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The Effect of Treadmill Gait Training Accompanied by Visual Feedback on the Gait and Balance of Chronic Stroke Patients (만성뇌졸중 환자에 시각적 되먹임 트레드밀 보행 훈련이 보행과 균형 능력에 미치는 효과)

  • Kim, Ji-Seon;Ahn, Jin-Hwan;Lee, Hyeon-Hee;Park, Hyo-Jeong;Ki, Kyong-Il
    • PNF and Movement
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    • v.15 no.2
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    • pp.133-140
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    • 2017
  • Purpose: This study compares the effects of treadmill gait training accompanied by visual feedback and general treadmill gait training on the gait and balance ability of patients with chronic stroke. Methods: A total of 11 patients with chronic stroke were randomly divided into either the treadmill gait training accompanied by visual feedback group (six patients) or the general treadmill gait training group (five patients). The gait and balance ability of the two groups were measured before and after the interventions using the functional reach test, the Timed Up and Go (TUG) test, Berg's balance test, and the Biodex balance test. The treadmill gait training accompanied by visual feedback group performed the exercise under the supervision of a therapist after first being provided with a hat and a goal that was devised for the purpose of providing visual feedback information. The interventions were applied to the respective groups for four weeks. For the statistical analysis, we conducted a Mann-Whitney test to compare the results between the two groups. Additionally, the Wilcoxon test was used to compare the results from before and after the intervention in each group. Results: The treadmill gait training accompanied by visual feedback group showed a significant difference in terms of the functional reach test after the intervention when compared to the general treadmill gait training group (p<0.05). Although there was no significant difference, the treadmill gait training accompanied by visual feedback group showed a larger improvement in the TUG test, Berg's balance test, and the Biodex balance test than the general treadmill gait training group (p>0.05). Conclusion: The results of this study suggest that treadmill gait training accompanied by visual feedback can be used as a beneficial intervention scheme for the recovery of the gait and balance ability of patients with chronic stroke.

Correlations between Foot Sensory Impairment, Timed Up and Go Test and Berg Balance Scale, and Mental Activities for Prevention of Falling in Elderly People

  • Lee, Young-Ho;Jang, Seon-Jung;Kang, Gi-Beom;Choi, Ye-Seul;Hwang, Young-In
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.4
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    • pp.9-17
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    • 2019
  • PURPOSE: This research was designed to study the correlations between physical activities such as foot sensory impairment, balance and ambulatory abilities, as well as fall risk factors and mental activities such as cognitive performance and depression in order to provide fundamental data for the prevention of falling in the elderly. METHODS: A total of 36 elderly people over the age of 65 years who voluntarily joined the research were selected as subjects. Sensory perception in both feet was measured by using a monofilament in 10 parts with each part given one point. The points for each foot were integrated to analyze the correlations between physical and mental activities indices, and the results were analyzed by using Pearson's correlation coefficient. RESULTS: The results of this research show that the extent to which senses in feet were impaired was correlated to TUG, a functional activity index involved in tranfers, gait, and turning movements, which was correlated to BBS (balance index) as well as MMSE-K and K-GDS (mental activities index). BBS was interrelated to FES-K (physical activities index) and MMSE-K. The muscular strength of the right ankle dorsiflexor had mutual relations with FES-K. CONCLUSION: The results of this research indicate that TUG is widely correlated to foot sensory impairment as well as general physical and mental activities in elderly people. BBS was also shown to be correlated with TUG, FES-K, and MMSE-K. Thus, it might be necessary that TUG and BBS be included as two items in physical and mental check-ups for the elderly, and further studies on correlations using evaluation items for physical and mental activities should lead to the simplification of the evaluation criteria.

Effects of Taping on Balance and Gait in Patients With Stroke: A Meta-analysis

  • Eun-Ji Kim;Joo-Hee Park;Yixin Wang;Hye-Seon Jeon
    • Physical Therapy Korea
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    • v.30 no.2
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    • pp.92-101
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    • 2023
  • Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.

The Effect of Ankle Balance Taping on Gait and Balance in Stroke Patients

  • Kyoung-Won Kim;Ki Bum Jung;Dong-Ho Kim;Yongwoo Lee
    • Physical Therapy Rehabilitation Science
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    • v.12 no.2
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    • pp.123-129
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    • 2023
  • Objective: Kinesio tape has been applied to the ankle to improve balance and gait. Stroke patients show abnormal gait patterns due to foot drop. This study aimed to determine the effects of ankle balance taping which to support the ankle joint on balance and gait in patients with chronic stroke. Design: A randomized controlled trial. Methods: Twenty-four chronic stroke patients were selected and randomized into experimental group (n=12) and control group (n=12). The experimental group applied kinesio taping three times a week for three weeks, and the control group applied placebo taping for the same amount of time. To evaluate the effectiveness of the treatment, the subjects' walking ability, static balance, and dynamic balance were assessed before and after the experiment. Gait speed and spatiotemporal gait ability were measured to examine walking ability, postural sway velocity and velocity moment for static balance, and Timed-Up and Go test and Berg Balance Scale were conducted to check dynamic balance. Results: The experimental group showed a significant increase in walking ability, static balance, and dynamic balance in the within-group pre-post difference (p<0.05). In the between-group comparison, the experimental group had a significant difference in walking ability than the control group (p<0.05). Conclusions: Ankle balance taping can help improve gait, and this study can be used as a basis for future studies of ankle balance taping.

Relationship Between Gait Symmetry and Functional Balance, Walking Performance in Subjects with Stroke (뇌졸중 환자의 보행 대칭성과 기능적 균형 및 보행과의 상관관계 연구)

  • Kim, Joong-Hwi
    • The Journal of Korean Physical Therapy
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    • v.26 no.1
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    • pp.1-8
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    • 2014
  • Purpose: The aim of the present study was to understand the relationship between gait symmetry and functional balance, walking performance in stroke patients and to makes recommendation regarding the most suitable measure for standardization of expression of spatiotemporal gait symmetry. Methods: 45 subjects with stroke (31 men, 14 women, $57.3{\pm}10.3$ years old) participated in this study. Gait symmetry was calculated by equations of symmetry ratio (SR) and symmetry criterion (SC) for stance time, swing time, single leg support time (SLST), step length, and stride length. Spatiotemporal parameters were measured respectively by walkway system ($GAITRite^{TM}$ system). Limit of stability (LOS) by using forceplate (Balance Performance Monitor) during voluntary weight displacement and Berg Balance Scale (BBS) were measured as functional balance and Timed Up and Go test (TUG) and Functional Ambulation Category (FAC) were assessed as functional walking. Results: SR in stance time and swing time was correlation with BBS, TUG and FAC (p<0.05). SR in SLST only with BBS (p<0.01), SR in step length only with FAC (p<0.05). SC in stance time was correlation with BBS and TUG (p<0.05). SC in swing time and SLST with BBS, TUG and FAC (p<0.01), SC in step length with TUG and FAC (p<0.01), SC in stride length with BBS and FAC (p<0.01). Conclusion: Gait symmetry in spatiotemporal gait parameters provides meaningful information about functional balance and walking performance in stroke subjects. Our analysis may support the recommendations of the symmetry criterion as equation for standardization of gait symmetry.

Effects of Inclined Treadmill Walking Training with Rhythmic Auditory Stimulation on Balance and Gait in Stroke Patients: A pilot study (리듬청각자극을 동반한 경사 트레드밀 보행훈련이 뇌졸중 환자의 균형 및 보행에 미치는 영향: 예비연구)

  • Yoon, Sungkyeung;Kang, Soonhee
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.4
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    • pp.69-78
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    • 2015
  • Purpose: The purpose of this study was to identify whether inclined treadmill gait training with rhythmic auditory simulation (RAS) could improve on balance and gait in stroke patients. Method: Fifteen stroke patients who had agreed with the study were allocated to the group 1(n=5), group 2(n=5), or group 3(n=5). The group 1, group 2 and group 3 performed RAS with inclined treadmill gait training, inclined treadmill gait training and treadmill without incline gait training respectively for 3 weeks (30 minutes per session, 5 times in a week). The balance was assessed using Timed Up & Go (TUG) and Berg Balance Sale (BBS), and the gait was evaluated using 6 Minutes Walking Test (6MWT) and spatio-temporal walking variables as walking speed, cadence, Single Limb Support of affected side(SLS) and Symmetric Index(SI) before and after training. Result: Both the group 1 and group 2 showed significant improvement after training in all variables of balance and gait. The group 3 showed significant improvement in TUG values, 6MWT values, walking speed, cadence and SI. The changes in the group 1 were significantly greater in all dependent variables of balance and gait than those of the group 2 and group 3. The changes in the group 2 were significantly greater in TUG values, BBS scores, 6MWT values, walking speed, and cadence than those of the group 3. Conclusion: The result of this study show inclined treadmill gait training with RAS is more effective to improve balance and gait in stoke patients than inclined treadmill or general treadmill gait training without RAS.

The Effects of Upper and Lower Limb Coordinated Exercise of PNF for Balance in Elderly Woman (고유수용성신경근촉진법의 상하지 협응 운동이 여성노인의 균형능력에 미치는 효과)

  • Cho, Hyuk-Shin;Shin, Hyo-Seob;Bang, Dae-Hyuk
    • PNF and Movement
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    • v.13 no.4
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    • pp.189-196
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    • 2015
  • Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) upper and lower limb coordinated exercises on balance in elderly women. Methods: The study was conducted with 27 elderly women who were at least 65-year-old. The subjects were randomly assigned to a PNF upper and lower limb coordinated exercise group consisting of 14 subjects and an aero step balance exercise group consisting of 13 subjects, and the exercises were performed for 30 minutes, three times per week, for eight weeks. One Leg Stance Tests (OLST), Functional Reaching Tests (FRT), Four Square Step Tests (FSST), and Timed Up and Go (TUB) tests were conducted before and after the exercises to evaluate the subjects' static balance ability and dynamic balance ability. Among the collected data, the subjects' general characteristics were evaluated using descriptive statistics, the intra-group differences of the test results before and after the intervention were compared using paired sample t-tests, and the inter-group differences in the results before and after the intervention were evaluated using independent sample t-tests. The statistical significance level was set to 0.05. Results: Among the OLST, FRT, FSST, and TUG tests, the experimental group showed positive FSST results that were statistically significantly greater than the control group; the results of the other tests were also more positive for this group, but the differences between the groups were not statistically significant. The magnitude of the effects for both groups was clinically significant. Conclusion: Since inter-limb coordinated exercises for PNF applied to elderly women were found to produce good results for both static balance ability and dynamic balance ability, these exercises can be used in exercise programs to improve balance in elderly women.

Factors Related to Subjective Health Status in Community-Dwelling Older Adults Living Alone on Low Income (지역사회 거주 저소득 독거노인의 주관적 건강상태 관련요인)

  • Yi, Yumi;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.29 no.3
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    • pp.205-217
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    • 2022
  • Purpose: This study aimed to investigate the factors affecting the subjective health status (SHS) of low-income older adults living alone. Methods: This is a cross-sectional correlational study using secondary data analysis. Sociodemographic and health-related characteristics were included in this analysis. The health-related characteristics were categorized into three domains: physical, characterized by the number of chronic diseases and fall-related factors, timed up and go, and grip strength; psychological, in terms of depression and loneliness; and social, in terms of social support. Data were analyzed using descriptive analysis, t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis. Results: The mean SHS score was 2.46 out of five. Several factors influenced the SHS of low-income older adults living alone, including sex, age, level of education, monthly income, and the three domains. Four significant predictive factors of SHS in low-income older adults living alone were identified (42.5%): the number of chronic diseases, fear of falling, depression, and social support. Conclusion: SHS is a critical factor for older adults living alone on a low-income. Hence, evaluating SHS and developing interventions to improve it periodically is necessay. Such interventions should consider chronic disease management, screening and mediation for depression and fear of falling, and strengthening their social support systems.

Comparison of the Effects of Wii Balance Games and Mirror Self-Balancing Exercises on Knee Joint Proprioception and Balance in Chronic Stroke Patients (Wii 균형 게임과 자가 거울 균형 운동이 만성 뇌졸중 환자의 균형 및 무릎관절 고유수용성 감각에 미치는 효과 비교)

  • Sim, Gyeong-seop;Jeon, Hye-seon
    • Physical Therapy Korea
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    • v.24 no.1
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    • pp.30-40
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    • 2017
  • Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.

Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: a pilot randomized controlled trial

  • Kang, Hyungkyu;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.1 no.1
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    • pp.33-39
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    • 2012
  • Objective: The objective of this study is to investigate the effect of treadmill training with real optic flow scene on functional recovery of balance and balance self-efficacy in stroke patients. Design: Single blind, Randomized controlled trial. Methods: Nine patients following stroke were divided randomly into the treadmill with optic flow group (n=3), treadmill with virtual reality group (n=3), and control group (n=3). Subjects in the treadmill with optic flow group wore a head-mounted display in order to receive a speed modulated real optic flow scene during treadmill training for 30 minutes, while those in the treadmill with virtual reality group and control group received treadmill training with virtual reality and regular therapy for the same amount of time, five times per week for a period of three weeks. Timed up and go test (TUG) and activities-specific balance confidence scale (ABC scale) were evaluated before and after the intervention. Results: TUG in the treadmill training with optic flow group showed significantly greater improvement, compared with the treadmill training with virtual reality group and control group (p<0.05). Significantly greater improvement in the ABC scale was observed in the treadmill training with optic flow group and the tread mill training with virtual reality group, compared with the control group (p<0.05). Conclusions: Findings of this study demonstrate that treadmill training with real optic flow scene can be helpful in improving balance and balance self-efficacy of patients with chronic stroke and may be used as a practical adjunct to routine rehabilitation therapy.

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