• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.411-417
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• 2014

Purpose: This study attempts to find the effects of water-based exercise performed on stroke patients in their physiological cost index and static and dynamic balance. Methods: The subjects were 30 stroke patients, who were randomly divided a water-based exercise group and a land-based exercise group, each with 15 patients. Both exercises ware performed 3 day per week, for 40 minutes a day, for a period of eight weeks. Results: The Water-based exercise group showed a decreased physiological cost index compared to the land-based exercise group, with the physiological cost index of the water-based exercise group decreasing, while the land-based exercise group, showing a significant decrease. Water-based exercise increased static and dynamic balance capacity better than land-based group, showing a significant difference and better efficiency of water-based exercise when compared to land-based exercise. Conclusion: From the result of the study, we found that water-based exercise is more effective in improving PCI and static and dynamic balance capacity. Through this study, training in water-based stroke patients could use cardiovascular endurance and buoyancy and the vortex, as an effective treatment that can enhance the growth and voluntary participation in the range of the patient's own movement the thought is, in consideration of the changes in the physiological cost index due to the difference in the ground and water, and should establish a training program that matches the purpose.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.3
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• pp.39-47
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• 2016

PURPOSE : This study attempts to find the effects of water perturbation exercise performed on stroke patients in their physiological cost index and gait ability tests. METHOD : The subjects were 30 stroke patients, water perturbation exercise group was performed 3 day per week, for 40 minutes a day, for a period of eight weeks. The physiological cost index and gait of all subjects were assessed by using the polar, 6 Minute Walk Test (6MWT), and 10 meter Walk Test(10mWT) at pre training and post training. Paired t-test was used to analyze change before and after intervention in group. Pearson's correlation was used to analyze correlation of all variables. RESULT : Water perturbation exercise group showed increased physiological cost index. Water perturbation exercise increased gait ability, showing a significant difference. Showing the correlation between the relatively high amount between physiological cost index and 6 minutes walking test. CONCLUSION : From the result of the study, we found that water perturbation exercise was effective in improving physiological cost index and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the cardiovascular system and ability to walk. Through underwater training for stroke patients in the future on the basis of this study it is considered to require additional clinical studies on the impact on daily living and quality of life of stroke patients.

• Physical Therapy Korea
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• v.13 no.3
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• pp.67-74
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• 2006

The purpose of this study was to investigate the effects of walking aid on hemiplegic gait of chronic stroke patients. Twelve stroke patients participated in this study. Physiological cost index (PCI), gait speed, and climbing stairs with and without walking aid were measured and analyzed. The results showed that walking with walking aid significantly improved gait speed and reduced physiological cost index and time needed to climb stair (height 7 cm) in comparison with a walking without walking aid. In conclusion, walking aid may improve the speed and efficiency of hemiplegic gait in chronic stroke patients.

• Physical Therapy Korea
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• v.13 no.1
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• pp.32-37
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• 2006

The purpose of this study was to investigate the effects of clinical characteristics of chronic stroke patients on physiological cost index (PCI) during walking. Fourteen stroke patients participated in this study. To investigate the clinical characteristics, Fugl-Meyer score (FMS), gait velocity (GV), muscle strength of the knee extensor, modified Ashworth scale (MAS) of ankle plantar flexor, devices, and gait patterns during walking were measured and analyzed. The results were as follows: Firstly, use of devices and high MAS of the ankle plantar flexor significantly increased PCI. Secondly, PCI was significantly correlated with the FMS and MAS of the ankle plantar flexor. In conclusion, inhibition of spasticity of the ankle plantar flexor is considered to reduce PCI during walking for chronic stroke patients.

• Physical Therapy Korea
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• v.9 no.1
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• pp.43-51
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• 2002

Physiological Cost Index (PCI) of walking has been widely used to predict oxygen consumption in healthy subjects or patients. The purpose of this study was to evaluate the predictability of physiological cost index of walking for the amount of exercise and cardiac function. Walking exercise was conducted in 67 healthy children (age 4-12) with a self-selected comfortable walking speed on the level surface. Walking speed was calculated, and heart rate was measured before and immediately after the walking. PCI was calculated for statistical analysis. The results were as follows; 1) The walking speed tends to increase and PCI of walking tends to decrease with age. There was significant difference in walking speed and PCI of walking among three age groups (p<.05). The change of walking heart rate tends to decrease with age, however, there was no significant difference among three age groups. 2) Linear regression equation between walking speed and age was 'Y (walking speed) = 2.124X (age) + 48.286' ($R^2$=.337), (p=.00). 3) The walking heart rate tends to decrease with age. Linear regression equation between walking heart rate and age was 'Y (walking heart rate) = 143.346 - 2.63X (age)' ($R^2$=.3425), (p=.00). 4) The walking heart rate decreased as body surface area (BSA) increased. Linear regression equation between walking heart rate and BSA was 'Y (walking heart rate) = 149.830 - 27.115X (BSA)' ($R^2$=.3066), (p=.00). In conclusion, these equations and PCI could be useful to quantify the variation of energy expenditure of children with pathological gait when compared with age-matched healthy children.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.93-103
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• 2017

PURPOSE: This study aimed to determine the effect of active trunk training in the sitting position on balance and energy consumption in early stroke patients. METHODS: The subjects of this study were twenty four early stroke patients were recruited and randomly divided into two groups; experimental group (n=12) and control group (n=12). The subjects in the experimental group participated in active trunk training (20 min) and conventional physical therapy (20 min) five times a week for four weeks. The control group conducted general balance exercise (20 min) and conventional physical therapy (20 min) five times a week for four weeks. The outcomes were assessed using the Berg balance scale, Timed up and go test and energy cost and physiological cost index. RESULTS: Both groups showed a significant increase in their Berg balance scale and significant decrease in their Timed up and go test score, and energy cost and physiological cost index (p<.05). Compared to the control group, the experimental group experienced a greater increase in the Berg balance scale (p<.05) and a larger decrease in the timed up and go test score, and energy cost and physiological cost index (p<.05). CONCLUSION: We suggest that active trunk training in the sitting position may be effective in improving balance and energy consumption in early stroke patients. Thus, active trunk training is important for such patients. Further studies are needed to better understand the effectiveness of trunk training in early stroke patients.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.285-294
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• 2000

80 persons who don't have past history of cardiopulmonary and neuromuscular disease. The results were as follow; 1. PCI(Physiological Cost Index) value without loading to ankle were significantly increased compared to 1kg, and 2kg (p<0.01). 2. Female Subjects showed more increased PCI value in without loading and lkg, 2kg loading compared to male subjects (p<0.01). 3. In every PCI condition the difference among height groups was observed (p<0.01). 4. The difference among weight groups in each PCI condition was observed (p<0.01). These results showed that energy consumption was increased according to loading on the ankle during gait so weight of orthosis or prosthesis must be considered when choosing them and during gait training with these ones.

• Safety and Health at Work
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• v.10 no.2
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• pp.219-223
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• 2019

Background: Ice cooling vests can cause tissue damage and have no flexibility. Therefore, these two undesirable properties of ice cooling vest were optimized, and the present study was aimed to compare the impact of the optimized ice cooling vest and a commercial paraffin cooling vest on physiological and perceptual strain under controlled conditions. Methods: For optimizing, hydrogel was used to increase the flexibility and a layer of the ethylene vinyl acetate foam was placed into the inside layer of packs to prevent tissue damage. Then, 15 men with an optimized ice cooling vest, with a commercial paraffin cooling vest, and without a cooling vest performed tests including exercise on a treadmill (speed of 2.8 km/hr and slope of %0) under hot ($40^{\circ}C$) and dry (40 %) condition for 60 min. The physiological strain index and skin temperature were measured every 5 and 15 minutes, respectively. The heat strain score index and perceptual strain index were also assessed every 15 minutes. Results: The mean values of the physiological and perceptual indices differed significantly between exercise with and without cooling vests (P < 0.05). However, the difference of the mean values of the indices except the value of the skin temperature during the exercises with the commercial paraffin cooling vest and the optimized ice cooling vest was not significant (P > 0.05). Conclusions: The optimized ice cooling vest was as effective as the commercial paraffin cooling vest to control the thermal strain. However, ice has a greater latent heat and less production cost.

• Physical Therapy Korea
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• v.20 no.1
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• pp.18-27
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• 2013

The purpose of this study was to compare the ring lock type knee-ankle-foot orthosis (KAFO) with newly developed 4-bar linkage KAFO on the gait characteristics of persons with poliomyelitis clinically. This 4-bar linkage is the stance control type KAFO which provide the stability during stance phase and knee flexion during swing phase. Two subjects participated in this study voluntarily. We provided the customized 4-bar linkage KAFO then asked the subjects to walk in level surface and stairs under the two different KAFO conditions. The characteristics of gait in the persons with poliomyelitis were evaluated using a 3D motion analysis system and force plate. Additionally 6 minute walk test for physiological cost index were conducted using pulse oximeter to measure the energy consumption. In the results of this study, the differences of 4-bar linkage KAFO compared with ring lock type KAFO are as follows: (1) Walking speed, stride length, and step length on level increased in subjects, (2) The gait symmetry was improved by generated knee flexion and decreased pelvic external rotation on level and stairs walking, (3) Decreased vertical excursion of center of mass and pelvic elevation during swing phase was decreased on level, (4) Knee extension moment, hip flexion moment, hip and knee internal rotation moment of non-braced limb were decreased on level walking, (5) Walking speed in 6-minute walk test was increased and physiological cost index was decreased. These findings indicate that 4-bar linkage KAFO compared with ring lock type KAFO is effective in enhancing pattern, endurance, and energy consumption in level surface and stairs walking.

• Physical Therapy Korea
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• v.7 no.2
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• pp.20-34
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• 2000

The purpose of this study was to establish modified physiological cost index (PCI) for predicting energy consumption by heart rate (HR) at isokinetic ergometer exercise testing. The subjects were twenty-eight healthy men in their twenties. All of them performed upper and lower extremity isokinetic ergometer exercise tests which had six loads (400, 500, 600, 700, 800, and 900 kg-m/min) and five loads (400, 500, 600, 700, and 800 kg-m/min) respectively. The exercise sessions were finished when HR was in plateau. HR and oxygen consumption were determined during the final minute. Resting heart rate and oxygen consumption were used for calculating heart rate, oxygen consumption changes and modified PCI. Regression analysis established the relationship between each variable to work load, HR and oxygen consumption. The results were as follows: 1) In the lower extremity ergometer exercise test, oxygen consumption increased continuously as work load increased, but in the upper extremity ergometer test, oxygen consumption only increased until work load was 700 kg-m/min. 2) HR increased as work load increased in both exercise tests, but in the upper extremity ergometer test, HR decreased from the 700 kg-m/min. 3) The modified PCI increased as work load mcreased until the 700 kg-m/min point in the lower extremity ergometer test and until the 500 kg-m/min point in the upper extremity ergometer test when it started to decrease in both tests. 4) In the lower extremity ergometer exercise test, regression analysis established the relation as $dVO_2$ = -.0215HR - .2141 where $dVO_2$ is given in l/min and HR in beat/min ($R^2$ = .2677, p = .000). ln the upper extremity ergometer exercise test. regression analysis established the relation as $dVO_2$ = -.0115HR + .2746 ($R^2$ = .1308, p = .000). The results of this study were similar to previous studies but were different under high work load conditions. So modified PCI should be used with only low intensity work load testing. Subjects for upper extremity ergometer exercise testing should complete a prescribed training course prior to testing, and only low intensity work load should be used for safety considerations.