty-two adults (13 men, 9 women; mean age, $73.7{\pm}5.2$ yrs) with chronic hemiparetic stroke are the experimental group. Nineteen elderly people (5 men, 14 women; mean age, $72.3{\pm}3.5$ yrs) were recruited as control group. Patients had mild to moderate chronic hemiparetic gait deficits, making handrail support necessary during treadmill walking. Free and peak effort treadmill walking tests were measured and then repeated at least two days later. Reliability was calculated from HR and walking velocity during free and peak effort treadmill walking test. Among the people who had strokes, HR [ICC(2,1)=.85, r=.86] and velocity [ICC(2,1)=.93, r=.93] were good parameters during free testing. Maximal testing generated good results for HR [ICC(2,1)=.81, r=.82] and velocity [ICC(2,1)=.96, r=.96] with the chronic hemiparetic stroke. In elderly people, HR [ICC(2,1)=.59, r=.62] and velocity [ICC(2,1)=.77, r=.76] were moderately reliable during free testing. Maximal testing produced moderate parameters for HR [ICC(2,1)=.74, r=.74] and velocity [ICC(2,1)=.66, r=.66] in the elderly. This study provides that free and maximal treadmill testing produce highly reliable HR and velocity measurements in adults with chronic hemiplegia using minimal handrail support.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.47-54
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• 2020

PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.1
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• pp.39-47
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• 2008

Purpose : The purpose of this study was to investigate the change of the peak plantar pressure distribution under the foot areas and the range of motion (ROM) of ankle joint according to gradients in treadmill gait. Method : Thirty normal subjects (15 male and 15 female) walked on treadmill at three gradient conditions ($0^{\circ}$, $10^{\circ}$, and $15^{\circ}$) in normal speed. The ankle ROM was measured using the CMS70P that is three dimensional analyzer for excursion of ankle ROM, plantar flexion, and dorsi flexion. The peak plantar pressure distribution under the hallux, 1st metatarsal head (MTH) and heel was measured using the F -Scan system with an in-shoe sensor. Data was collected from 9 steps of left sife foot in at each gradient condition while all subjects walked. Result : As the treadmill gradient increased, the excursion of ankle joint was significantly increased (p<.05). Also, plantar flexion and dorsi flexion was significantly increased according to treadmill gradients (p<.05). The peak plantar pressure under the 1st MTH was significantly increased (p<.05) and the peak plantar pressure under the heel was significantly decreased (p<.05) as the treadmill gradient increased. No significant different in the peak plantar pressure under the hallux was observed. Conclusion : This study suggests that physical therapy for patients who have limited ankle ROM should be considered sufficient range of motion for functional ambulation. And individuals that have painful forefoot syndromes, including metatarsalgia, hallux valgus, and plantar ulceration should be careful in walking to uphill, as there is high plantar pressure under the forefoot.

• PNF and Movement
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• v.14 no.2
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• pp.83-91
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• 2016

Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects' balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at ${\alpha}=0.05$. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects' gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients' gait and balance abilities.