Purpose: To investigate the effect of treadmill training applied simultaneously with gait related action observation on walking ability in chronic stroke patients. Methods: Sixteen chronic stroke patients participated in this study. Participants were randomly allocated into either the treadmill applied simultaneously with action observation training group (TAG) or treadmill applied simultaneously with landscape observation training group (TLG). The participants in both group underwent treadmill training for four weeks (a total of twelve minute, once a day, three times weekly for a four week period). All participants were measured to gait speed (10 m walking test, 10 MWT), gait endurance (6 minute walk distance, 6 MWD), dynamic gait index (DGI). In order to assure the statistical significance of the results, we used for SPSS 15.0 for windows. The Wilcoxon signed ranks test was used to compare pre-test and post-test result, and the Mann-Whitney U-test was employed for comparison between groups. Results: The 10 MWT, 6 MWD, DGI was significantly different between the TAG and the TLG group. Conclusion: According the results of this study, treadmill applied simultaneously with action observation (TAG) is effective intervention for improvement of walking ability in chronic stroke patient.
Hip articulation fusion is to relieve hip pain from pathologic joint problem. The questionnaire is followed by hip articulation fusion surgery in order to evaluate the degree of pain, function, mobility. However, this subjective evaluation is controversial. The patient endurance of pain which affect function and mobility of lower extremity call not assess objectively. Therefore, gait analysis is necessary for objective evaluation. This study is to evaluate objectively function and mobility after hip articulation fusion surgery using gait analysis.
Kim, Jwa-Jun;Rho, Min-He;Goo, Bong-Oh;Ahn, So-Youn
The Journal of Korean Physical Therapy
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v.17
no.3
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pp.339-350
/
2005
This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.
Journal of the Korean Society of Physical Medicine
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v.16
no.3
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pp.99-106
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2021
PURPOSE: This study aimed to provide supporting data for the clinical use of breathing exercise with a WBV stimulation as a sustained and safe intervention program, by examining the effect of breathing exercise with WBV stimulation on the pulmonary function, gait ability, and life quality in patients with severe chronic obstructive pulmonary disease (COPD), who have difficulty performing exercise. METHODS: For this study, after collecting the samples from 20 patients with severe COPD, they were placed randomly in an experimental group to perform breathing exercises with a WBV stimulation (n = 10) and a control group to perform breathing exercises only (n=10). Before the intervention, pulmonary function, six-minute gait distance, and health-related life quality were measured as pre-tests. After applying the intervention program to the patients for 30 minutes once a day, for four days a week, for six weeks, the post-test items were remeasured in the same way as the pre-tests, and the results were analyzed. RESULTS: In the within-group comparison, both the experimental and control groups showed significant differences in the forced expiratory volume in one second, six-minute gait distance, and health-related life quality (p < .01) (p < .05). In the intergroup comparison, there were significant differences in the forced expiratory volume in one second and the six-minute gait distance (p < .05). CONCLUSION: WBV stimulation was more effective for the patients by improving the muscular strength and muscular endurance through the reflexive contraction of muscles, and increasing the exercise tolerance. This result could serve as an alternative means to clinically improve the physical function of patients with severe COPD, who have difficulty performing breathing exercises in the future.
Purpose: The aim of this study was to evaluate functional gait and pulmonary function of patients with subacute or chronic stroke for aperiod after the onset of stroke. Healthy people of similar ages served as a control group. The study focused on the clinical importance of intervention with cardiopulmonary rehabilitation treatment in patients with stroke. Methods: The standard time period used to differentiate the subacute and the chronic stroke groups was six months. Each group, including the control, was allocated 11 subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume at one second ($FEV_1$) were measured with a spirometer for each subject. Walk tests (10 m and 6 min) and functional gait tests were then conducted. Results: Significant differences were noted for VC, FVC, and $FEV_1$ between the subacute stroke group and the normal group and between the chronic stroke group and the normal group (p<0.05), but no significant difference was evident between the subacute stroke group and the chronic stroke group (p>0.05). No significant difference was seen between the subacute stroke group and the chronic stroke group in the 6min walk test (p>0.05), whereas a significant difference was observed between the subacute stroke group and the chronic stroke group in the 10 m walk test (p<0.05). Conclusion: The general rehabilitation treatment is effective with respect to functional aspects, but it has limited effect in improving pulmonary function and muscular endurance. Therefore, additional intervention of cardiopulmonary rehabilitation is necessary in the rehabilitation treatment process of patients with stroke.
This study examined the association of gait variability and physical fitness with frailty status in older women. In a cross-sectional design, 168 elderly women, aged 65 years and older (75.07±5.40 years), measured body composition, gait parameters gait variability, physical fitness variables, MMSE-DS and CES-D. Subjects were classified as robust, pre-frail, and frailty based on the Fried et al.(2001) criteria for frailty weight loss, exhaustion, low hand-grip strength, low gait speed, and physical inactivity. Logistic regression analyses were used to determine the odds ratio (ORs) and 95% confidence interval (CI) of frailty status for having gait variability and physical fitness levels. Compared to the robust group (OR=1), the frailty group had significantly higher ORs of having terminal double limb stance (OR=1.48, 95% CI=0.10-2.21, p=.049), step cadence (OR=2.06, 95%CI=1.20-3.43, p=.009) variability, and significantly lower ORs of having upper-strength (OR=0.49, 95%CI=0.31-0.77, p=.002) even after adjusting for age, education, comorbidity, K-IADL, MMSE-KC and CES-D score. The finding of this study suggested that terminal double limb stance, step cadence and upper body muscular strength were independent predictors of frailty.
The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.
Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.
Functional Electrical Stimulation (FES) is used for muscle reeducation, reduction of spasticity, delay of atrophy, and muscle strengthening. FES stronger stimulation than other forms of electrical stimulation. The efficacy of FES in improving function has been substantiated in the literature. Treatment programs employing FES - activation of muscular tissue through the intact peripheral nervous system - can be broken into five major categories, according to the goal of treatment. These broad areas would include the use of FES to: (1) a direct excitation onto the alpha motoneuron, through peripheral stimulation of the Ia myotatic sensory system and ascending afferent information, which will be integrated at conscious and subconscious level of the CNS. (2) The quality of a stimulated muscle contraction is determined by combination of many parameters, including stimulus amplitude, pulse duration, stimulus frequency, and duty cycle. (3) A unit that has a pulse duration between 200 and $400{\mu}sec$ will be more than adequate for FES applications. (4) The neuromuscular plasticity is critically important to return of function using muscle re-education and facilitation applications. (5) Prior to using FES as an electrical orthosis, the patient should build up endurance in the muscles to be stimu1ated during the gait cycle.
With the advent of westernized diet and a lack of exercise, young female college students are paying more attention to their bodyweight and health. Whole-body vibration has been demonstrated to be a suitable training method for improving knee extension maximal strength in young female athletes, as well as the gait performance in elderly women. This study aimed to evaluate the effects of a vertical vibration intervention on the physical fitness and postural balance in young females. Fifty-four young women were recruited; all subjects were randomly assigned to the intervention group and control group. The intervention group underwent vertical vibration with a platform for 12 weeks. The results showed that body mass index and body fat percentage had decreased (P<0.05). In addition, their muscle endurance as indicated by a sit-up test and their flexibility as indicated by a sit-and-reach test were both increased. With regard to postural balance, their 30-second sit-to-stand and timed up and go test results were improved. At the same time, their mean single-leg stance with eyes closed time increased (P<0.05). However, there were no significant differences, meanwhile, for the control group. Overall, the results showed that the whole body vibration (WBV) intervention had some beneficial effects on physical fitness and postural balance in young women.
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