• 대한한방내과학회지
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• 제42권2호
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• pp.75-85
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• 2021

Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

• Physical Therapy Rehabilitation Science
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• 제6권2호
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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.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• 한국노년학
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• 제30권3호
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• pp.993-1003
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• 2010

본 연구는 여성노인을 대상으로 8주간의 경피신경자극(TENS)과 균형운동을 적용하여 균형 능력의 개선 여부를 알아보고자 하였다. 노인대학에 참여한 65세 이상의 여성노인 42명을 연구대상자로 선정하였다. 대상자는 무작위로 두 그룹으로 나누어 TENS군(21명, 84.53세)과 균형운동군(21명, 79.93세)으로 진행하였다. TENS의 적용과 균형운동은 8주 동안 주 3회에 걸쳐 연구자에 의해 실시하였다. 실험 전과 후에는 동적균형검사로 일어나 걸어가기 검사 (TUG)와 정적균형검사로 힘판을 이용하여 맨 바닥과 foam 위에서의 자세 동요 속도와 기능적 팔 뻗기 검사 (FRT)와 측방 기능적 팔 뻗기 검사 (LFRT)를 시행하여 다음과 같은 결과를 얻었다. TUG는 두 군 모두 유의하게 감소되었고(p<.05), 힘판을 이용한 자세동요 속도에서도 두 군 모두 모든 조건에서 유의하게 감소되었다(p<.05). FRT와 LFRT는 두 군 모두 유의하게 증가하였다(p<.05). TUG와 눈 감은 상태의 자세동요 속도는 두 군 간의 유의한 차이를 나타냈다(p<.05). 체성감각이 떨어져 있는 여성노인에게 적용한 TENS는 균형능력 증진에 효과적인 것으로 나타났다.

• 한국산학기술학회논문지
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• 제11권9호
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• pp.3353-3357
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• 2010

본 연구는 만성 뇌졸중 환자를 대상으로 시각리듬자극(rhythmic visual stimulation, RVS)을 이용한 보행 운동을 적용하여 보행과 고유수용성감각에 미치는 효과를 알아보고자 하였다. 뇌졸중으로 6개월 이상 장애를 가진 21명이 연구에 참여하였고 실험군 10명과 대조군 11명으로 나누었다. 대조군은 14m의 보행로가 확보된 공간에서 준비운동 5분, 보행운동 20분, 정리운동 5분 씩 주 3회, 4주간 12회를 실시하였고, 실험군은 대조군의 운동프로그램과 같은 조건에서 보행운동시 시각리듬자극(RVS)을 추가적으로 적용하였다. 운동 전 후에 보행과 고유수용성감각을 측정하여 효과를 비교하였다. 통계처리 방법으로 실험 전?후 차이를 검증하기 위하여 Wilcoxon 부호 순위 검정을 실시하였고 대조군과의 차이 검증을 위하여 공분산분석 검정을 실시하였다. 모든 통계적 유의수준은 p<0.05로 하였다. 본 연구의 결과 시각리듬자극(RVS)이 적용된 실험군에서 보행속도와 분속수, Timed up and go test(TUG) 시간이 유의하게 증가하였고(p<.05), 고유수용성감각이 유의하게 증가하였다(p<.05). 결론적으로 시각리듬자극(RVS)을 이용한 보행운동이 만성 뇌졸중 환자의 보행과 고유수용성감각에 효과가 있는 것으로 나타났다. 향후 만성 뇌졸중 환자에게 음악적 요소인 시각리듬자극(RVS)이 정신적 육체적 기능을 상실한 뇌졸중 환자의 재활치료 프로그램에 적용하는 연구가 필요할 것으로 기대된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.

• 한국전문물리치료학회지
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• 제21권3호
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• pp.45-54
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• 2014

Fall is one of the most intimidating health conditions in elders. Comprehensive assessment is necessary to understand the individual and environmental aspects of the falls such as balancing abilities, depression, and quality of life. The purpose of this study was to compare the balancing ability, depression, and quality of life between elderly fallers and elderly non-fallers. Thirty-two community-dwelling elders (fifteen males and seventeen females between 65 and 83 years old), who have experienced fall on walking during last twelve months, were involved in the elderly fallers group. And twenty-four males and twenty-two females between 65 and 83 years old of community-dwelling elders, who have no experienced fall on walking during last twelve months, were involved in the elderly non-fallers group. Berg balance scale (BBS), timed up and go test (TUG), and functional reach test (FRT), were used to evaluate the ability of the physical balance. 'Beck depression scale in Korean' questionnaire was used to assess the depression. 'Korean version of World Health Organization Quality of Life Assessment Instrument-Bref' questionnaire was used to assess the quality of life. The results were as follows: 1) Balancing abilities measured by the BBS, TUG in the elderly fallers group were meaningfully lower than that of the elderly non-fallers group (p<.05), whereas no significant difference in the FRT was found (p>.05). 2) Depression level in the elderly fallers group was significantly higher than that of the elderly non-fallers group (p<.05). 3) Quality of life in the elderly fallers group was significantly lower than that of the elderly non-fallers group, excluding environment domain (p<.05). Therefore, in order for clinical evaluation of the community-dwelling elders those with reduced balancing ability, it is necessary to evaluate and understand the fall experience, depression, and quality of life.

• 대한한방내과학회지
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• 제40권4호
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• pp.730-741
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• 2019

Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment with rehabilitation exercise on a chronic intracerebral hemorrhage patient with a severe gait disturbance. Method: The patient was treated with Korean herbal medicine (Gami-sibjeondaebo-tang) along with acupuncture, moxibustion, and rehabilitation exercise. The treatment effect was evaluated through the Manual Muscle Test (MMT) and the Korean version of the Modified Barthel Index (K-MBI). The gait of the patient was evaluated by Functional Ambulatory Category (FAC) and the Timed Up and Go (TUG) test. The spatiotemporal parameters were evaluated by a walkway system (GAITRite(R) system) and gait symmetry was evaluated by Symmetry Criterion (SC). Results: After 111 days of traditional Korean medicine treatment, the spatiotemporal parameters and symmetry of the patient's gait improved. Conclusion: This study suggested that traditional Korean medicine treatment with rehabilitation exercise could be effective for gait disturbance in patients with chronic intracerebral hemorrhage.

• 재활복지
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• 제17권4호
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• pp.383-399
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• 2013

본 연구는 수중과 지상에서의 장애물 훈련 프로그램이 만성 뇌졸중 환자의 균형에 미치는 효과를 비교하고자 시행하였다. 연구대상자는 수중운동집단(15명)과 지상운동집단(15명)으로 나누어 장애물 훈련 프로그램을 12주간 주 3회, 40분씩 실시하였다. 정적균형은 Good Balance System을 이용하여 눈을 뜬 상태에서 내 외측 동요속도와 전 후측 동요속도 그리고 동요면적을 측정하였고, 동적 균형검사는 기능적 팔 뻗기 검사와 일어나 걸어가기 검사를 이용하여 측정하였다. 그 결과, 두 집단 모두에서 정적 균형(내 외측 동요속도, 전 후측 동요속도, 동요면적)과 동적균형(기능적 팔 뻗기 검사와 일어나 걸어가기 검사)에서 유의한 차이를 보였고, 집단 간 차이에서는 모든 변수에서 수중운동군과 지상운동군 간의 유의한 차이를 보였다. 이상의 결과를 볼 때, 수중과 지상에서의 장애물 훈련이 만성 뇌졸중 환자의 균형 능력 증진을 향상시키며, 수중이란 환경에서의 훈련이 지상운동보다 유의한 효과가 있다는 결과를 알 수 있었다. 수중운동은 만성 뇌졸중 환자의 균형 능력 증진을 위한 방법으로 유용하다고 생각되며, 앞으로도 균형능력 증진을 위한 수중운동에 대한 연구가 활발하게 이루어져야 할 것으로 사료된다.

• 대한물리의학회지
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• 제17권4호
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• pp.103-111
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• 2022

PURPOSE: This study was performed to investigate the effects of the whole-body vibration exercise combined with ankle joint mobilization on the gait and balancing ability in patients with hemiplegic stroke. METHODS: A total of 19 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (whole-body vibration exercise combined with ankle joint mobilization, n=10) or control group (whole-body vibration exercise, n=9). All participants underwent 30 min of comprehensive rehabilitation therapy (5 × /week for 6 weeks). Additionally, the experimental group performed the whole body vibration exercise and ankle joint mobilization (15 minutes each, 30 minutes total, 3 × / week for 6 weeks). In the control group, only the whole- body vibration exercise was performed in the same manner and not the ankle joint mobilization. The gait and balancing abilities were measured before and after the 6-week training. RESULTS: Significant improvements were observed in the 10-m walk test, timed up-and-go (TUG) test, center of pressure (COP) path length, and COP path velocity in the experimental group (p < .05). The experimental group showed a larger decrease in the COP path length and velocity than the control group (COP path length, -10.27 mm vs. -3.67 mm, p < .05; COP path velocity, -.33 cm/sec vs. -.13 cm/sec, p < .05, respectively). CONCLUSION: The whole-body vibration exercise combined with ankle joint mobilization could be effective in improving the gait and balancing ability of stroke patients and could also be more effective for improving the static balance ability than the general whole-body vibration exercise alone.