• 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.11 no.2
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• pp.63-70
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• 2016

PURPOSE: The aim of this study was to conduct an Otago exercise program with stroke patients in a clinical setting and ascertain its effects on balance and walking ability. METHODS: The participating subjects were 45 people who had been diagnosed with stroke. They were assigned to two groups (Otago exercise; OE, n=22; balance exercise; BE, n=23), and the exercises were conducted for three sessions per week for eight weeks. The main balance outcomes were evaluated using the timed up and go test (TUG) and the four step square test (FSST), while walking ability was evaluated using the 10 m walk test (10MWT), direction change ability was measured using the figure 8 of walk test (F8WT), and the decrease of fear was evaluated using the modified falls efficacy scale (MFES). RESULTS: In the analysis results, the Otago exercise group showed significant increases in TUG, FSST, 10MWT, and F8WT within the both groups. There were significant differences in all variables between the OE group and the BE group at the post-intervention evaluation, but there was no significant difference between the groups with respect to the 10MWT. This study showed that conducting Otago exercise in stroke patients increased the main outcomes for TUG, FSST, F8WT scores, but not for 10MWT. CONCLUSION: The results of this study demonstrated that Otago exercise would be useful to improve balance and gait for stroke patients who want to improve their abilities and activities of daily living.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.435-443
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• 2010

Purpose : The goal of this study was to identify the effects of treadmill walking training (TW) and ergometer bicycle training (EB) on gait and balance in stroke patients. Methods : The subjects consisted of 42 stroke patients. They were randomly divided to two groups: TW(n=20) and EB(n=22). Each group trained along with the conventional physical therapy, three times a week for six weeks. The ability of gait was assessed by the 10m walk test and Timed Up and Go test(TUG). The ability of balance was assessed by Berg Balance Scale(BBS) and Balance Performance Monitor(BPM). Results : There was no significant difference between the 10m walking test and TUG groups, but there was a statistical difference between before and after the training for all groups. The result of BBS that assessed balance showed a significant reduction between before and after the training for all groups, but there was no difference between the two groups. While the two groups showed no difference in the BPM assessment, only the EB showed a significant improvement of before and after the training in each group. Conclusion : The outcomes suggest that stroke patients can improve their gait and balance performance through the TW and EB trainings. Although dynamic mean balance showed significance from EB, no significant difference was found between two groups. Even though it cannot be determined through this study which training group is more effective among the above mentioned two, it could be suggested that each training is effective to gait ability and the ability of balance of stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.370-377
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• 2012

This study examines the effects of different environments on the application of hemiplegia patients circuit balance training. Group 1 performed circuit balance training without any auditory intervention Group 2 performed training in noiseless environments and Group 3 performed training in white noise environments. First, among lower extremity muscular strength evaluation items, maximum activity time(MAT) was not significantly different(p>.05). Maximum muscle strength(MMS) increased significantly in Group 3(p<.01), there was no significant difference in MMS among the groups. Average muscle strength(AMS) indexes also significantly increased in Group 3(p<.01), there was no significant difference in AMS among the groups. Second, among balancing ability evaluation items, Berg's balance scale(BBS) scores significantly increased in all groups(p<.05), BBS scores were significantly difference among the groups. Based on the results, Group 1, 2 and Group 1, 3 showed significant increases (p<.05). Functional reach test(FRT) values significantly increased in Group 2, 3(p<.05), and there was no significant difference in FRT values among the groups. Timed up and go(TUG) test values significantly decreased in Group 2, 3(p<.05), and there was no significant difference in TUG test values among the groups. Third, among walking speed evaluation items, the time required to walk 10m significantly decreased in all groups(p<.05), and there was no significant difference in the values among the groups. Average walking speeds showed significant increases in Group 1, 3(p<.05), and there was no significant difference in the values among the groups. Based on the results of this study, noise environments should be improved by either considering auditory interventions and noiseless environments, or by ensuring that white noise environments facilitate the enhancement of balancing ability.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.49-57
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• 2015

PURPOSE: This study aimed to investigate the effect of emphasized initial contact gait training on balance and gait ability in hemiplegia patients. METHODS: Twenty-four hemiplegic patients were randomly allocated to an experimental group or control group. All participants received 30-min neurodevelopmental treatment. Furthermore, the experimental group received initial contact-emphasized auditory feedback gait training, whereas the control group received gait training without auditory feedback. The intervention was performed 3 times per week, 20 min per each time, for a total of 6 weeks. Balance was assessed using the center of pressure path length, center of pressure velocity, and limitation of stability path length, whereas gait ability was assessed using the 10-m walking test and functional gait assessment. RESULTS: In both groups, center of pressure path length and center of pressure velocity significantly decreased after training. Compared to the control group, the experimental group showed a 10% significant improvement (p<.05). In the limitation of stability path length of both sides, the experimental group showed a significant increase compared to that before intervention. Compared to the control group, the experimental group showed a 7% significant improvement in results of the 10-m walking test and functional gait assessment (p<.05). CONCLUSION: Emphasized Initial contact gait training is considered an effective treatment for improving gait ability and balance ability in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.137-145
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• 2018

PURPOSE: The purpose of this study was to investigate the effect of action observational physical training with rhythmic auditory stimulation on muscle activity and gait ability in patients with stroke. METHODS: Twenty-six chronic stroke patients participated in this study were assigned into three groups, experimental group 1 (10% faster tempo rhythmic auditory stimulation with action observation training) n=8, experimental group 2 (average tempo rhythmic auditory stimulation with action observation training) n=9, and control group (action observation training) n=9. In this experiment, the corresponding exercise were applied into the subjects of three group for 30 minute a day, 3 time a week during 4 weeks. All participants were measured to muscle activity of lower limb, 10 meter walking test, Figure of 8 walk test, Dynamic gait Index. The collected data were analyzed by using SPSS (version 18.0 for window) and verified that each data was a normal distribution based on Shapiro-Wilk test. Between-group and within-group comparison was analyzed by using One-way ANOVA test, Paired t-test respectively. In all statistical analyses, significance level, ${\alpha}$ was set by .05. RESULTS: The above results revealed that the all experimental group 1 and experimental group 2 and control group were all effective to improve the lower limb muscle activities, gait ability. However more positive effects shown action observational physical training with rhythmic auditory stimulation experimental group. CONCLUSION: This study suggest that action observation physical training with rhythmic auditory stimulation is effective intervention for improvement of muscle activity and walking ability in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.369-379
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• 2011

Purpose : The purpose of this study is to compare the initial effect of nerve mobilization (NM), static stretching (SS), and contract-relax (CR) techniques to find the best method in improving hamstring flexibility and gait function in patients with hemiplegia. Methods : Eleven patients with hemiplegia were included in this study. Passive knee extension (PKE) range of motion and the sit and reach (SR) test were used to measure hamstring flexibility, while timed up and go (TUG) and the 10m walking (10MW) test were used to measure the subject's gait. Measurements on each test were assessed prior to the experiment, immediately following the experiment, and 30 minutes after the experiment. Analysis of the results utilized a repeated measures analysis of variance to examine hamstring flexibility and the difference in walking ability. Results : The results suggest significant increases in NM, SS, and CR techniques as they relate to hamstring flexibility (p<.05) following (both immediate and 30 minutes post experiment) PKE range of motion and the SR test, but post-hoc showed no significant difference between the three techniques (p>.05). Additionally, the results suggest significant increases in NM, SS, and CR techniques as they relate to gait function (p<.05) following the TUG test, but found no significant difference in the 10MW test (p>.05). Post-hoc analysis between the three techniques suggests that only the NM technique significantly changed gait function. The time of TUG and 10MW test showed no significant difference between the three techniques before an experiment, just after an experiment, and 30 minutes following the experiment according to the measurement points in time (p>.05). Conclusion : This study suggests NM, SS, and CR techniques immediately improve hamstring length and flexibility while improving gait function in patients with hemiplegia.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.39B no.7
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• pp.479-490
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• 2014

A lower extremity exoskeleton is a robot device that attaches to the lower limbs of the human body to augment or assist with the walking ability of the wearer. In order to improve the wearer's walking ability, the robot senses the wearer's walking locomotion and classifies it into a gait-phase state, after which it drives the appropriate robot motions for each state using its actuators. This paper presents a method by which the robot senses the wearer's locomotion along with a novel classification algorithm which classifies the sensed data as a gait-phase state. The robot determines its control mode using this gait-phase information. If erroneous information is delivered, the robot will fail to improve the walking ability or will bring some discomfort to the wearer. Therefore, it is necessary for the algorithm constantly to classify the correct gait-phase information. However, our device for sensing a human's locomotion has very sensitive characteristics sufficient for it to detect small movements. With only simple logic like a threshold-based classification, it is difficult to deliver the correct information continually. In order to overcome this and provide correct information in a timely manner, a probabilistic gait-phase classification algorithm is proposed. Experimental results demonstrate that the proposed algorithm offers excellent accuracy.

• Journal of the Korean housing association
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• v.14 no.5
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• pp.117-128
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• 2003

The purpose of this study is to investigate the effect of functional ability on relocation among the elderly. Longitudinal data from the Asset and Health Dynamics among the Oldest Old (1993, 1995) were analyzed for 6,225 respondents aged 70 or older. Among functional ability measures, difficulties in advanced activities of daily living (i. e., making telephone calls, taking medications, and managing money), lower body activities (i. e., walking several blocks, climbing one flight of stairs, pulling or pushing large objects, and carrying over 10 pounds), and household activities of daily living (i. e., preparing hot meals and shopping for groceries) were the predictors of increased residential move. Difficulties in basic activities of daily living (i. e., bathing, dressing, getting in and out, and using the toilet) were strongly related to increased entrance into an institutional care facility. Efforts to enhance the independent living of the elderly in the community setting should target the compensation of these functional difficulties.

• Journal of Korean Physical Therapy Science
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• v.15 no.2
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• pp.79-86
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• 2008

Background: The purpose of this study was to present a practical method of medical treatment to improve the balance and motor ability of the mentally retarded child with a single mentally retarded child-subject. Methods: The subject of the study was a 39-month-old mentally retarded female. This study included a 2-week basic period and a 13-week treatment period. The treatment method was based on the Bobath Approach. Gross motor function measurement (GMFM) was used to examine changes in motor ability, and the Pediatric Balance Scale (PBS) was used to measure changes in balance ability. The curative program was composed of normalization of muscle tone, strengthening of leg endurance and muscular strength, the improvement of trunk alignment, and the increase of balance. Visual rate of change was used to examine the results. Results: As a result of this study, balance ability increased on the Pediatric Balance Scale (PBS) by 24 points, and motor function increased in terms of Gross Motor Function Measurement (GMFM) by 6.9% (18 points). Standing increased by 41% (16 points), and walking, running, and jumping increased by 31.9% (23 points) compared to thebasic period. Therefore, the Bobath Approach appears to be an appropriate method to improve balance and motor ability in mentally retarded children. Conclusion: It is surmised that aggressive intervention by physical therapists and occupational therapists, and a follow-up study, are required for the growth of motor ability in mentally retarded children.