• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.185-196
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• 2021

Objective: Falling is one of main accident to facilitate the physical injuries in order adults. The purpose of the systematic review was to determine the effects of postural balance training whether the recovery of falls in elderly with normal physical function or not throughout summing the selected studies quantitatively. Design: A systematic review Methods: MEDLINE and other four databases were searched up to April 20, 2021 and randomized controlled trials (RCTs) evaluating postural balance approaches on fall risks in elderly. The researched studies excluded the double studies, titles and abstract, and finally full-reported study. The selected RCTs studies were extracted characteristics of the studies and summary of results based on PICOS-SD (population, intervention, comparison, outcomes, and setting- study design) model to synthesize the papers qualitatively. Results: The review involved 22 RCT reports with 4,847 community older adults aged 65 years or over. Nineteen of the selected RCT studies reported dual or multimodal exercises show the beneficial effect for older adults compared to one-type treatment or no intervention. All of selected showed low risk in the selection, attrition, and reporting bias. However, detection bias showed low risk at 75% records of the involved RCTs and performance bias was low risk at only three records. Conclusions: The results of the systematic review propose that a standardized therapeutic approach and the intensity are needed for improving risk of falls in older adults.

• 대한의용생체공학회:의공학회지
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• 제18권2호
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• pp.157-166
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• 1997

Postural balancing in human is known to be maintained by the complex mechanism coupled with cerebellum, equilibrium organ of ear, proprioception and other various organs. We developed a Computerized Balance Evaluation and Training system(COBET system) to evaluate postural control and to rehabilitate geriatrics and disabled patient. In addition, 55 normal adult were tested to investigate the influencing factors on balancing posture. For the analysis of static postural sway, areas of the moving center of pressure were calculated under 8 different positions of subjects. And subjects were also asked to follow the visual targets on monitor for the evaluation of the dynamic postural sway. In comparison of the first and the second sets of tests, there was test-retest reliability($\textit{p}$< 0.05). The controllability of the static pmtwn sway was decreased as the ages of subjects increase. When the ages of subject are over 60, the controllability was significantly decrease4 The dynamic postural sway was significantly greater in the age groups of 7th and 8th decade than the younger groups. It is concluded that COBET system is a reliable system in the evaluation of postural sway. The COBET system is considered to be a valuable training modality for the disabled patients as well as the elderly.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.87-93
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• 2016

Background: Posture balance control is the ability to maintain the body's center of gravity in the minimal postural sway state on a supportive surface. This ability is obtained through a complicated process of sensing the movements of the human body through sensory organs and then integrating the information into the central nervous system and reacting to the musculoskeletal system and the support action of the musculoskeletal system. Motor function, including coordination, motor, and vision, vestibular sense, and sensory function, including proprioception, should act in an integrated way. However, more than half of stroke patients have motor, sensory, cognitive, and emotional disorders for a long time. Motor and sensory disorders cause the greatest difficulty in postural control among stroke patients. Objects: The purpose of this study is to determine the effect of visual and somatosensory information on postural sway in stroke patients and carrying out a kinematic analysis using a tri-axial accelerometer and a quantitative assessment. Methods: Thirty-four subjects posed four stance condition was accepted various sensory information for counterbalance. This experiment referred to the computerized dynamic posturography assessments and was redesigned four condition blocking visual and somatosensory information. To measure the postural sway of the subjects' trunk, a wireless tri-axial accelerometer was used by signal vector magnitude value. Ony-way measure analysis of variance was performed among four condition. Results: There were significant differences when somatosensory information input blocked (p<.05). Conclusion: The sensory significantly affecting the balance ability of stroke patients is somatosensory, and the amount of actual movement of the trunk could be objectively compared and analyzed through quantitative figures using a tri-axial accelerometer for balance ability.

• 한국산학기술학회논문지
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• 제12권8호
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• pp.3555-3562
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• 2011

본 연구는 이중과제 훈련이 만성 뇌졸중 환자의 자세안정성과 균형능력에 미치는 효과를 알아보고자 하였다. 실험을 위해 모집 된 이동 가능한 25명의 편마비 환자를 무작위화 하여 이중과제 훈련군 13명과 대조군 12명으로 나누었다. 두 그룹 모두 6주간 주 5회 일 30분의 일반적인 물리치료를 시행하였으며, 추가적으로 이중과제 훈련군은 6주간 주3회 일 50분의 이중과제 훈련을 실시하였다. 훈련 전후 체간손상척도, 자세조절능력과 눈을 뜨고 감은 상태에서의 자세동요를 측정하였다. 연구 결과 이중과제 훈련군에서 자세안정성과 균형능력이 유의하게 향상되는 것을 확인할 수 있었다(p<0.05). 본 연구의 결과를 통하여 이중과제 훈련이 만성뇌졸중 환자에게 효과적인 운동방법이 될 수 있을 것이라 생각한다.

• 대한물리치료과학회지
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• 제26권2호
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• pp.24-31
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• 2019

Purpose: The purpose of this study was to investigate the effect of olfactory stimulation on the balance ability of the elderly. Design: Randomized controlled trial. Methods: A total of 20 subjects were randomly assigned to the olfactory stimulation group (2 males and 8 females) and deception olfactory stimulation group (3 males and 7 females). Subjects were subjected to 30 second 3 times olfactory stimulation and deception olfactory stimulation, and the assessment measured pre and post postural distance and postural speed. Results: In the elderly, the olfactory stimulation group was significantly improved the postural distance and postural speed in the eyes closed state than the deception stimulation group (p<.05). Conclusion: As the information is provided through the olfactory stimulation, the postural distance and postural speed are significantly improved. therefore, it is expected that the olfactory stimulation in the elderly will be an effective intervention method to prevent fall.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.1-10
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• 2016

Background: Patients with chronic low back pain (CLBP) functionally adapt to decreased postural control due to impaired processing of sensory information. Standing postural control has been the focus of recent research in CLBP. Change in postural control may be a risk factor for CLBP, although available studies are not conclusive. Objects: This study aimed to identify the role of partial weight supported treadmill training (PWSTT) in improving balance, dysfunction, and pain in patients with chronic low back pain. Methods: The study included 22 patients with CLBP. Patients in the control group ($n_1=8$) performed three 20 min stabilization exercise sessions per week, for 4 weeks. Patients in the full weight treadmill training group ($n_2=7$) performed treadmill training for 30 min after stabilization exercise. Patients in the PWSTT group ($n_3=7$) performed PWSTT with 20% of their body weight unloaded after stabilization exercises. By using the Biodex balance system, the dynamic balance abilities of the patients in the three groups were assessed in the quiet standing position under combined conditions of visual feedback (eyes open and closed) and platform stability (level 8). The Korean version of the Oswestry Disability Index and visual analogue scale score were used as the main measure. Results: The results of this study showed that dysfunction and pain were significantly improved in all groups. Although dynamic postural stability with eyes closed was significantly improved only in the PWSTT group (p<.05), no significant difference was found in the other groups. Conclusion: The results of this study indicate that PWSTT improved balance, dysfunction and pain in the patients with CLBP. Thus, this intervention is necessary for patients with CLBP with decreased postural control.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

• 대한인간공학회지
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• 제25권3호
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• pp.1-15
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• 2006

Loss of postural balance can possibly lead to increased risk of slips and falls in work places. Present study was performed to investigate the effects of noisy environments on postural stability during standing. It is known that a sound is characterized by the frequency and pressure level of the sound. Therefore, effects of the frequency and pressure level on postural stability were of primary concern. Ten male subjects participated in the experiment. Subject's center of pressure(COP) position was collected on a force plate while they were exposed to different frequency and pressure levels of the sound. Measured COP was then converted into the length of postural sway path in both anterior-posterior(AP) and medio-lateral(ML) axis. Results showed that the length of sway path in AP axis was significantly affected by the frequency of sound. The length of sway path was lowest at frequency level of 2000Hz and increased below and above this frequency range. The sound pressure level, however, did not significantly affect the postural sway length in both AP and ML axis. The results imply that industrial workers in noisy environments should be aware that their abilities of postural balance can be disturbed significantly.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.117-126
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• 2007

In this paper, we propose an early rehabilitation training system for the improvement of postural balance with multi-modality on a tilting bed. The integration of the visual, somatosensory and vestibular functions is significant to for maintaining the postural control of the human body. However, conventional rehabilitation systems do not provide multi-modality to trainees. We analyzed the characterization of postural control at different tilt angles of an early rehabilitation training system, which consists of a tilting bed, a visual feedback, a computer interface, a computer, and a force plate. The software that we developed for the system consists of the training programs and the analysis programs. To evaluate the characterization of postural control, we conducted the first evaluation before the beginning of the training. In the following four weeks, 12 healthy young and 5 healthy elderly subjects were trained to improve postural control using the training programs with the tilting bed. After four weeks of training, we conducted the second evaluation. The analysis programs assess (center of pressure) COP moving time, COP maintaining time, and mean absolute deviation of the trace before and after training at different tilt angles on the bed. After 4 weeks, the COP moving time was reduced, the COP maintaining time was lengthened, and the mean absolute deviation of the trace was lowered through the repeated use of vertical, horizontal, dynamic circle movement training programs. These results show that this system improves postural balance and could be applied to clinical use as an effective training system.

• 대한의용생체공학회:의공학회지
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• 제28권5호
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• pp.647-656
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• 2007

The purpose of this study was to analyze the effects of vibratory stimulus as somatosensory inputs on the postural control in human standing. To study these effects, the center of pressure(COP) was observed while subjects were standing on a stable and an unstable support with co-stimulated mechanical vibrations to flexor ankle muscles(tibialis anterior tendon, achilles tendon) and two plantar zones on both foot. The COP sway measurement was repeated twice in four conditions: (1) with visual cue and vibration, (2) without visual cue and vibration, (3) with visual cue and without vibration, (4) without visual cue and with vibration. The calculated parameters were the COP sway area and the distance, the median frequency and the spectral energy of COP sway in three intervals $0.1{\sim}0.3,\;0.3{\sim}1,\;1{\sim}3Hz$. The results showed that vibratory stimulus affect postural stability. The reduction rate of the COP sway with vibratory stimulus were higher on the unstable support because the effect of postural stability increases when afferent nervous flow is more activated by vibration on unstable support. If unclear visual or vibratory information is received, one type of information is compared with the other type of sensory information. Then the input balance between visual and vibratory information is corrected to maintain postural stability. These findings are important for the rehabilitation system of postural balance control and the use of vibratory information.