• 대한물리의학회지
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• 제6권2호
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• pp.153-163
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• 2011

Purpose: This study was conducted to compare the effect of visual feedback training using mirror and the training without mirror on the balance in people with hemiplegic paralysis. Methods: A total of 26 stroke patients were enrolled in this study. The participants were allocated randomly to 2 groups : visual feedback training group(n=13) and control group(n=13). Both groups received PNF(proprioceptive neuromuscular facilitation) for 5 times(each 30 minutes) per week over 6 weeks period. The group, which is enrolled in visual feed back training, performed additional exercise in front of mirror for 30 minutes. The control group performed same exercise without mirror. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. Results: The visual feedback training group showed significantly increased foot pressure and total pressure compared to the control group(p<.05) and significantly decreased body sway compared to the control group (p<.05). Also, visual feedback training group showed significant increase on the Berg Balance Scale(BBS), Timed Up and Go test(TUG) compared to the control group(p<.05). Conclusion: These results support the perceived benefits of visual feedback training using mirror to augment the balance of stroke patients. Therefore, visual feedback training using mirror is feasible and suitable for stroke patients.

• 대한정형도수물리치료학회지
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• 제17권2호
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• pp.25-32
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• 2011

Background: This study was to examine the effect of applying leg exercise using visual informations on improving stroke patient's muscle power, balance and gait. Methods: The subjects of this study were hemiplegic patients by stroke, 30 patients were picked up, who were agreed with this research and were having hospital care for 8 weeks at RS, RB and HH medical centers. The study group was 15 and comparison group was 15, totally 30 patients were confirmed. leg exercise using visual informations was applied to study group, leg exercise without visual informations was applied to comparison group. These were proceeded for 8 weeks (5 days a week, 20 minutes a day), change of muscle power, balance and gait was checked to investigate the effect. Electromyography apparatus was used for checking muscle power, K-BBS (Korean version of Berg Balance Scale) and COP (center of pressure) were used for balance, then Functional Gait Assessment (FGA), timed up and go test (TUG) were used for checking the capacity of gait. Results: Vastus lateralis (p=.002), biceps femoris (p=.000), K-BBS (p=.000), COP (p=.007), FGA (p=.002), TUG (p=.009) are significant difference between the two groups. Conclusion: This study showed that visual informations impact change of muscle activity, balance and locomotor ability in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.63-69
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• 2016

Objective: To evaluate the effects of sit-to-stand (STS) imagery group training (IGT) on STS movement and balance performance for chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: A total of 30 people with chronic hemiparetic stroke (15 for STS-IGT group and 15 for control) were recruited in this study. The STS-IGT group participated in a videotape-based STS-IGT for 30 minutes a day, five days a week for six weeks, while the control group watched a documentary on television for the same period. The STS-IGT focused on a five-stage protocol. Specifically, external imagery was used during the four phases of the STS movement from the seat of the chair to standing up. All of the participants also participated in a regular rehabilitation program. STS movement and balance performance were assessed using three clinical measures. Results: After training, time to perform the 5-repetition STS test significantly increased in the STS-IGT group (change value, $4.0{\pm}2.0$ sec) compared with the control group (change value, $0.9{\pm}0.7$ sec) (p<0.05). There was a greater improvement in Berg balance scale scores in the STS-IGT group (change value, $0.2{\pm}4.1$ points) compared with the control group (change value, $0.3{\pm}0.9$ points) (p<0.05). There was a greater improvement in Timed Up and Go scores in the STS-IGT group (change value, $2.6{\pm}1.5$ sec) compared with the control group (change value, $0.9{\pm}1.0$ sec) (p<0.05). Conclusions: STS-IGT can be considered as a useful option for restoration of STS movement and balance performance for individuals with chronic hemiparetic stroke who are unable to fully participate in physical activities.

• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.62-71
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• 2023

Objective: Stroke patients need the training to adjust their posture and maintain balance is necessary to restore movement function, and unstable support training is one of the appropriate training. In this study, a systematic review and meta-analysis were conducted to find out the effects of unstable surface training on balance and gait in stroke patients. Design: Systematic review and meta-analysis Methods: After creating a search expression referring to MeSH and EMTREE, the literature from 1976 to February 2022 was searched in the databases of PubMed, EMBASE, and Cochrane Library CENTRAL. A total of 331 studies were searched from three databases, and 11 studies were finally selected according to the inclusion criteria. Unstable surface training included studies using balance trainer, Whole-body vibration, and sand surfaces. Results: The results were found to be d=2.28 (p=0.02) and the effect size was 0.36 (95% CI: 0.05, 0.67) on the Berg Balance Scale. In the Kinesthetic Ability Trainer static balance, d=2.59 (p=0.01) and the effect size was 1.01 (95% CI: 0.24, 1.78). Timed Up and Go test showed that d=2.18 (p=0.03) and the effect size was 0.38 (95% CI: 0.04, 0.72). At the gait speed, d=0.99 (p=0.32) and the effect size was 0.15 (95% CI: -0.15, 0.45). In the 6-minute walk test, d=0.14 (p=0.89) and the effect size was 0.04 (95% CI: -0.47, 0.55). Conclusions: In this study was found that training was effective in balance if it became unstable in standing posture. Therefore, unstable surface training can be used to improve the balance of stroke patients in clinical practice.

• 대한물리의학회지
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• 제14권4호
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• pp.71-80
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• 2019

PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.

• 대한물리의학회지
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• 제9권2호
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• pp.223-231
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• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• 대한물리의학회지
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• 제5권4호
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• pp.587-596
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• 2010

Purpose : This study was performed to investigate the effects of somatosensory training on the spatiotemporal gait parameters and balance in patients with stroke patients. Methods : 24 stroke survivors were allocated in this study, and randomly divided into experimental(n=12) and control group(n=12), independently. Experimental group was applied somatosensory training program plus conventional physical therapy, and control group was applied only conventional physical therapy. All subjects were administered for 30 minutes per day during 8 weeks(5 times a week). Results : Spatiotemporal parameters of gait were significant difference between pre and post intervention in experimental group, except of step length asymmetry ratio(SLAR) and single support time asymmetry ratio (SSAR)(p<.05). But control group had no statistical significance(p>.05). And also there was significant difference between experimental and control group(p<.05), except of cadence and SSAR(p>.05). Balance parameters were significant difference between pre and post intervention in experimental group(p<.05). But control group had no statistical significance(p>.05). And experimental timed up and go test was significantly decreased than control group(p<.05), but berg balance scale and functional reach test were not significant difference between experimental and control group(p>.05). Conclusion : This study was suggested that somatosensory training has effectiveness on the spatiotemporal gait parameters and balance in patients with stroke survivors. So this therapeutic intervention will be effectivelyapply to the stroke survivors in the clinical setting.

• 대한정형도수물리치료학회지
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• 제17권2호
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• pp.19-24
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• 2011

Background: The elderly are likely to fall due to physical and mental atrophies, and experiencing falls may result in fear of falls and lack of self-confidence, which also leads to hesitation to physical activities and changes in walk and balance, the major variables in independent daily life. Methods: In three senior citizen centers located in D city, 22 elderly women aged 65 or older were chosen, and they filled in the questionnaire which included their agreement to voluntarily participate in the survey and medical histories. As to whether they had falls experience, the medical history items in the questionnaire asked them if they had falling down or falls once a year, twice for the three years. The objects were divided to NFE (non-falls experience) and FE (falls experience). Results: 1. As to walking abilities, significant difference was found between NFE and FE regarding walk width, stepping with two feet, and stride length while there was no significant different in terms of cadence. 2. As to balancing abilities, was significant difference between NFE and FE in terms of the physical body center area. As to the sit-to-stand, tandom gait test, no significant difference was found, and neither in the timed up and go test. Conclusions: The elderly with falls experience has inferior walking and balancing abilities to those without falls experience, and thus they are more exposed to the risks of falls.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.55-62
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• 2014

Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.

• 대한물리의학회지
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• 제19권2호
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• pp.17-28
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• 2024

PURPOSE: This study was conducted to investigate the effect of gluteal muscle strengthening exercises (GMSE) with ankle joint pumping exercises (AJPE) on thigh swelling, gait ability, and pain level in patients who underwent total hip arthroplasty. METHODS: A total of 38 patients who had undergone total hip replacement surgery >1 week prior participated in this study. Participants were randomly assigned to a group that performed only GMSE (CG; n = 19) and a group that performed GMSE and AJPE (EG; n = 19). The CG group performed GMSE for 30 min, and the EG group performed GMSE for 30 min followed by AJPE for 15 min. Exercises were performed five times a week, for a total of 20 times over 4 weeks in both groups. Thigh swelling (thigh size), 10 m walking test (10MWT) and timed up and go test (TUG) results, pain level (visual analogue scale, VAS) scores, Short Form 36 health survey (SF-36), and hip outcome scale (HOS) scores were evaluated before and after the intervention. RESULTS: After 4 weeks of intervention, significant differences were observed in the thigh size, 10MWT, TUG, VAS, SF-36, HOS before and after intervention in both groups (p < . 05). However, only thigh size showed a significant interaction between group and measurement time (p < . 05). CONCLUSION: GMSE combined with AJPE might be effective in improving the gait ability and pain level in patients with total hip arthroplasty, and GMSE may be more effective in improving thigh swelling and gait ability than GMSE without AJPE.