• 대한물리의학회지
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• 제11권3호
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• pp.133-139
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• 2016

PURPOSE: The purpose of this study is to examine the impact of balance training on a three-dimensional balance trainer that provides the up-and-down vertical movement of the knee joint and left-and-right horizontal movement, along with visual feedback on the functional ability of children with spastic cerebral palsy (CPs). METHODS: 8 CPs participated in this study. The experiment was implemented for 40 minutes, three times a week for a total of six weeks. The subjects received general physiotherapy for 15 minutes in each session focused on balance and walking, as based on the neuro-developmental treatment theory. Balance training was performed for 20 minutes on a three-dimensional balance trainer where knee joint movement providing visual feedback is applied. The evaluations were conducted before and after the test, and posture sway was measured using 10 Meter Walking Test (10MWT), Timed Up & Go Test (TUG), and the Good Balance System to evaluate the functional ability and balance of the subjects RESULTS: 10MWT was not statistically significant (p>.05). On the contrary, TUG and postural sway indicate static balance showed a statistically significant decrease (p<.05). In a static balance test using the Good Balance System, the average moving speed statistically significantly decreased in the AP and ML directions (p<.05), and the mean velocity moment also significantly decreased (p<.05). CONCLUSION: These findings suggested that balance training using the three-dimensional balance trainer, with the features of visual feedback and up-and-down knee joint movement effects on increasing dynamic and static balance.

• 한국산학기술학회논문지
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• 제14권11호
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• pp.5723-5729
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• 2013

본 연구의 목적은 불균형 상태의 근 긴장도와 무리한 보행훈련에 자주 노출되는 만성 뇌졸중 환자에서 경직에 따른 족저근막의 두께 변화를 알아보고자 하였다. 연구대상은 만성 뇌졸중 환자 54명에서 Group I(MAS G0) 18명, Group II(MAS G1) 18명, Gropup III(MAS G3) 18명으로 선정하였다. 측정방법으로는 임상증상 및 이학적 검사, MAS(Modified Ashworth Scale), 초음파영상 촬영장치, ROM(Range of Motion), VAS(Visual Analogue Scale), TUG(Timed Up and Go test)로 측정하였다. 연구결과, 각 그룹 간 정상측과 마비측의 족저근막의 두께는 통계학적으로 유의하게 두꺼워졌다(p<.001). 각 그룹 간 정상측과 마비측의 족관절 배측굴곡 ROM은 통계학적으로 유의하게 작아졌으며(p<.001), VAS(p<.001), TUG(p<.001)는 통계학적으로 유의하게 커졌다(p<.001). 본 연구는 족저근막에 대한 병리역학(pathokinesiology)적 내용을 제시함으로서 뇌졸중 환자의 보행훈련 시 고려해야 할 내용 중 하나임을 제시하였다.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권5호
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• pp.427-436
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• 2019

본 연구에는 편마비가 있는 뇌졸중 환자의 환측 경직성 하지에 체외 충격파 치료를 적용하여 보행 중 무릎각도와 MAS, TUG에 미치는 영향을 알아보기 위해서 실시하였다. 본 연구는 재활 병원에서 뇌졸중으로 진단받은 후 병원에서 재활치료를 받는 환자 20명을 연구대상자로 선정하였다. 대조군(n=10)은 일반적인 물리치료인 고유 수용성 감각 신경근 촉진법을 받았으며, 실험군(n=10)은 고유 수용성 감각 신경근 촉진법(PNF) 치료 후 체외 충격파 치료(ESWT)를 손상측 하지에 적용하였다. 본 연구에서 보행을 분석하기 위해 통합운동분석장치(4D-MT, Relive, Korea)를 사용하였으며 환자의 동적균형 능력을 평가하기 위해 Timed up and go test를 실시하였고 경련성을 평가하기 위해서 MAS를 사용하였다. 본 연구의 결과에서 무릎관절의 각도는 모든 그룹이 그룹 내 비교에서 통계학적으로 유의한 차이가 있었으나(p<0.05) 그룹 간에는 통계학적으로 유의한 차이가 없었다(p>0.05). 본 연구의 결과에서 TUG는 모든 그룹이 그룹 내 비교에서 통계학적으로 유의한 차이가 있었으나(p<0.05) 그룹 간에는 통계학적으로 유의한 차이가 없었다(p>0.05). 본 연구의 결과를 바탕으로 보다 세분화된 연구가 진행되기를 바란다.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• The Journal of Korean Physical Therapy
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• 제20권1호
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.67-72
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• 2018

Purpose: The purpose of this study was to compare to aquatic treadmill and anti-gravity treadmill gait training to improve balance and gait abilities in stroke patients. Methods: All subjects were randomly divided into three groups where nine subjects were in the aquatic treadmill group, eight subjects in the anti-gravity treadmill group, and ten subjects in the control group. Subjects in the aquatic treadmill group and the anti-gravity treadmill group received gait training during 30 minutes, with 3 sessions per week for 4 weeks, and subjects in all groups received conventional physical therapy during 30 minutes, with 5 sessions per week for 4 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go test (TUG) and 10-meter walk test (10MWT) pre and post intervention. Results: Results showed that BBS, TUG and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas pre-post intervention (p<0.05). In addition, it has been confirmed that aquatic treadmill group and anti-gravity treadmill group had significantly improved in BBS, TUG and 10MWT scores compared with the control group (p<0.05). However, no significant difference was found in the comparison between the aquatic treadmill and the anti-gravity treadmill group. Conclusion: Finding of this study suggested that aquatic treadmill and anti-gravity treadmill improves balance and gait abilities in stroke patients.

• 대한물리의학회지
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• 제14권1호
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• pp.7-14
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• 2019

PURPOSE: This study examined the effects of observing a self-video or a video of another person performing balance and gait training, followed by actual performance of the observed movements on the balance and walking ability of chronic stroke patients. METHODS: Thirty patients, who had experienced a stroke and were admitted to S rehabilitation hospital for treatment, were selected randomly and divided into three groups with 10 patients each: self-action observation (SAO) group, other-action observation (OAO) group, and treadmill walking training (TWT) group. The training program was conducted five times per week for four weeks. The GAITRite system, 10 m walking test, and timed up and go test were performed to measure the subjects' gait and balance ability. RESULTS: The velocity, cadence, double support, and stride length were increased significantly in the SAO and OAO groups (p<.05) but the T group showed no significant changes; no significant difference was observed among the groups (p >.05). The 10MWT decreased significantly in the OAO group (p<.05), but there were no significant changes in the SAO and T groups, and no significant difference was observed among the groups (p>.05). The TUG decreased significantly in the SAO and OAO groups (p<.05), but there were no significant changes in the T group, and no significant difference was observed among the groups (p>.05). CONCLUSION: The self or other action observation training helps improve the balance and gait ability.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.345-350
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• 2015

Purpose: This study was conducted to determine the effects of ankle joint position during closed kinetic chain (CKC) exercise on knee extensor strength and balance in patients with chronic stroke. Methods: Sixteen patients with chronic stroke participated in the study. Participants were randomly assigned to two groups: $15^{\circ}$ ankle joint plantar flexion group (n=8) and ankle joint neutral group (n=8) during CKC exercise. All participants underwent conventional physical therapy for 30 minutes. In addition, the experimental group ($15^{\circ}$ ankle joint plantar flexion group) and control group (ankle joint neutral group) participated in a 20-minute CKC exercise program. In both groups exercise was performed three times a week for four weeks. Outcomes including knee extensor strength and balance ability (Five times sit-to-stand test, Timed up and go test, and Balancia) were measured before and after exercise. Results: Significant differences in knee extensor strength and balance ability were observed between pre- and post-exercise in all groups (p<0.05). The improvement of knee extensor strength and dynamic balance was significantly higher in the experimental group than in the control group (p<0.05). Conclusion: These findings demonstrated that $15^{\circ}$ ankle joint plantar flexion during closed kinetic chain exercise is effective in improvement of knee extensor strength and dynamic balance in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제29권2호
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• pp.74-79
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• 2017

Purpose: The purpose of this study was to compare the effects of the FES-gait with augmented feedback training to the FES alone on the gait and functional performance in individuals with chronic stroke. Methods: This study used a pretest and posttest randomized control design. The subjects who signed the agreement were randomly divided into 12 experimental groups and 12 control groups. The experimental groups performed two types of augmented feedback training (knowledge of performance and knowledge of results) together with FES, and the control group performed FES on the TA and GM without augmented feedback and then walked for 30 minutes for 40 meters. Both the experimental groups and the control groups received training five times a week for four weeks. Results: The groups that received the FES with augmented feedback training significantly showed a greater improvement in single limb support (SLS) and gait velocity than the groups that received FES alone. In addition, timed up and go (TUG) test and six minute walk test (6MWT) showed a significant improvement in the groups that received FES with augmented feedback compared to the groups that received FES alone. Conclusion: Compared with the existing FES gait training, augmented feedback showed improvements in gait parameters, walking ability, and dynamic balance. The augmented feedback will be an important method that can provide motivation for motor learning to stroke patients.

• Physical Therapy Rehabilitation Science
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• 제7권1호
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• pp.6-12
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• 2018

Objective: The purpose of this study was to investigate the effects of an additional weight aquatic exercise program on the balance and lower extremity strength on aquatic environment in persons with stroke. Design: Randomized controlled trial. Methods: All subjects were randomly divided into three groups where thirteen subjects were in the additional weight aquatic exercise group, twelve subjects in the aquatic exercise group, and fifteen subjects in the control group. Subjects received a graded aquatic exercise program for 30 minutes, with 3 sessions per week for 6 weeks, and subjects in all groups received conventional physical therapy. All subjects were assessed with the Medical Research Council (MRC), the Berg Balance scale (BBS), Timed Up and Go test (TUG), and 10-meter walk test (10MWT) pre and post intervention. Results: The MRC, BBS, TUG, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas post-treatment (p<0.05). In addition, it has been confirmed that the additional weight aquatic exercise group had significantly improved in MRC, BBS, and TUG scores compared with the aquatic exercise and control group (p<0.05). Conclusions: The findings of this study suggested that the additional weight aquatic exercise program improves lower extremity and balance in persons with stroke.