• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.364-368
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• 2015

Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.

• The Journal of Korean Physical Therapy
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• v.29 no.6
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• pp.303-306
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• 2017

Purpose: Gait variability is defined as the intrinsic fluctuations which occur during continuous gait cycles. Increased gait variability is closely associated with increased fall risk in older adults. This study investigated the influence of attention-demanding tasks on gait variability in elderly healthy adults. Methods: We recruited 15 healthy elderly adults in this study. All participants performed two cognitive tasks: a subtraction dual-task (SDT) and working memory dual-task (WMDT) during gait plus one normal gait. Using the $LEGSys^+$ system, we measured the coefficient of variation (CV %=$100{\times}$[standard deviation/mean]) for participants' stride time, stride length, and stride velocity. Results: SDT gait showed significant increment of stride time variability compared with usual gait (p<0.05), however, stride length and velocity variability did not difference between SDT gait and usual gait (p>0.05). WMDT gait showed significant increment of stride time and velocity variability compared with usual gait (p<0.05). In addition, stride time variability during WMDT gait also significantly increased compared with SDT gait (p<0.05). Conclusion: We reported that SDT and WMDT gait can induce the increment of the gait variability in elderly adults. We assume that attention demanding task based on working memory has the most influence on the interference between cognitive and gait function. Understanding the changes during dual task gait in older ages would be helpful for physical intervention strategies and improved risk assessment.

• PNF and Movement
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• v.15 no.3
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• pp.361-371
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• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.407-415
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• 2013

PURPOSE: This study is to examine the effects of different types of tasks on gait functions of chronic stroke patients when different types of dual tasks were applied while the patients were implementing practical and continuous circuit tasks using their upper and lower extremities circulating many workbenches. METHODS: Forty-four chronic stroke patients were divided into a dual motor circuit task training group, a dual cognitive circuit task training group and a simple task training group. Before training, all the patients were identically encouraged to receive conservative physical therapy for 30 minutes by a physical therapist were thereafter made to train for 30 minutes, five times a week for a total of eight weeks with individual additional tasks. The dual motor circuit task training consisted of continuous circuit training motor tasks and additional motor tasks and the dual cognitive circuit task training consisted of tasks combining the same circuit training motor tasks and additional cognitive tasks. The simple task training consisted of natural walks on a flat terrain to the front, rear and lateral sides of the terrain. Changes in functional gait abilities made through the training were evaluated using GAITRite. SPSS Win 12.0 was used for the data analysis. RESULTS: As for the gait variables that showed significant differences in comparison between the groups over the training period, the dual motor circuit task training group showed more significant differences than the dual cognitive circuit task training group and the simple task training group at 4 weeks and 8 weeks of training(p<.05). CONCLUSION: Therefore, it could be seen that the practical and continuous dual circuit task training was more effective than simple task training on gait. In comparison between the types of dual tasks, the dual motor circuit task training group showed more effects than the dual cognitive circuit task training group.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.65-73
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• 2024

PURPOSE: This study examined the effects of kinesio taping of tibialis anterior combined with cognitive dual-task training on balance and gait ability in post-stroke patients. METHODS: This study was a single-blinded, randomized control design. Thirty post-stroke patients were allocated randomly to two groups: 1) kinesio taping of tibialis anterior combined with cognitive dual-task training (KTCDT group, n = 15) and cognitive dual-task training (Control group, n = 15). Both groups were given training for 30 minutes, five days a week for four weeks. The Berg balance test and timed up-and-go test were used to measure the balance ability. GaitRite was used to analyze the gait ability. RESULTS: Both groups showed significant improvements in balance and gait ability. The KTCDT group showed significantly greater improvement in balance ability after four weeks than the control group (p < .05). In addition, the KTCDT group showed significantly greater improvement in gait ability after four weeks compared to the control group (p < .05). CONCLUSION: Kinesio taping of the tibialis anterior combined with cognitive dual-task training effectively improves the balance and gait abilities in post-stroke patients.

• PNF and Movement
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• v.20 no.2
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• pp.243-251
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• 2022

Purpose: This study aimed to compare the effects of aquatic and land dual-task training on balance, gait, and depression in chronic stroke patients. Methods: A total of 24 patients diagnosed with chronic stroke were the subjects. They were assigned to either the experimental group (n = 12) or the control group (n = 12). The experimental group performed aquatic dual-task training, while the control group performed land dual-task training. The aquatic and land dual-task training sessions were conducted once a day for 30 min, 5 days per week, for 6 weeks. Balance was measured using the Berg balance scale. Gait was measured using the Timed Up and Go Test. The Beck's Depression Inventory was used to measure depression. Results: Both the experimental and control groups showed significant differences in balance, gait, and depression after the intervention (p < 0.05) in the within-group comparisons. It was found that the experimental group showed more significant differences in balance, gait, and depression than the control group (p < 0.05) when the two groups were compared. Conclusion: It can be concluded that aquatic dual-task training effectively improved the balance ability, gait ability, and chronic stroke patients' depression based on these results.

• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.64-70
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• 2023

Purpose: This study investigated the influence of attention-demanding tasks on gait and measured differences in the temporal, spatial and kinematic characteristics between young healthy adults and elderly healthy adults. Methods: We recruited 16 healthy young adults and 15 healthy elderly adults in this study. All participants performed two cognitive tasks: a subtraction dual-task (SDT) and working memory dual-task (WMDT) during gait plus one normal gait. Using the LEGSys+ system, knee and hip-joint kinematic data during stance and swing phase and spatiotemporal parameter data were assessed in this study. Results: In the elderly adult group, attention-demanding tasks with gait showed a significant decrease in hip-joint motion during the stance phase, compared to the normal gait. Step length, stride length and stride velocity of the elderly adult group were significantly decreased in WMDT gait compared to normal gait (p<0.05). In the young adult group, kinematic data did not show any significant difference. However, stride velocity and cadence during SDT and WMDT gaits were significantly decreased compared to those of normal gait (p<0.05). Conclusion: We determined that attention-demanding tasks during gait in elderly adults can induce decreased hip-joint motion during stance phase and decreased gait speed and stride length to maintain balance and prevent risk of falling. We believe that understanding the changes during gait in older ages, particularly during attention-demanding tasks, would be helpful for intervention strategies and improved risk assessment.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.170-176
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• 2016

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

• PNF and Movement
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• v.7 no.4
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• pp.31-36
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• 2009

Many daily activities require people to complete a motor task while walking. Substantial gait decrements during simultaneous attention to a variety of cognitive tasks have been shown by a group of severely injured neurological patients of mixed etiology. And previous studies have shown that the attentional load of a walking-associated task increased with its level of difficulty. The purpose of this study was to analyze subjects' gait changes are affected by the effects of arithmetic task difficulty and performance level. Participants performed a walking task alone, three different Arithmetic tasks while seated, and among them, two kinds of the simillar Arithmetic tasks in combination with walking. Reaction time and accuracy were recorded for two of the Arithmetic tasks. The mean values of the gait were measured using a Timed Up and Go test among 11 with post-stroke patients while walking with and without forward counting (WFC) and backward counting(WBC).There was significant Arithmetic Task Difficulty level between the 10-forward counting task condition(FC) and the 10-backward counting task condition(BC)(p=0.008). The mean values of T.U.G time were significantly higher under backward counting dual-task condition than during a simple walking task(p=0.009) and WFC(p=0.009). The change in T.U.G time during WFC was higher when compared with the change during a simple walking, but there was no significant difference (p=0.246). This study suggesting that a high interference could be linked with a high level of difficulty, whereas adaptive task enabled participants to perfectly share their attention between two concurrent tasks. Future research should determine whether dual task training can reduce gait decrements in dual task situations in people after stroke. And the dual-task-based exercise program is feasible and beneficial for improving walking ability in subjects with stroke.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.9-14
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• 2016

Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.