• 한국전문물리치료학회지
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• 제27권3호
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• pp.178-184
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• 2020

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.123-128
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• 2018

Purpose: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. Methods: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. Results: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. Conclusion: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.

• 대한물리의학회지
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• 제15권4호
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• pp.75-85
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• 2020

PURPOSE: Cerebral palsy is a common cause of disability in children, requiring constant rehabilitation. Improving balance in children with cerebral palsy helps to alleviate daily movement and the quality of life. This study examines a program that combines Resistance Exercise and Group Exercise, and investigates the effect on trunk control ability, balance ability, maximum grip strength, and quality of life of children with cerebral palsy. METHODS: Totally, 9 children with cerebral palsy participated in this study. Resistance exercise was performed for 8 weeks, 40 minutes every day. Group Exercise was conducted for 8 weeks, 40 minutes each Sunday. All participants were evaluated by the Korean version of the trunk control measurement scale, pediatric reach test, grip strength test, and KIDSCREEN-52. RESULTS: The trunk control ability was significantly improved in all subcategories (p < .05). In the pediatric reach test, the left and right directions were significantly improved (p < .05). Maximum grip strength was significantly improved in both hands (p < .05). The quality of life significantly improved in total score, physical well-being, general moods, self-perception, autonomy, relationship with parents, and home life (p < .05). CONCLUSION: Considering the encouraging results, we propose to use Resistance Exercise and Group Exercise as programs other than rehabilitation treatment in hospitals, to improve motor function and quality of life of children with cerebral palsy.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.18-27
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• 2011

This study was to investigate the positive effects of specially designed trunk-stabilization exercise program on lower extremity balance of elderly with history of leprosy. In this participants, lower extremity functions has been undermined by the development of damage in peripheral nerves. A total of 40 elderly with history of leprosy were divided into 2 groups of equal size ($n_{1,\;2}=20$): a group that participated in the exercise program, and a control group that did not exercise but did continue to engage in normal daily activities (including walking). The exercise group exercised for 60 minutes 2 days a week for 12 weeks. Static balance ability was measured by asking study participants to a one leg standing test: dynamic balancing ability was measured with a tandem walking test and a timed up-and-go test. The participants in the exercise program and the control group were tested before and after completion of the exercise program for comparison, and then divided according to their ability to feel sensory in the soles of their feet into the categories of normal sensory group: group with sensory loss in one foot: and group with sensory loss in both feet. The participants in the exercise program showed a positive, statistically significant difference in static balance compared with the control group (p<.05) as measured using the one leg standing test. Similarly, the participants in dynamic balance (p<.05) as measured using the tandem walking and timed up-and-go tests. Finally, these improvements were related to the severity of sensory loss in the soles of the feet for all study participants.

• 한국운동역학회지
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• 제16권2호
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• pp.121-134
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• 2006

The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.201-206
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• 2017

Purpose: The aim of this study was to identify the effects of Pilates mat exercise may improve trunk muscle thickness and balance in healthy adults. Methods: Eighteen healthy adults participated in this study. They were randomly assigned to one of two groups: Pilates mat exercise group (n=9) and the control group (n=9). Subjects in Pilates mat exercise group performed the exercises three days per week for 6 weeks, which consisted of warm up, main workout, and cool down. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), multifidus (MF), and erector spine (ES) were measured using an ultrasonography. Balance ability was evaluated using Romberg test and limits of stability (LOS). Measurements were performed before training, 3 weeks after training, and 6 weeks after training. Results: There was a significant difference of RA, EO, IO, MF, and ES according to the main effect of time (p<0.05). There was a significant difference of EO, MF, ES, Romberg, and LOS according to interaction effect between the time and group (p<0.05). There was a significant difference only for LOS according to the main effect of the group (p<0.05). Conclusion: Pilates mat exercise did increase trunk muscle thickness and balance. However, the effect with respect to trunk thickness was limited. Pilates mat exercise appears to be more effective in improving muscles related to trunk extension and balance.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.156-164
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• 2022

Background: Low back pain (LBP) is a representative disease, and LBP is characterized by muscle dysfunction that provides stability to the lumbar spine. This causes physical functional problems such as decreased posture control ability by reducing the muscular endurance and balance of the lumbar spine. Pelvic compression using instruments, which has been used during recent stabilization exercises, focuses on the anterior superior iliac spine of the pelvis and puts pressure on the sacroiliac joint during exercise, making the pelvis more symmetrical and stable. Currently, research has been actively conducted on the use of pelvic compression belts and non-elastic pelvic belts; however, few studies have conducted research on the application effect of pelvic compression using instruments. Objects: This study aimed to investigate whether there is a difference in trunk muscular endurance and dynamic and static balance ability levels by applying pelvic stabilization through a pelvic compression device between the LBP group and the non-LBP group. Methods: Thirty-nine subjects currently enrolled in Daejeon University were divided into 20 subjects with LBP group and 19 subjects without LBP (NLBP group), and the groups were compared with and without pelvic compression. The trunk muscular endurance test was performed with 4 movements, the dynamic balance test was performed using a Y-balance test, and the static balance test was performed using a Wii balance board. Results: There was a significant difference the LBP group and the NLBP group after pelvic compression was applied to all tests (p < 0.05). In the static and dynamic balance ability test after pelvic compression was applied, there was a significant difference in the LBP group than in the NLBP group (p < 0.05). Conclusion: These results show that pelvic compression using instruments has a positive effect on both those with and without LBP and that it has a greater impact on balance ability when applied to those with LBP.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• Journal of Acupuncture Research
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• 제26권2호
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• pp.171-179
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• 2009

Objectives: The purpose of this study was to investigate the changes of obesity, blood composition and physical ability in obese children on body weight control program. Methods : The body weight control program included exercise, nutrition education and auricular acupuncture was performed 4 times a week during 12 weeks. 32 obese children whose body fat ratio were over 30% participated in this study. Measuring materials were body composition(weight, muscle mass, fat mass, fat ratio, BMI), physical measurement(height, waist circumference, chest circumference, hip circumference), physical ability(grip strength, sit-ups, sitting trunk flexion, sit-down stand-up test, standing long jump, opened eyes foot balance, side step), blood composition(WBC, Hb, ESR, Total Cholesterol, TG, GOT, GPT, BUN, Creatinine, Glucose) and survey(changes of eating habits, changes of living habits, knowledge of obesity, self-confidence, self-esteem). Results : From the results, positive changes were made in BMI, height, waist circumferences, chest circumferences, hip circumferences, sit-ups, sitting trunk flexion, sit-down stand-up test, standing long jump, opened eyes foot balance, side step, Hb, ESR, GOT, GPT and changes of eating habits through the body weight control program. Conclusions : This results suggest that body weight control program including exercise, nutrition education and auricular acupuncture may be effective for helping obese children.