• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.131-142
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• 2024

PURPOSE: This study was a systematic review and meta-analysis of the literature comparing the differences between task-oriented treadmill training and general treadmill training for stroke patients. METHODS: Literature published in the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), and PubMed was reviewed. A total of 1,163 studies were initially retrieved, of which eight articles were included in the final review. A quality assessment of the included studies was conducted using the Risk of Bias (RoB) 2.0 tool, and Duval and Tweedie's trim and fill method was used to evaluate publication bias. Data analysis was performed using R studio 4.2.1. RESULTS: According to the quality assessment using RoB 2.0, three articles were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size of task-oriented tradmill training was .35. Regarding gait function, the values were .76, .25, and .40, respectively, for gait endurance, gait speed, and gait pattern. According to Duval and Tweedie's trim and fill method, no publication bias was observed. CONCLUSION: Study findings indicate that task-oriented treadmill training is the most effective intervention for improving gait endurance in patients with stroke. Therefore, applying this intervention to patients with stroke in the community is recommended.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.88-93
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• 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 Korea
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• v.13 no.2
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• pp.1-8
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• 2006

The main purposes of this study were to find the correlation between walking ability assessment tools using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), Spinal Cord Injury Measurement II (SCIM II), Walking Index for Spinal Cord Injury (WISCI), walking velocity, and walking endurance. The study population consisted of 56 patients with spinal cord injury referred to the department of Rehabilitative Medicine in the National Rehabilitation Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed by MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance. The data were analyzed using Pearson correlation analysis and X2. There was significant correlation between the MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance (p<.01). In particular, WISCI has a significant correlation with SCIM II(p<.001). Therefore the WISCI scale is an appropriate assessment tool to predict the gait ability of patients with spinal cord injury. Further study about MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance is needed using a longitudinal study design.

• Journal of Korean Society of Forest Science
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• v.103 no.3
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• pp.503-509
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• 2014

The purpose of this study was to investigate the effect of Forest-walking exercise on gait pattern in the elderly. The subjects (n=37) were assigned to 2 groups: Forest-walking exercise (FWE) group (n=19, $66.34{\pm}4.31$ years old) and In-door treadmill-walking exercise (ITWE) group (n=18, $67.18{\pm}2.78$ years old). The subjects participated in FWE program or ITWE program (3 times/week, 80 min/day) for 12 weeks. The subjects were tested on functional fitness (strength, endurance, agility/balance, BMI) and gait pattern (cadence, velocity, and stability) at the beginning and the end of the 12-weeks program. For data analysis, mean and standard deviation scores were calculated, and independent t-test and repeated two-way ANOVA were used. The results of this study were as follow: First, FWE group was significantly more improved than ITWE group on functional fitness(lower-body muscular strength, lower-body flexibility, mobility, cardiorespiratory endurance) after 12-weeks exercise program. But both groups showed equally improvements on functional fitness (upper-body muscular strength, upper-body flexibility, BMI). Second, FWE group was significantly more improved than ITWE group on cadence, gait velocity, and gait stability after 12-weeks exercise program. Therefore, this study may suggest that Forest-walking exercise based on sensory-motor functional integration improves efficiently functional fitness and gait pattern in the elderly, and further becomes an effective exercise method that makes more dynamic life, and prevents from falling.

• PNF and Movement
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• v.15 no.2
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• pp.185-194
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• 2017

Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P<0.05). Significant differences between the PWBV and WBV groups were found (P<0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.

• PNF and Movement
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• v.16 no.3
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• pp.461-473
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• 2018

Purpose: The purpose of this study was to evaluate and compare the effects of inspiratory muscle training with chest expansion exercises on pulmonary function, maximal inspiratory pressure, and gait in individuals with stroke. Methods: The participants in this study included 36 stroke patients. These patients were randomly divided into three groups: an inspiratory muscle training (IMT) with chest expansion (CE) group (n=12), an IMT group (n=12), and a control group (n=12). Participants in the IMT with CE group underwent IMT and CE exercises 5 times per week for 30 minutes over 4 weeks, whereas those in the CE group and the control group received IMT and conventional physical therapy, respectively, for the same duration. The investigator measured the patients' pulmonary function, maximal inspiratory pressure, and gait endurance. Results: After the intervention, the change values for the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and six-minute walk test (6MWT) in the IMT with CE group and the control group were significantly greater than those of the control group (p<0.05). Similarly, after the intervention, the change values of the FVC, FEV1, PEF, MIP, and 6MWT in the IMT with CE group were significantly greater than those in the IMT group (p<0.05). Conclusion: These findings suggest that IMT with CE could be used to increase pulmonary function, maximal inspiratory pressure, and gait endurance in stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.743-751
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• 2014

This study aims to identify the effect of home physical therapy on patients who left the hospital after total knee arthroplasty, compared to the Daily living group, when it was applied to them, under the guidance of physical therapists. As research subjects, 20 patients that were scheduled to leave the hospital after unilateral total knee arthroplasty, were chosen, and they were randomly divided into a home physical therapy group(10 patients) and an Daily living group(10 patients) in order to conduct an experiment. During the 4-week research, home physical therapy was offered for 40 mins once for 5 days a week, and muscular strength, gait components were measured. For muscular strength, quadriceps muscle strength, hamstring muscle strength were measured, and as gait components, endurance, speed, step time, single-limb support were analysed. For this experiment, pre- and post-measurement were performed, and collected data were analyzed using SPSS ver. 18.0 statistical program. From the analysis of data, the following study results were obtained. Home physical therapy group and Daily living group both showed significant improvements in quadriceps muscle strength, hamstring muscle strength, and quadriceps muscle strength, hamstring muscle strength of home physical therapy group more significantly improved than Daily living group's. In relation to gait components, gait endurance, gait speed, step time significantly improved in both of home physical therapy group and Daily living group, whereas home physical therapy group only showed significant improvements in single-limp support. According to the comparison between two groups, gait speed, single-limp support and step time improved more significantly in the home physical therapy group than in the Daily living group. In conclusion, positive results were revealed in both home physical therapy group and Daily living group, with regard to muscular recovery of lower limbs of patients discharged from the hospital after total knee arthroplasty and walking, but considering the comparison results between two groups, it seems that applying home physical therapy is more effective than maintaining a daily life.

• 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.

• Women's Health Nursing
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• v.20 no.4
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• pp.297-308
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• 2014

Purpose: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. Methods: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. Results: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. Conclusion: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.

• PNF and Movement
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• v.14 no.2
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• pp.67-74
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• 2016

Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.