• The Journal of Korean Physical Therapy
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• 제23권3호
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• pp.71-77
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• 2011

Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

• 대한물리의학회지
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• 제14권4호
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• pp.45-53
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• 2019

PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

• 대한통합의학회지
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• 제8권4호
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• 대한한의학회지
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• 제33권1호
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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.

• PNF and Movement
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• 제19권1호
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• pp.105-113
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• 2021

Purpose: The purpose of this study was to investigate the effect of trunk-stabilization training using stabilizing reversal and rhythmic stabilization techniques of PNF on trunk muscle strength and respiratory function in elderly stroke patients. Methods: There were 26 stroke patients included in the study. Patients were divided into two groups, and all patients performed exercise 30 min five times per week for six weeks. The experimental group performed trunk stability exercise using stabilizing reversal and rhythmic stabilization techniques of PNF, and the control group performed flexibility and strength training. Trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure were measured to determine the changes after the intervention. For statistical processing, a paired t-test was performed within the group, and the value after intervention was performed as an independent t-test to find out the difference between the two groups. Results: In the experimental group, all of the trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure showed significant differences according to the intervention. In the control group, there were statistically significant differences in trunk muscle strength and forced vital capacity, but the maximum inspiratory pressure and the maximum expiration pressure did not show any statistical change. Conclusion: From these results, it can be seen that the trunk stability exercises that use the proprioceptive neuromuscular promotion method of stable reversal and rhythm stabilization can be a good intervention for the respiratory function of stroke patients.

• PNF and Movement
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• 제15권3호
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• pp.333-341
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• 2017

Purpose: This study was to explore the effects of trunk exercise using PNF combined with treadmill training on balance and walking ability in patients with Parkinson's disease. Methods: This study included 16 patients with Parkinson's disease. Participants were randomly assigned to 2 groups: an experimental group (n=8) and a control group (n=8). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (trunk exercise using PNF) and control group (conventional training) participated in a 30-minute exercise program. Both groups performed the training 5 times per week for 4 weeks. Disease severity (determined using the unified Parkinson's disease rating scale motor subscale, UPDRS-3), balance (determined using the Berg balance scale, BBS), walking speed (determined using the 10-meter walking test, 10MWT), and walking endurance (determined using the 6-minute walking test, 6MWT) were measured at baseline and after 4 weeks. Results: Pre- to post-intervention improvement was noted on all outcome measures for both groups (p<0.05). Post-intervention, there was a significant improvement in the experimental group as compared to the control group for the following measured outcomes (p<0.05): UPDRS-3 (p=0.03; 95% CI, -5.52 to -0.24), BBS (p=0.04; 95% CI, 0.59 to 6.45), 10MWT (p=0.01; 95% CI, -2.19 to -0.42), and 6MWT (p=0.04; 95% CI, 1.81 to 96.72) Conclusion: The results of this study revealed that trunk exercise using PNF plus treadmill training improves balance and walking ability as compared to conventional training plus treadmill training in patients with Parkinson's disease.

• 대한물리의학회지
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• 제12권1호
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• pp.25-33
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• 2017

PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS: A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14). All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS: The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION: The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.

• 대한물리의학회지
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• 제11권1호
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• pp.1-9
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• 2016

PURPOSE: This study compared the effectiveness of trunk control exercise performed on an unstable surface with that of general balance exercise on dynamic balance in the patients with chronic stroke. METHODS: The persons of this study were thirty-seven chronic stroke patients were recruited and randomly divided into 2 groups; (1) those who performed trunk control exercise on a foam roll and (2) those who performed general balance exercise. The exercises were performed 5 times a week for 4 weeks. To determine the effectiveness of the 2 types of exercises, we measured dynamic balance at the beginning of the exercises and again after 4 weeks at the completion of exercises program. RESULTS: After 4 weeks of exercise, both the groups showed increased Berg's balance scale and timed-up-and-go test (p<.001) scores. However, Trunk control exercise group was more effective than general balance exercise group was in increasing the Berg's balance scale (p<.01) and timed-up-and-go test (p<.05) scores. CONCLUSION: We suggest that trunk control exercise may be effective in increasing the balance ability of patients with chronic stroke than general balance exercise. Thus, trunk control exercise is important for such patients. Further studies are needed for better understanding of the effectiveness of trunk control exercise in chronic stroke patients.

• 한국산학기술학회논문지
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• 제12권3호
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• pp.1244-1252
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• 2011

본 연구의 목적은 슬링을 이용한 편마비 환자의 체간-골반 안정성 집중훈련 시 체간의 근활성도 및 균형능력에 미치는 효과를 알아보고자 하였다. 6개월 이상에서 1년 된 편마비로 진단 받은 입원 환자 20명을 대상으로 무작위 추출하여 두 그룹으로 나누었다. 실험은 4주간, 주 5회, 1회당 30분간 운동치료를 시행하였고, 대조군(n=10)은 일반적 운동훈련만 적용하였고, 실험군(n=10)은 일반적 운동훈련 및 슬링을 이용한 체간-골반 안전성 집중훈련을 실시하였다. 훈련 효과를 알아보기 위해 훈련 전 후에 체간조절능력, 근활성도, 균형능력을 각각 측정하였다. 훈련 후, 유의한 차이는 실험군에서 체간조절능력(TIS)(p<.001), 특히, 정적조절능력(p<.05), 동적조절능력(p<.01), 협응능력(p<.05), 근 활성도는 RA(p<.001), EO(p<.001), ES(p<.001), Multifidus(p<.05), FMA (Balance)(p<.01), MTD-Balance에서는 정적(p<.001), 동적균형능력(p<.001) 모두 각각 유의한 차이를 보였다. 이로써 슬링을 이용한 체간-골반 안정성 집중훈련은 체간의 근활성도와 균형능력 향상에 효과적인 치료임을 증명하였고, 균형에 있어서 체간-골반 안정화 및 조절의 중요성을 확인할 수 있었다.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.10-20
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• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.