• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2126-2134
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• 2020

Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

• PNF and Movement
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• v.13 no.4
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• pp.181-188
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• 2015

Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.369-379
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• 2011

Purpose : The purpose of this study is to compare the initial effect of nerve mobilization (NM), static stretching (SS), and contract-relax (CR) techniques to find the best method in improving hamstring flexibility and gait function in patients with hemiplegia. Methods : Eleven patients with hemiplegia were included in this study. Passive knee extension (PKE) range of motion and the sit and reach (SR) test were used to measure hamstring flexibility, while timed up and go (TUG) and the 10m walking (10MW) test were used to measure the subject's gait. Measurements on each test were assessed prior to the experiment, immediately following the experiment, and 30 minutes after the experiment. Analysis of the results utilized a repeated measures analysis of variance to examine hamstring flexibility and the difference in walking ability. Results : The results suggest significant increases in NM, SS, and CR techniques as they relate to hamstring flexibility (p<.05) following (both immediate and 30 minutes post experiment) PKE range of motion and the SR test, but post-hoc showed no significant difference between the three techniques (p>.05). Additionally, the results suggest significant increases in NM, SS, and CR techniques as they relate to gait function (p<.05) following the TUG test, but found no significant difference in the 10MW test (p>.05). Post-hoc analysis between the three techniques suggests that only the NM technique significantly changed gait function. The time of TUG and 10MW test showed no significant difference between the three techniques before an experiment, just after an experiment, and 30 minutes following the experiment according to the measurement points in time (p>.05). Conclusion : This study suggests NM, SS, and CR techniques immediately improve hamstring length and flexibility while improving gait function in patients with hemiplegia.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.90-95
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• 2017

Objective: The purpose of this study was to investigate the physical therapists' perception of the use of gait measures, the frequency of the gait measures used, and also to identify the barriers that limit the use of these assessment tools. Design: Cross-sectional study. Methods: Physical therapists from the Seoul, Gyeonggi area from March to July 2016 were included in the study. Over the course of 18 weeks, a cross-sectional study was conducted with a self-report questionnaire. A total of 700 questionnaires were distributed and 350 questionnaires (50%) were collected, however with the exclusion of 140 questionnaires due to non-consent, a total of 210 questionnaires (30%) were analysed. Results: Out of the 10 standardized assessment tools, the therapists showed the highest perception for the timed up and go test (TUG [n=153, 72.9%]) and they also had high perception for the 10 meters walk test (10MWT [n=149, 71.0%]), and 6-minute walk test (6MWT [n=123, 58.6%]). The respondents answered that the TUG (n=116, 55.2%), 10MWT (n=100, 47.6%), and 6MWT (n=51, 24.3%) was used the most often. On the contrary, only four (1.9%) therapists have used the Chedoke-McMaster stroke assessment and the Rivermead Mobility Index. The lack of time was considered as the most important barrier to the use of assessment tools in clinical practice. Conclusions: Through this study, it has been shown that the domestic physical therapists used the TUG and the 10MWT mainly due to high recognition and evaluation status; however, the lack of time was the greatest impediment to the clinical application of the gait assessment tools.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.2
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• pp.67-75
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• 2012

Background: Hemiplegic patients have the problems of the balance and weight shifting to the affected leg in walking. The aim of this study was to investigate the effect of unilateral stepping exercise combined with auditory feedback on balance and walking ability of the hemiplegic patients. Methods: Thirty hemiplegic patients were allocated in study group (n=15) or control group (n=15). General exercise and weight supporting exercise were conducted for the control group, and general exercises and unilateral stepping exercise combined with auditory feedback were conducted for the study group. Exercise were conducted three times a week for six weeks. Balance ability was measured by Berg Balance Scale (BBS), postural assessment scale for stroke (PASS), and performance-oriented mobility assessment (POMA). Walking ability was measured by time up and go test (TUG), 10m walk test (10mWT), and six minutes walk test (6MWT). Results: Balance and walking ability were significant increased in both group (p<.05). Balance and walking ability of the study group were more increased than that of the control group (p<.05). Conclusions: Unilateral stepping exercise combined with auditory feedback is more effective than weight supporting exercise to increase on balance and walking ability for the hemiplegic patients.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.3
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• pp.17-24
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• 2018

Purpose : Kinesio taping is a therapeutic method used in the treatment of various musculoskeletal and neuromuscular deficits limited evidence the effects of gluteus medius kinesio taping in neurologic patients. Therefore, this study aimed to determine the effects of gluteus medius kinesio taping on balance ability and gait function in after a stroke. Methods : Twenty-four post-stroke patients were included in this study. Gluteus medius taping group and sham gluteus medius taping group were divided into intervention. Kinesio tape was applied the gluteus medius muscles. In all the subjects, the balance ability was measured using the force plate and timed up & go test (TUG) and gait function was assessed using the 10-meter walking test at time points of both before and after the taping. Result : There was a significant difference in balance ability and gait function between the two groups before and after gluteus medius taping group (p<.05). The gluteus medius taping group showed a significant difference between the groups (p<.05). Conclusion : The results suggest that taping may be a useful method during rehabilitation programs for stroke patients. Application of Kinesio taping to the gluteus medius muscles was found to be useful especially in improving balance ability.

• International journal of advanced smart convergence
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• v.9 no.1
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• pp.202-208
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• 2020

Body balance necessary for ordinary daily activities can be undermined by diverse causes. In this study, as a way to control such a problem, we have produced smart insole as a wearable device in the form of insole and developed analysis software evaluating body balance, which measures ground reaction force applied to each area of sole and Center of Pressure (COP). The software visualized changes in COP positions while a user was moving and average COP positions, and it is also capable of measuring the COP values in the Anterior-Posterior (AP) and Medial-Lateral (ML) areas of feet. Through gait analysis, it can analyze the time of walking, strides, speed, COP trajectory while walking, etc. In addition, we have developed training contents for body balance improvement designed in consideration of Y-Balance Test and Timed Up and Go (TUG) Test. They were established in virtual reality similar to daily living environment so that people can expect more effective training results regardless of places.

• Journal of Korean Physical Therapy Science
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• v.18 no.1
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• pp.11-19
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• 2011

Purpose: The purpose of this study is to understand the effect of balance and gait when simultaneous application of Kinesio Taping on the lower extremities is done to improve the pattern of hemiplegic patients asymmetric lower extremity. Methods: This study was performed with 7 patients who have hemiplegia symptoms due to stoke. The taping on the paralyzed side was done on tibialis anterior, gluteus medius, gluteus maximus and psoas major and the taping on the unparalyzed side was done on the calf muscle and quadriceps. Berg Balance Scale(BBS) and Time Up and Go Test(TUG) was used to assessment the balance and gait of the patient after the kinesio taping was done on the lower extremities. The results of the test was analyzed by Wilcoxon Signed Rank Test on SPSS(Ver. 10.1). Results: When the taping was done on the paralyzed side, there was a significant improvement of balance and gait in BBS and TUG. When the taping was done on the lower extremities, it showed significant improvement of balance and gait, compared to when the taping was only done on the paralyzed side, according to BBS and TUG. Conclusion: The result of this study shows that the simultaneous taping of the lower extremities of the hemiplegic patients improves balance and gait by improving the pattern of patients lower extremities.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.403-410
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• 2020

The purpose of this study was to determine whether olfactory stimulation would improve spasticity, balance ability and quality of life in stroke patients. Twenty-one stroke patients were recruited and were randomly divided into two groups: olfactory stimulation group (n=10) and sham stimulation group (n=11). Participants in both groups received conventional physical therapy for 30 minutes before the intervention. Additionally, subject in the olfactory stimulation group performed olfactory stimulation using lavender oil for 6 minutes (2 minx3 set), five times a week for two weeks, while the sham stimulation group conducted olfactory stimulation using water for the same amount of time. Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors. Dynamic balance was measured using a TUG. Postural-sway distance was measured using a force platform. Quality of life were measured by SF-36. There was no significant difference within group and between the groups in the spasticity. Significant improvement in postural-sway and TUG were observed in the olfactory stimulation group compared to the sham stimulation group (p<0.05). The Mental Componnt Summary of the SF 36 in the olfactory stimulation group improved significantly greater than the sham stimulation group (p<0.05). Our findings indicate that olfactory stimulation is beneficial and effective to improve balance ability and quality of life in stroke patients.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.2
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• pp.107-112
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• 2016

The purpose of this study was to determine the effect of aquatic ramp walking exercise on the activity of the quadriceps, gait and activity of daily living in child with Spinal Muscular Atrophy (SMA) type II. A 5 years-old girl with SMA type II participated in this study. This study used single-subject reverse(A-B-A) design study. There are 12 sessions(4weeks 3 times a week) each during the baseline phase(A), the intervention phase(B), the follow up phase(A). During the baseline phase and the follow up phase performed general aquatic therapy, the intervention phase additional performed walking activity on ramp in pool (60m). Surface electromyogram, Timed Up and Go (TUG) test, ACTIVLIM were used as outcome. During the intervention phase, there were decrease on the activity of the quadriceps. In modified TUG test, gait time reduced during the intervention phase. The ACTIVLIM logit score increased during intervention phase by comparison with the baseline phase. These findings suggest that an aquatic ramp walking exercise activities have the therapeutic possibility on the quadriceps activity and gait ability for child with SMA type II.