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The Effects of Lower Extremity Strengthening Program on Balance, Gait and Upper Limb Function in Patients with Stroke (뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과)

  • Kim, Ju-O;Lee, Byoung-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.6
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    • pp.114-123
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    • 2020
  • The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke.

Effects of Somatosensory Training on Upper Limb for Postural Control and Locomotion in Hemiplegic Stroke with Unilateral Neglect

  • Song, Bo-Kyoung
    • The Journal of Korean Physical Therapy
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    • v.27 no.5
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    • pp.332-338
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    • 2015
  • Purpose: The purpose of this study was to examine the effect of postural control and locomotion on improvement of two point discrimination (TPD), stereognosis (ST) through somatosensory training (SST) on the upper limb (UL). Methods: The subjects were 20 hemiplegia patients who have problems with unilateral neglect after stroke. The patients were divided into two groups, the experimental group (EG) and the control group (CG). In the EG, SST for TPD, ST was performed 18 times, three times a week for six weeks, together with physical therapy (PT) and occupational therapy (OT). In the CG conventional PT and OT without SST was performed for six weeks. Several assessment tools were used in comparison of groups; two point discrimination test (TPDT) on forearm (F), thenar (T), hypothenar (TH), thumb tip (TH-T), index finger tip (IN-T), stereognosis test (ST), postural assessment scale for stroke (PASS), and clinical test of sensory interaction on balance (CTSIB) and timed up and go test (TUG). Results: In the CG, conventional PT and OT resulted in statistically improved TPDT (F), ST, PASS, and TUG. In the EG, SST resulted in statistically improved TPDT (F, T, HT, TH-T, IN-T), ST, PASS, and TUG. TPDT-T, ST, and CTSIB with length of displacement with eye open (LDEO) also showed significant improvement between the groups. Conclusion: In both groups TPDT ST, PASS and TUG, and SST had effects on the UL and TPDT, ST and static postural control had greater effects compared with the PG. Therefore, we could assume that TPD and ST are very important in performing human activities including postural control and locomotion.

The Effect of Action Observation Training on Sit to Walk with Chronic Stroke Patients

  • Kim, Jin-Cheol;Lee, Hyun-Min
    • The Journal of Korean Physical Therapy
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    • v.27 no.6
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    • pp.413-418
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    • 2015
  • Purpose: This study was performed to examine the effect of action observation training on sit to-walk times in chronic stroke patients. Methods: Twelve stroke patients were randomly allocated to two groups, as follows: an action observation training (AOT) group and a scenery picture observation (SPO) group. The AOT group was engaged in video observation for 2 minutes 30 seconds with 12 ADL functional activities related to the sit-to-walk task: physical training was carried out in two repetitions lasting 2 minutes 30 seconds. The landscape imagery control group observed landscape picture for 2 minutes 30 seconds and then carried out the same physical training. The intervention involved a total of 12 sessions over 4 weeks, and each session lasted 30 minutes. The pre and post-tests measured the timed up and go test (TUG), Sit to stand test (STS), and Dynamic gait index (DGI). The Wilcoxon signed ranks test was used to compare pre-test and post-test result, and the Mann-Whitney U test was employed for comparison between groups. Results: The TUG time was significantly different between the AOT group and the SPO group. According to the findings, the experimental group's TUG was significantly decreased (p<0.05). In comparison of the two groups, there was no significant in STS or DGI between the AOT group and SPO group. Conclusion: This study showed that the intervention can be used to decrease TUG time. Our research suggests that action observation training has a positive effect on sit-to-walk times in 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.

The effect of Hominis Placenta Pharmacopuncture on Leg spasticity of stroke patients (A Pilot study, Double blind, Randomized, Controlled Clinical Trial) (중풍 환자의 하지 경직에 대한 자하거 약침의 효과 연구)

  • Noh, Ju-Hwan;Park, Jung-Ah;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm;Kim, Cheol-Hong
    • Journal of Pharmacopuncture
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    • v.12 no.4
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    • pp.97-110
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    • 2009
  • Objective : The purpose of this study is to determine the effect of Hominis Placenta Pharmacopuncture(HPP) on lower limb spasticity control in stroke patients. Methods : Twenty stroke patients with Leg spasticity were randomly divided into two groups, a Distilled water Pharmacopuncture(group I) and a HPP(group II). The number of Pharmacopuncture was 5 times a week and acupuncture treatment was 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), H-reflex/M-response ratio(H/M ratio), Berg Balance Scale(BBS) and Time Up & Go(TUG) were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p$<$.05) in BBS but no significant improvement in MAS, H/M ratio, and TUG. Group II showed significant improvement(p$<$.05) in MAS, BBS, and TUG, but no significant improvement in H/M ratio. The results showed significant difference in TUG, but no significant difference in MAS, H/M ratio and BBS between 2 groups. Conclusion : These results showed that HPP might decrease lower limb spasticity and increase leg motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on lower limb in spasticity by HPP.

Effects of Virtual Reality Based Video game and Rehabilitation Exercise on the Balance and Activities of Daily Living of Chronic Stroke Patients (가상현실기반 비디오게임과 재활운동이 만성기 뇌졸중 환자의 균형 및 일상생활동작에 미치는 영향)

  • Lee, Hyun-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.2
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    • pp.201-207
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    • 2013
  • 연구목적: 닌텐도 위를 이용한 가상현실기반 비디오게임 프로그램을 만성기 뇌졸중 환자에게 적용하여 균형능력 및 일상생활동작에 어떠한 영향을 미치는지 알아보고, 뇌졸중 환자의 재활프로그램으로서 적용 가능성이 있는지 알아보고자 한다. 연구방법: 만성기 뇌졸중 환자를 무작위로 가상현실기반 비디오게임 프로그램을 적용한 실험군(n=7)과 적용하지 않은 대조군(n=10)으로 구분하여 연구를 진행하였다. 연구에 참여한 모든 대상자에게 30분의 Bobath therapy와 15분간의 FES 치료를 기본적으로 실시하였다. 이에 더하여 실험군은 가상현실기반 비디오게임 프로그램을 1일 30분이내, 주 5회, 3주간 실시하였다. 대조군은 자전거 운동과 보행훈련으로 30분간 시행하였다. 실험 전 후 눈뜨고 외발서기(OLST; open leg standing test), Timed Up and Go(TUG) 검사, 10m 걷기 검사, Functional Independence Measure(FIM)를 측정하였다. 실험 전과 실험 후 측정값의 차이를 비교하기 위해 Wilcoxon Signed Ranks Test를 실시하였다. 그리고 각 측정값의 변화량에 대한 실험군과 대조군 사이의 차이를 알아보기 위해 Mann-Whitney U Test를 실시하였다. 연구결과: 실험결과는 다음과 같다. 1) 실험군에서는 FIM의 유의한 증가와 TUG, 10m 걷기 검사의 유의한 감소를(p<.05) 보였다. 대조군에서는 OLST의 증가와 TUG, 10m walking test의 감소가 나타났지만 통계적으로 유의하지 않았다. 오직 FIM에서만 유의한 증가가 나타났다(p<.05). 2) 실험 전 후의 실험군과 대조군의 각 측정값들의 평균차를 비교한 결과 실험군은 대조군보다 실험 전 후 OLST, TUG, 10m walking test 차이의 평균은 컸지만 통계적으로 유의하지 않았다. 결론: 이상의 결과로부터 가상현실기반 비디오게임이 만성기 뇌졸중 환자의 동적균형능력 및 일상생활동작 향상에 효과가 있음을 알 수 있었다.

Effects of Balance Training on Different Support Surface on Balance and Gait in Patients with Chronic Stroke

  • Kong, Hae-na;Bang, Dae-hyouk;Shin, Won-seob
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.57-65
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    • 2015
  • PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.

Correlation of Curved Walking Ability with Straight Walking Ability and Motor Function in Patients with Hemiplegia

  • Lim, Jae-Heon;Park, Jang-Sung;Seo, Sam-Ki
    • The Journal of Korean Physical Therapy
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    • v.23 no.3
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    • pp.13-19
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    • 2011
  • Purpose: In real life there are both straight-paths and curved-paths. To evaluate walking ability of both kinds, a figure-8 walking test (F8WT) was developed. The aim of this study was to validate the measure in hemiplegic patients with walking difficulties and to identify correlations of curved walking ability with straight walking ability, motor function, and walking performance ability. Methods: Twenty subjects participated in this study. Curved walking was measured by a F8WT. Straight walking ability was measured by a 10-meter walking test (10MWT). Dynamic balancea bility was measured by timed up and go (TUG) tests. Walking performance ability was measured using a modified motor assessment scale (MMAS). Motor function was measured by the Fugl-Meyer assessment (FMA) scale. Data were analyzed using Pearson correlation analysis. Linear regression analyses were performed to explore other functional tests in mobility ability by F8WT time, 10MWT (dependent variable). Results: There was a significant positive correlation of F8WT time with 10MWT and TUG. There was a significant negative correlation of F8WT time with MMAS and FMA-coordination. There was a significant positive correlation of 10MWT with TUG. There was a significant negative correlation of 10MWT with MMAS and FMA-coordination. The F8WT time for curved walking ability was attributed to 10MWT for straight walking ability as 94% level of contribution. Conclusion: The results suggest that the F8WT is a good instrument for measuring walking ability because there is a robust correlation of F8WT time with 10MWT, TUG, MMAS, and FMA-coordination in hemiplegic patients who, after stroke, have a mobility deficiency.

The Effects of Handrails during Treadmill Gait Training in Stroke Patients (뇌졸중 환자의 트레드밀 훈련 시 손잡이 유무 및 위치가 보행 및 균형에 미치는 영향)

  • Nam, Seok-Hyun;Kang, Kyung-Woo;Kwon, Jung-Won;Choi, Yong-Won;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.1
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    • pp.23-28
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    • 2013
  • Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.

The Effect of Berg Balance Scale Evaluating Frequency for Dynamic Balance and Walking Speed of Patients With Stroke (버그 균형 척도 평가 빈도수가 뇌졸중 환자의 동적 균형 및 보행 속도에 미치는 영향)

  • Choi, Hyun-Suk;Kim, Hyun-Jin
    • Journal of Korean Physical Therapy Science
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    • v.19 no.4
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    • pp.7-15
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    • 2012
  • Background : The purpose of this study is to determine the effect Berg Balance Scale(BBS) evaluating frequency on the walking speed and dynamic balance control in patient with stroke. Method : sixteen patient with stroke were randomly allocated to an experimental and control group of eight patients each. For the experimental group, we performed both general physical therapy and BBS and general physical therapy only for the control group. The general physical therapy programs for the 2 group were conducted for 1 hour 1 a day, 5 times a week for 4 weeks, and BBS for the experimental group was conducted for 1 time a week. Result : A comparison of the Berg Balance Scale(BBS). Timed Up Go test(TUG) and 10 meter Walking Test(10mWT) score obtained before and after the 4-week treatment revealed statistical significant different(p<.05) for the experimental group. BBS evaluated weekly and the first day and the last day evaluated in both groups after 4 weeks of BBS assessment improved significantly were (p<.05) especially in the assessment group on a weekly basis more improvement was. BBS weekly assessment group and the first day and on the last day, a group evaluation after 4 weeks in both the change of the TUG, 10mWT was significantly improved in the evaluation group(p<.05). Conclusion : 1 time a week of the BBS assessment of with stroke patients BBS, TUG, 10mWT that can help to improve. especially on a weekly basis, more has been improved.

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