• The Journal of Korean Physical Therapy
• /
• v.30 no.5
• /
• pp.159-165
• /
• 2018

Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

• Physical Therapy Rehabilitation Science
• /
• v.6 no.2
• /
• pp.59-64
• /
• 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.

• Journal of Haehwa Medicine
• /
• v.29 no.2
• /
• pp.1-11
• /
• 2020

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.

• PNF and Movement
• /
• v.16 no.1
• /
• pp.75-83
• /
• 2018

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.

• PNF and Movement
• /
• v.16 no.1
• /
• pp.93-103
• /
• 2018

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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.15 no.1
• /
• pp.22-31
• /
• 2009

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.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.2
• /
• pp.88-93
• /
• 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.

• Physical Therapy Rehabilitation Science
• /
• v.10 no.3
• /
• pp.356-366
• /
• 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.

• Physical Therapy Korea
• /
• v.26 no.1
• /
• pp.37-50
• /
• 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.

• Journal of the Korean Society of Physical Medicine
• /
• v.17 no.1
• /
• pp.21-30
• /
• 2022

PURPOSE: This study examined the effects of treadmill training with taping on the affected ankle joint on the gait and balancing ability in patients with sub-acute stroke. METHODS: Nineteen patients with sub-acute hemiplegic stroke in a rehabilitation hospital were assigned randomly to either the experimental group (n = 10), who received treadmill training with taping on the affected ankle joint or the control group (n = 9), who received general treadmill training. All participants performed 60 min of comprehensive rehabilitation therapy (five sessions per week for four weeks). Each group received treadmill training with or without taping on the affected ankle joint for 20 min (three sessions per week for four weeks). The gait and balancing ability were measured before and after the four-week training. RESULTS: Post-training scores of 10-meter walk test (10 MWT), timed up and go (TUG) test, and center of pressure (COP) path length and velocity for the experimental group increased significantly compared to that pre-training (p < .05). The experimental group showed a larger decrease in the 10 MWT and TUG test than the control group (-3.5 s vs. -1.01 s, p < .05; -4.9 s vs. -1.7 s, p < .05; respectively) CONCLUSION: Treadmill training with taping on the affected ankle joint might improve the gait and balancing ability of stroke patients and is considered a more effective method for improving gait and balancing ability than the method of general treadmill training.