• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.21-28
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• 2010

Purpose: The purpose of this study was to investigate the kinematic adaptation of head and trunk to ascend stairs and a ramp. Subjects were healthy young adults. Three-dimensional kinematic patterns of head and trunk movements were examined during stair climbing and steeper ramp climbing. Methods: Fourteen young subjects with no history of chronic or acute musculoskeletal, cardiovascular or respiratory disorders took part in this experiment. Kinematic data were collected using a 6 camera Vicon system (Oxford Metrix, Oxford, England). Repeated measures ANOVA analyses were used to investigate the effect of gait mode on kinematics of the head and trunk. Results: The angle of the trunk while ascending stairs or a ramp was modified in three human planes (p<0.05). The angle of head and neck during the ascending of stairs or a ramp was not changed in the sagittal plane but was changed in the frontal and transverse planes (p<0.05). Conclusion: This study describes and discusses some basic kinematic mechanisms underlying the pattern of head and trunk changes during stair and ramp climbing and showed that postural adaptation of the head and trunk is necessary to maintain balance.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.119-122
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• 2009

본 연구는 뇌졸중으로 인한 편마비 환자 20명을 대상으로 총 8주간 시지각 운동 과제를 적용하여 자세 균형, 보행 양상에 미치는 효과를 검증하고자 시행하였다. 실험군(n=10)과 대조군(n=10) 모두 보존적인 물리치료를 실시하였고 실험군에는 시지각 운동 과제 프로그램을 더하여 실시하였다. 본 연구의 결과는 실험군의 되먹임 측정을 통한 자세 균형 검사에서 편평한 지면 위에서 눈을 뜨고 감은 상태의 안정성 지수는 유의한 감소를 보였으며, pillow 위에서 눈을 뜨고 감은 상태의 안정성 지수도 유의하게 감소하였다. 체중분포지수는 편평한 지면에서 눈을 뜨고, 감은 상태와 pillow 위에서 눈을 뜨고 감은 상태 모두에서 유의하게 감소하였다. 실험군에서 10m 보행 속도는 대조군과 달리 유의하게 증가하였다. 본 연구에서의 시지각적 운동과제 프로그램은 편마비 환자의 신체기능과 관련된 자세균형 및 보행을 증진시키는 효과가 있었고 이에 보다 효과적인 운동방법으로 제시할 수 있다.

• Proceedings of the Korea Contents Association Conference
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• 2012.05a
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• pp.93-94
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• 2012

본 연구의 목적은 만성뇌졸중 환자에게 승마 시뮬레이터 기계를 이용한 운동이 환자의 균형능력에 어떠한 영향을 주는지 알아보고자 한다. 연구대상자와 연구방법으로는 67명의 만성 뇌졸중 환자를 승마운동그룹(n=34)과 일반 매트운동그룹(n=33)으로 나누어 두 그룹 모두 병원에서 일반적인 운동치료를 실시한후 추가적으로 승마운동과, 매트운동을 실시하였다. 운동시간은 주당 5회 8주동안 35분간 실시하였다. 균형능력 평가는 무게중심의 동요 거리를 통해 측정하였다. 결과는 두그룹 모두 눈을 뜬상태에서 균형능력이 증가하였으나($^*$p<0.05), 눈을 감은 상태에서는 지상운동군보다 수중운동군에서 통계적으로 유의한 균형능력 증가가 나타났다($^*$p<0.05). 연구 결과를 바탕으로 승마 시뮬레이터 훈련이 만성뇌졸중 환자의 균형능력 향상에 효과적이다.

• Physical Therapy Korea
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• v.7 no.2
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• pp.1-19
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• 2000

Decreased equilibrium in standing and walking is a common problem associated with hemiparesis secondary to cerebral vascular accident. In patients with hemiplegia, postural sway is increased and often displaced laterally over the non-affected leg, reflecting asymmetry in lower extremity weight bearing during standing balance. Human balance is a complex motor control task, requiring integration of sensory information, neural processing, and biomechanical factors. Limits of stability (LOS) is a one of the biomechanical factors. The purposes of this study were to establish the influence of asymmetrical weight-bearing on the LOS of independent ambulatory hemiparetic patients. The subjects of this study were 29 hemiparetic patients (18 males, 11 females) being treated as admitted or out patients at Young-Nam University Hospital and Taegu Catholic University Hospital, all of whom agreed to participate in the study. Participants were asked to lean and displace their center of gravity (COG) as far as possible in directions to the sides and front of the body. The LOS and weight-bearing ratio were measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. In order to assure the statistical significance of the results, the independent t-test and a Pearson's correlation were applied at the .05 and .01 level of significance. The results of this study were as follows: 1) There were statistically significant differences in anteroposterior LOS according to the cause of brain demage (p<.01). 2) There were statistically significant differences in mediolateral LOS according to the hemiparetic side (p<.05). 3) There were statistically significant differences in anteroposterior and mediolateral LOS according to the brain operation (p<.01). 4) The mediolateral LOS significantly correlated with weight-bearing ratio (p<.01).

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.11
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• pp.1185-1190
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• 2011

The lower limb somatosensory deficit observed among peripheral neuropathy patients is partially related to the decline in their balance ability. In general, balance ability has been examined by measuring the postural response (i.e., action). However, body motion is induced by integrated multisensory cues (i.e., motion perception). In this study, we hypothesized that the reduced lower limb somatosensation might also lower motion perception. We induced lower limb sensory deficits through ischemia and then measured the cutaneous sensory sensitivity and directional motion perception. The sensory deficit was successfully induced, and it also lowered the motion perception. However, the center of pressure (COP) variation did not significantly change under the sensory deficit. This result implies that measuring motion perception could enable the detection of precursors of sensory deficits.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.3
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• pp.334-342
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• 2010

Purpose: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. Method: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. Results: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. Conclusion: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

• Physical Therapy Rehabilitation Science
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• v.7 no.4
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• pp.179-185
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• 2018

Objective: The purpose of this study was to analyze and compare vertical ground reaction forces during sit to stand (STS) and gait between female elderly and young individuals using the Wii Balance Board (WBB). Design: Cross-sectional study. Methods: Fifty-one female elderly people (age: $75.18{\pm}4.60years$), and 13 young people (age: $29.85{\pm}3.69years$) performed the five times STS test and gait respectively on the WBB. We analyzed time (s), vertical peak (%), integral summation (Int_SUM, %), and counter variables (%) in STS and 1st peak (body weight, BW%), 2nd peak (BW%), peak minimum (BW%), time (second), center of pressure (COP) path length (mm), and Int_SUM (BW%) in gait. The independent t-test was used to assess for differences in STS, gait ability, and general characteristics between the female elderly group and young adults group. With the first and last trials excluded, the mean value was obtained from the middle three of the five trials. Results: During STS, Int_SUM and time of young adults were significantly less than of the female elderly subjects. There were no significant differences in peak and counter variables. In gait, all variables (1st peak, 2nd peak, min, time, COP_path, and Int_SUM) showed significant differences between groups (p<0.05). This study demonstrated that the validity of vertical ground reaction forces occurring during STS and gait was significant in female elderly and young adults. Conclusions: Based on the measurement of vertical ground reaction forces in STS and gait using the WBB, it is possible to clinically improve the quality of geriatric physical therapy. Further studies are necessary to examine concurrent validity of elderly patients who have undergone total hip or knee replacement.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.265-271
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• 2021

Purpose: We aimed to analyze the reliability of the test for choice stepping reaction time (CSRT) under an unstable surface and determine whether there were differences in CSRT between support surface conditions (stable vs. unstable conditions) and between age groups (young adults vs. community-dwelling older adults). Methods: Twenty healthy community-dwelling older adults and twenty young adults performed the stepping task under an unstable condition over two visits. The mean of the two trials measured for each visit was used for the analysis. The test-retest reliability was analyzed using intra-class correlation coefficient (ICC) with a 95% confidence interval, standard error of measurement (SEM), and minimal detectable change (MDC). Differences in CSRT between support surface conditions and age groups were analyzed using the independent t-test with Bonferroni correction. Results: Excellent consistency was observed for ICC >0.90 in both groups. Moreover, the SEM and MDC values of the CSRT in older and young adults were 0.03 and 0.09 and 0.01 and 0.04, respectively. There was a significant difference in the CSRT between the age groups under stable (p<0.001) and unstable conditions (p<0.001). Conclusion: The findings demonstrated that the test for CSRT under an unstable condition had reliable results in both groups. Although older adults demonstrated longer reaction times than younger adults in all surface conditions, increasing the balance control demand by implementing a choice stepping task concomitant with a balance task had no influence on the reaction time in both age groups.

• Physical Therapy Korea
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• v.31 no.2
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• pp.91-103
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• 2024

Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger's regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger's regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.