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Gait Training Strategy Focusing on Perceptual Learning for Improved Gait Capacity in Stroke Survivors

  • Jung, Jee Woon
    • The Journal of Korean Physical Therapy
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    • v.32 no.5
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    • pp.283-289
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    • 2020
  • Objective: The purpose of this study was to determine the force of lower extremities, the change in walking ability on the ground by applying a walking training program based on perceptual learning to improve gait capacity of chronic stroke patients. Method: This study included Twenty-four patients with chronic stroke. Using a perceptual-based gait training, the experimental group trained twice a day for 30 minutes each time, 5 times a week, for a total of 8 weeks. The control group underwent ground gait training that excluded the element of a perceptual training for 30 minutes, 5 times a week for 8 weeks. Results: In the two groups, the maximum forefoot pressure after intervention was significantly different in both the LEPGT and GGT (p<0.05). The maximum midfoot pressure was significantly different in LEPGT (p<0.05). There was a significant difference in the maximum heel pressure after intervention between the two groups (p<0.05). As a result of comparing the change in step length and stride length after intervention in the two groups, there was a significant difference between the two groups (p<0.05). Conclusion: Both gait training programs was found that gait training based on perceptual learning and ground gait training were the training for improving the functional gait of stroke patient. Perceptual learning gait training utilizing intensive perceptual awareness was the training for improving gait capacity within the period than ground gait training.

Effect of Dual Task Training in Visual Control and Unstable Base on the Gait of Stroke Patient

  • Lee, Sa Gyeom;Kim, Yang Rae
    • Journal of International Academy of Physical Therapy Research
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    • v.6 no.1
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    • pp.788-794
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    • 2015
  • This study examines changes in walking ability among patients with stroke after applying dual-task training under the condition of visual control and unstable supporting ground; the purpose is to provide reference data for selecting intervention methods that enhance the walking ability of patients with stroke. Among the patients with stroke who received rehabilitation treatment(at Rehabilitation Hospital B in Gyeonggi, South Korea from May 2014 to July 2014), 29 patients were selected as research subjects; all of them understood the purpose and contents of this research and agreed to participate in the experiment. The research subjects were divided into a visual control and unstable supporting ground dual-task(VUDT) group(10 patients), a visual control dual-task(VDT) group(10 patients), and an unstable supporting ground dual-task(UDT) group(9 patients); all of the subjects received 30-minute trainings, three times a week for a total of four weeks. A Timed-Up-and-Go(TUG) test was performed to investigate the change of walking function among the subjects, and a 10m walking test was conducted to measure their walking speed. According to the study results, all three groups showed significant differences after dual-task training; the dual-task training group under the condition of visual control and unstable supporting ground showed the most prominent change. This study confirmed that dual-task training using visual control and unstable supporting ground has a positive impact on the walking ability of patients with stroke. Through the study results, we found that implementing dual-task training under the condition of visual control and unstable supporting ground can more effectively improve the walking ability of patients with stroke, rather than performing visual control dual-task training or unstable supporting ground dual-task training only.

A Comparison of Underwater Gait Training with Additional Weight Application and Over-ground Gait Training to Improve Balance and Lower Extremity Strength in Persons with Stroke

  • Park, Jae-Ho;Chung, Yijung
    • The Journal of Korean Physical Therapy
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    • v.29 no.2
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    • pp.101-107
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    • 2017
  • Purpose: This purpose of this study was to compare additionally applied weight underwater gait training and over-ground gait training to improve balance and lower extremity strength in stroke patients. Methods: Subjects were randomly allocated into two groups. Underwater gait training group (n=10) and Over-ground gait training group (n=9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 6 weeks. All subjects were assessed with the Berg balance scale test, the timed up and go test, and the medical research council test pre and post intervention. A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set at p<0.05. Results: The results showed that subjects in the underwater gait training group had a significantly increased Berg balance scale, timed up and go, and medical research council scores (p<0.05), and over-ground gait training group showed a significantly increased medical research council score (p<0.05) after intervention. The underwater gait training group showed a more significant improvement in medical research council, Berg balance scale and the timed up and go test scores compared to the over-ground gait training group (p<0.05). Conclusion: Findings of this study suggest that applying additional weight during underwater gait training improves lower extremity strength and balance in stroke patients. It' findings can contribute to the development of more efficient rehabilitation for stroke patients.

Effects of Ground Obstacle Walking Combined with Treadmill Training on Gait Ability in Chronic Stroke Patients -A Preliminary Study-

  • Jung, Young-Il;Woo, Young-Keun;Won, Jong-Im;Kim, Yong-Wook
    • PNF and Movement
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    • v.19 no.2
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    • pp.287-301
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    • 2021
  • Purpose: Gait training for stroke patients focuses on adjusting to new environments to facilitate outdoor walking. Therefore, the purpose of this study was to identify the effects of various ground obstacle walking combined with treadmill walking on the gait parameters and functional gait ability of chronic stroke patients. Methods: Twenty-four chronic stroke patients were divided into two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group received a combined gait training using various ground obstacle walking and treadmill walking (VGOW) five times/week for four weeks. The control group received traditional treadmill training (TW) five times/week for four weeks. Patients were evaluated using the figure-8 walk test (F8WT) and the Functional Gait Assessment (FGA) before and after each intervention. Results: The ANCOVA results showed that both treatments significantly influenced F8WT steps, F8WT time, and FGA score. The paired t-test results showed a significant improvement in F8WT steps, F8WT time, and FGA score in the experimental group compared to those in the control group. Conclusion: Combined gait training using various ground obstacle walking and treadmill walking can improve gait ability in chronic stroke patients.

Effect of backward walking training using an underwater treadmill on muscle strength, proprioception and gait ability in persons with stroke

  • Kum, Dong-Min;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.6 no.3
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    • pp.120-126
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    • 2017
  • Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on strength, proprioception, and walking ability in persons with stroke. Design: Randomized control trial. Methods: Twenty eight subjects participated in the study in which they were randomly assigned to either the underwater backward treadmill training (UBTT) group (n=13) or the BTT group (n=15). In both groups, forward gait training was performed for 20 minutes on the ground treadmill. The UBTT group performed backward gait on an underwater treadmill for 20 minutes while the BTT group performed backward gait on a ground treadmill for 20 minutes. The gait training in each group was performed twice a week for a total of six weeks. Muscle strength, proprioception, and gait ability was assessed using a digital power meter, joint angle recurrence method using the smartphone protractor application, the Figure-of-Eight walk test (F8W) and the functional gait assessment (FGA) respectively. Results: Both groups showed significant improvement in strength, F8W and FGA scores after training (p<0.05). However, there was no statistically significant difference between the two groups. Both groups showed significant improvement in proprioception after training (p<0.05). In the comparison between the two groups, there was a greater significant change in the UBTT group for joint proprioception (p<0.05). Conclusions: In this study, it was found that both backward treadmill gait training programs were effective on strength, proprioception, and gait ability, and that underwater training was particularly effective on proprioception compared to ground training.

Effects of Aquatic and Ground Obstacle Training on Balance and Muscle Activity in Patients With Chronic Stroke

  • Hwang, Hyun-chul;Kim, So-hee;Kim, Tae-ho
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.35-41
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    • 2019
  • Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

A Study on the Core Muscle Activation Characteristics of Suspension Training by Ground Type (지면의 유형에 따른 서스펜션 트레이닝의 코어근육 활성화에 대한 연구)

  • Yoon, Wan-Young
    • Journal of Digital Convergence
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    • v.18 no.2
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    • pp.483-487
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    • 2020
  • In this study, the effects of suspension training according to the types of ground. Fourteen healthy male college students measured for the characteristics of core muscle activity in suspension training on two different types of grounds, normal flat and unstable ground using a gym ball. EMG (Electromyography) was exploited to measure the activity of the core muscles according to the types of the ground. Muscle activity of the abdominal muscles, external oblique muscles, internal oblique muscles, and lower lumbar standing muscles was measured. The variables in analyses were measured by the means of % MVC method to standardize the EMG signal according to the ground type for each core muscle. In order to verify the differences in core muscles according to the type of ground the paired t-tests were performed at the significance level of 0.05 (p<.05). As a result of measuring the activity of the core muscles according to the various types of grounds, the difference between muscle characteristics obtained in two different grounds did not appear to be statistically significant. However, the result is an important clue to reconsider the notion that the training effect on the unstable ground is generally superior to the effect on the stable ground in the core muscle training. The type of ground in the core muscle training has been found not to significantly affect the muscle activation according to the results of this study. Regardless of the type of exercise program, hence, the difference in muscle activation will not be insignificant even with the standardized program strengthening core muscles.

The Effect of Backward Walking Training Methods on Walking in Stroke Patients

  • im, Sang-Jin;Jeon, Chun-Bae;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.23 no.3
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    • pp.21-27
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    • 2011
  • Purpose: The purpose of the present study was to examine, in stroke patients, differences between backward walking training applied on a treadmill and the same training applied on the ground. Methods: Twenty seven stroke patients were divided into a treadmill backward walking group of 14 patients and a ground backward walking group of 13 subjects. Each group performed their respective training method for 8 weeks (15 min per day, 4 days a week). Walking ability was measured using a 10 m MWS (Maximal Walking Speed) test and the GAITRite system to examine changes in walking. Cadence, stridelength, step time, step length and symmetry index of the less affected side were measured to examine changes in stance phase of the lower extremity of the more affected side. Results: 10 m MWS, cadence, stride length, step time and step length of the less affected side significantly increased and symmetry index significantly decreased after training in both groups. The treadmill backward walking group experienced a significantly greater increase in step time and step length and a significantly greater decrease in symmetry index than the ground backward walking group. Conclusion: The two walking training methods were effective for improving stability in stance phase of the lower extremity of the more affected side, but the treadmill method was more effective. The present study is meaningful in that it analyzed the effects of backward walking training methods on walking and the differences of the training methods to provide information necessary for effective treatment of stroke patients.

The effects of balance training on balance pad and sand on balance and gait ability in stroke patients (밸런스 패드와 모래에서의 균형운동이 뇌졸중 환자의 균형과 보행에 미치는 영향)

  • Song, Gui-bin;Park, Eun-cho
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.1
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    • pp.45-52
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    • 2016
  • PURPOSE: The purpose of this study was to determine the effects of balance training on balance pad and sand on balance and gait ability in stroke patients. METHODS: Sixty stroke patients were divided into a Balance Pad group(BPG, N = 20), a Sand group (SG, N = 20) and a Hard Ground group (HGG, N = 20) randomly. The subjects in the Hard Ground group stood in a comfortable position, faced a therapist, then threw a Swiss ball back and forth. They then performed balance training in which they raised and lowered their ankles while facing forward or moved objects from one table to another. The BPG performed same tasks in HGG, on an unstable surface using a balance pad. The SG performed same tasks on sand ground. All groups received training 30min per day, five times per week, for eight weeks. RESULTS: After intervention, all groups showed significant increases balance and gait components. And the BPG and the SG showed significant increase in weight distribution rate, Sway length and BBS compared with the HGG, but there was no significant difference in Cadence, Stride length among three groups. CONCLUSION: According to the results of this study, balance training on unstable surface using balance pad and sand was more effective in improving balance in stroke patients.

Effect of Acute Aquatic Plyometric Training on Muscle Strength, Edema and Pain

  • Kim, Byung Kwan;Jeong, Hwan Jong
    • International Journal of Internet, Broadcasting and Communication
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    • v.14 no.1
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    • pp.224-232
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    • 2022
  • The purpose of this study was to investigate the pre- and post-exercise performance, edema, and pain of plyometrics in water and land environments. Twelve males in their 20s were selected as subjects and performed 10 sets of squat jumps 10 times in 2 environmental conditions (water and ground). There was no significant difference in iEMG of vastus medilais according to exercise conditions and time. In MPV of CMJ, there was no significant difference according to exercise conditions and time. The thigh circumference showed a significant difference according to the exercise condition and time, and was higher in the ground condition after exercise. There was a significant difference in pain according to the exercise condition and time, and it was found to be high after exercise, 48 hours, and 72 hours in the ground condition. We believe that plyometric training in an aquatic environment will have less swelling and pain compared to plyometric training conducted in a land environment, and the pain will improve quickly, so we think that training can be conducted in a relatively shorter period than in the land environment.