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The Effect of Action Observation Training with Acoustic Stimulation on Balance and Gait in Stroke Patients

  • Kim, Young-Mi;Lee, Ho-Jeong;Lee, Jong-Su
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.4
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    • pp.13-21
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    • 2021
  • PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.

Correlation among Motor Function and Gait Velocity, and Explanatory Variable of Gait Velocity in Chronic Stroke Survivors

  • Lee, Dong Geon;Lee, Gyu Chang
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.181-188
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    • 2022
  • Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

Comparison of Effects of Non-surgical Continuous and Intermittent Traction on Pain, Balance and Physical Function in the Treatment of Knee Osteoarthritis

  • Lee, Dong-Kyu;Jeong, Jin-Gyu
    • The Journal of Korean Physical Therapy
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    • v.32 no.6
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    • pp.348-353
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    • 2020
  • Purpose: This study examined the comparison of effects of non-surgical continuous and intermittent traction on pain, balance and physical function in the treatment of knee osteoarthritis. Methods: A total of 30 knee osteoarthritis patients were recruited and randomized to a continuous traction group (n=10), an intermittent traction group (n=10), and a control group (n=10). The continuous traction group and intermittent traction group received a non-surgical continuous and intermittent knee joint traction workout five times a week, for 4 weeks. All subjects were assessed with the numeric rating scale (NRS), timed up and go test (TUGT), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after the 4-week treatment. Results: As a result of comparison within groups, the continuous traction group, intermittent traction group, and control group showed a significant difference for NRS, TUGT, and WOMAC after the experiment (p<0.05). According to the comparison of the three groups, the continuous traction group showed a more effectively significant difference than the intermittent traction group and the control group in the balance and physical functions before and after the experiment (p<0.05). Conclusion: This study showed that non-surgical continuous traction treatment was effective in improving pain, balance ability, and physical function in knee osteoarthritis patients.

The Effect of Silicone Sleeve and Taping on Balance and Strength in Anterior Cruciate Ligament Reconstruction Patients

  • Kwon, Hyo-Jeoung;Park, Dae-Sung;Jeong, Ju Ri;Jung, Kwang-Ik
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.147-155
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    • 2014
  • Purpose: This study was to determine the effects of before and after application of silicone sleeve on balance and muscle strength in anterior cruciate ligament (ACL) reconstruction patients. Methods: 13 subjects who had one or more months after ACL surgery were involved. Dynamic balance, timed up and go (TUG), stair step, vertical jump, proprioception and isokinetic knee strength were measured while subjects under taped, untapped and silicone sleeve conditions. Results: For 30 seconds one-leg standing, there was a significant improvement under silicone sleeve on operated side with eyes open and both taping and silicone sleeve revealed similar effects with eyes closed (p<0.01). Application of silicone sleeve showed significant effects in proprioceptive function on the operated side compared to both taping and none (p<0.05). For stair step test, TUG and vertical jump was a tendency to improve after application of silicone sleeve, but no significant different. Muscle strength on operated side of quadriceps and hamstring was significantly improved compared with none or taping(p<0.05). Conclusion: Silicone sleeve application for ACL reconstruction patients was effective immediately on improving strength and balance. Therefore, depending on the intended use and the disease is considered appropriate use of silicone sleeve will be able to help prevention and functional movement.

Walking behaviors for stroke survivors: comparison between straight line and curved path

  • Hwang, Wonjeong;Choi, Bora;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.141-145
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    • 2019
  • Objective: The purpose of this study was to compare walking conditions (straight line and curved path) on walking patterns in persons who had experienced hemiplegic stroke and to determine whether if they adapt their walking pattern and performances according to changes in environmental conditions. Design: Cross-sectional study. Methods: Forty-four hemiplegic stroke survivors participated in this study. This study measured walking performance in three different walking conditions, such as straight walking, the more-affected leg in the inner curve walking, and less-affected leg in the inner curve walking conditions, and a 2-dimentional gait analysis system was used as a primary measurement. This study also measured secondary clinical factors including the Timed Up-and-Go Test, the Trunk Impairment Scale, and the Dynamic Gait Index. Results: After analyzing, cadence and step length of the less-affected side, stride length in the more-affected side, and stride length in less-affected side were significantly different among the three different walking conditions in this study (p<0.05), but other temporospatial parameters were not significant. Cadence was the largest in the straight walking condition. Step length in the less-affected side, stride length in the more-affected side, and stride length in less-affected side were also the longest in the straight walking condition. Conclusions: The results of the study suggest that hemiplegic stroke survivors show walking adaptability according to changes in walking demands and conditions, and moreover, cadence and step and stride lengths were significantly different between straight and curved walking conditions.

The Effects of Ankle Strengthening Training and Whole Body Vibration on the Balance of Older Adults Who Have Experienced a Fall

  • Choi, Jung Hyun;An, Ho Jung
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.2
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    • pp.884-890
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    • 2015
  • This study observed the effects of ankle strengthening exercise and whole body vibration on the balance ability of older adults, thereby intending to provide basic materials for intervention methods aimed at improving older adults' balance ability. The subjects were 20 older adults who had experienced a fall. They were equally divided into two groups. Ankle strengthening training was applied to one group and ankle strengthening training and whole body vibration were applied to the other group, a timed up and go (TUG) test and Tinetti performance oriented mobility assessment (POMA) were performed, and changes in the subjects' limits of stability were observed. The TUG and POMA results significantly differed between before and after the experiment in the angle strengthening training (AST) group and the angle strengthening training with whole body vibration (ASTWV) group. In addition, the interaction between timing and each group was statistically significant. The limits of stability significantly changed after the intervention in both groups. Differences in the posterior and right limits of stability were significant between the AST group and ASTWV group. Therefore, ankle strengthening exercise and whole body vibration improve older adults' balance maintenance and reduce falls or the risk factors for falls in older adults.

Changes in Balance and Gait Following Backward Walking Exercise in Hemiplegic Stroke Patients (뒤로 걷기 운동에 따른 뇌졸중 편마비 환자의 균형능력 및 보행능력의 변화)

  • Shin, Kyu-Hyun;Kang, Soon-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.21-31
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    • 2017
  • PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.

The Relationships among Trunk Control Ability, Dynamic Balance and Gait in Stroke Patients (뇌졸중 환자의 체간조절 능력과 동적균형 및 보행과의 상관관계)

  • Chung, Eun-Jeong;Lee, Jong-Soo;Kim, Seong-Sik;Lee, Byoung-Hee
    • The Journal of Korean Medicine
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    • v.33 no.1
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    • pp.148-159
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    • 2012
  • Objectives: This study investigated the correlation among Postural Assessment Scale for Stroke (PASS), Timed "Up and Go" Test (TUG) and gait (velocity, cadence, step-length, stride-length and single-limb support). Methods: The 70 subjects were assessed on trunk control measured with the use of the PASS, dynamic balance (TUG) and gait function (by GAITRite). The data were analyzed using Pearson product correlation. Results: The PASS total scores were significantly correlated with PASS-M, PASS-C, and PASS-T (r =.80 ~ .88 p<.01). All items of the PASS were significantly correlated with TUG (r = -.63 ~ -.81 p<.01), velocity (r = .44~.58 p<.01), cadence (r =.38 ~.51. p<.01), affected side step length (r = .44 ~.56 p<.01) and affected side stride length (r = .45 ~.59 p<.01). But affected side single-limb support was lowly correlated with PASS-M, PASS-C, PASS-T and PASS-total (r = .25~.36 p<.05). Conclusions: Measures of trunk control were significantly related with values of dynamic balance and gait. Based on these results, trunk control is an essential core component of balance and gait. Trunk control training programs after stroke should be developed and emphasized.

The Effects of Interferential Current therapy on Spasticity, Range of Motion, and Balance Ability in stroke Patient (뇌졸중 환자의 경직 및 관절가동범위, 균형에 간섭전류 치료가 미치는 효과)

  • Kim, Bo-Yong;Choi, Won-Ho
    • The Journal of Korean Physical Therapy
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    • v.25 no.4
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    • pp.187-194
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    • 2013
  • Purpose: The aim of this study was to investigate the effects of interferential current therapy (ICT) on spasticity, ROM, and the balance function in patients with stroke. Methods: 30 inpatients with stroke were randomly divided into 2 groups: the ICT group (n=15) and the placebo-ICT group (n=15). Two groups have got the traditional rehabilitation for 30 minutes before applying either ICT or placebo-ICT stimulation. The stimulus of ICT has been applied to gastrocnemius at the level of 100 Hz, two times of sensation threshold, while the placebo-ICT group has put on the electrode without electrical stimulus. To assess spasticity in ankle, the modified Ashworth scale (MAS) was used, and goniometer was applied to measure the passive range of motion (PROM). Also, the Berg Balance Scale (BBS), the Timed-up and go (TUG), and the Functional Reach Test (FRT) were carried out to examine the balance ability. Results: The ICT group showed a significant reduction of spasticity and significantly increased PROM than the placebo-ICT group (p<0.05). The placebo-ICT group did not show significant changes in the BBS, the TUG, and the FRT, while the ICT group significantly improved the BBS, the TUG, and the FRT (p<0.05). Conclusion: Our results demonstrated that ICT applied to gastrocnemius effectively decreased spasticity and improved range of motion and balance function in patients with stroke.

Effect of Mirror Therapy Combined with Lower Extremity Muscle Strength Exercise on Gait and Balance of Patients with Chronic Stroke

  • Kim, Myoung-Kwon;Shin, Young-Jun;Choi, Eun-Hong
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.1
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    • pp.81-88
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    • 2018
  • PURPOSE: The present study aims to determine the effect of lower extremity muscle strength exercise at the non-paralyzed side of patients of stroke using a mirror on gait and balance. METHODS: Subjects were assigned randomly to a group of lower extremity exercise without using a mirror (n=10), a group of lower extremity motion exercise using a mirror (n=10), and a group of lower extremity muscle strength exercise using a mirror (n=10). The exercise is added to a physiotherapy program conducted at the hospital and subjects conducted their designed lower extremity exercises 30 times a day (5 sets), five days per week for four weeks. RESULTS: The study result showed that BBS(Berg balance scale)(p<.05) and TUG(timed up and go test)(p<.05) had a significant difference. In the comparison on gait ability, stride length, step length, step width and single support was a significant difference within two groups using a mirror before and after the intervention(p<.05). CONCLUSION: Conclusively, low extremity motion exercise using a mirror and low extremity muscle strength exercise using a mirror conducted along with general physiotherapy exercises had a positive effect on functions of lower extremity in patients with stroke and the recovery of paralyzed side thereby incurring a significant difference in balance and gait abilities.