• Title/Summary/Keyword: walking rehabilitation

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Role of Attentional Focus in Balance Training: Effects on Ankle Kinematics in Patients with Chronic Ankle Instability during Walking - A Double-Blinded Randomized Control Trial

  • Hyun Sik Chang;Hyung Gyu Jeon;Tae Kyu Kang;Kyeongtak Song;Sae Yong Lee
    • Korean Journal of Applied Biomechanics
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    • v.33 no.2
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    • pp.62-72
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    • 2023
  • Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

The Effects of COVID-19 Pandemic on the Recovery of Hip Fracture Patients

  • Young Yool Chung;Sung Nyun Baek;Tae Gyu Park;Min Young Kim
    • Hip & pelvis
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    • v.35 no.4
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    • pp.253-258
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    • 2023
  • Purpose: To figure out how complete control of family visits to prevent infection of coronavirus disease 2019 (COVID-19) affected the activity recovery of hip fracture patients admitted to nursing hospitals. Materials and Methods: Eighty-one patients with hip surgery in the two years prior to COVID-19 pandemic were classified as Group A, and 103 patients in the next two years were designated as Group B. The subjects' walking ability was evaluated by using the modified Koval index (MKI). In order to analyze the impact of the family visit control to the subjects, each group was classified into two different groups: (1) inpatients group who admitted to nursing hospitals and (2) home-treated patients. Additionally, statistical elements were processed in consideration of other factors that may affect the results of the experiment. Results: The MKI evaluated at 6 months postoperative was 3.31±1.79 in Group A and 2.77±1.91 in Group B, and it was meaningfully low after the pandemic (P=0.04). There was significantly low among both of Group A 2.74±1.76 and Group B 1.93±1.81 after the pandemic (P=0.03) among those treated at the nursing hospital. The rate of deterioration of the MKI was 35 (43.2%) in Group A and 57 (55.3%) in Group B, which increased by 12.1% after the pandemic. Conclusion: The pandemic had a negative effect on the recovery of postoperative activities of elderly hip fracture patients who admitted to nursing hospitals when family access was completely restricted to prevent infection.

Effect of home-based exercise program on balance, activities of daily living, depression and quality of life in elderly with chronic diseases (방문재활운동 프로그램이 만성질환 노인의 균형, 일상생활활동과 우울 및 삶의 질에 미치는 영향)

  • Il Yong Jang;Yo Han Song;Jae Woon Kim;Young Sung Moon
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.41-51
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    • 2024
  • Background: The purpose of this study was to identify the effect of home-based exercise program in elderly with chronic diseases on balance, activities of daily living, depression and quality of life. Design: One group pretest-posttest design Methods: The subjects consisted of 21 elderly people over the age of 65 years with chronic diseases lived in seo-gu, Gwangju. Home-based exercise program was performed twice a week, for an hour, during 6 weeks under supervision of an experienced instructor. The home-based exercise program was structured to last a total of 1 hour, consisting of 10 minutes of warm-up, 30 minutes of main exercises, and 20 minutes of concluding exercises. For the warm-up, we performed range of motion, stretching, and flexibility exercises. The main exercises comprised of strength, weight-bearing and balance exercises, and endurance exercises. The concluding exercises were tailored to the individual's home environment and needs, including task-oriented daily living training such as getting up from bed, moving to the restroom, and walking indoors. The subjects were assessed before and after the exercise program with berg balance scale(BBS), Korean-version modified barthel index(K-MBI), euro quality of life questionnaire 5-dimensional classification(EQ-5D), and geriatric depression scale short form-Korea(GDSSF-K). The collected data was analyzed using SPSS Win 18.0 program. Results: The results showed statistically significant difference in all domains of the BBS, K-MBI, EQ-5D, GDSSF-K after the exercise program. Conclusion: These results suggest that Home-based exercise program has resulted in a significant improvement on ADL, depression and quality of life in elderly with chronic diseases.

Development of Wireless Ambulatory Measurement System based on Inertial Sensors for Gait Analysis and its Application for Diagnosis on Elderly People with Diabetes Mellitus (관성센서 기반의 무선보행측정시스템 개발 및 노인 당뇨 환자 보행 진단에의 응용)

  • Jung, Ji-Yong;Yang, Yoon-Seok;Won, Yong-Gwan;Kim, Jung-Ja
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.2
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    • pp.38-46
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    • 2011
  • 3D motion analysis system which is currently widely used for walking analysis has limitations due to both necessity of wide space for many cameras for measurement, high cost, and complicated preparation procedure, which results in low accessability in use and application for clinical diagnosis. To resolve this problem, we developed 3-dimensional wireless ambulatory measurement system based on inertial sensor which can be easily applicable for clinical diagnosis for lower extremity deformity and developed system was evaluated by applying for 10 elderly people with diabetes mellitus. Developed system was composed of wireless ambulatory measurement module that consists of inertial measurement unit (IMU) which measures the gait characteristics, microcontroller which collects and precesses the inertial data, bluetooth device which transfers the measured data to PC and Window's application for storing and processing and analyzing received data. This system will utilize not only to measure lower extremity (foot) problem conveniently in clinical medicine but also to analyze 3D motion of human in other areas as sports science, rehabilitation.

Effects of the Dual-Task Training on Stroke Patients : A Systematic Review and Meta-analysis (이중과제 훈련이 뇌졸중 환자에게 미치는 영향 : 체계적 고찰 및 메타분석)

  • Won, Kyung-A;Lim, Seung-Ju;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.7-25
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    • 2020
  • Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

The Effects of Visual Rhythmic Stimulation in Gait and Proprioception with Chronic Stroke Patients (시각리듬자극이 만성뇌졸중 환자의 보행과 고유수용감각에 미치는 영향)

  • Cho, Nam-Jeong;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3353-3357
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    • 2010
  • The purpose of this study is to investigate the effect of visual rhythmic stimulation in gait ability and proprioception in chronic stroke patients. Twenty-one persons after six months post stroke participated in pre and post test control. The subjects were randomly assigned to a rhythmic visual stimulation(RVS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the proprioception test and gait characteristics by gait analysis. In gait characteristics, the walking speed, cadence and the TUG time were significantly different from RVS group. The proprioception were significantly different RVS and control group. This study showed that the RVS training increased better functional activity by postural adjustment and gait learning of chronic stroke patients than that of control group. And so, the RVS training of hemiplegic patients was very important to successive rehabilitation. A continuous examination of RVS training could be practical use of physical therapy with exercise.

Clinical Results of ACL Reconstruction -Bone-Patellar Tendon-Bone vs Hamstring Tendon Autograft- (자가 골-슬개건-골 및 슬괵건을 이용한 전십자인대 재건술후 결과 비교)

  • Song, Eun Kyoo;Lee, Keun Bae;Seo, Hyoung Yeon;Seol, Jong Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.91-96
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    • 1999
  • Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

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The Effects of Speed Variations in Treadmill Training on Thickness of Lower Extremity Muscles (속도가 다른 트레드밀 훈련이 다리 근두께에 미치는 영향)

  • Park, Chi-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.363-370
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    • 2016
  • The purpose of this study was to determine the effects of speed variations in treadmill training on the thickness of lower extremity muscles. A total of 36 university students were divided into three groups: MVTG (n=12), HVTG (n=12), and ATG (n=12). Subjects in MVTG underwent treadmill training with their own average speed; those in HVTG underwent treadmill training with 130% speed of their own average speed; and those in ATG underwent treadmill training with alteration of speed, between 100% and 130% of their own average speed. Treadmill training was performed for 60 minutes a day, three times per week, for a total of 6 weeks. Ultrasonography was used to compare the muscle thickness between rectus femoris, vastus lateralis, gastrocnemius, and tibialis anterior. The result was as follows: The rectus femoris, vastus lateralis, and gastrocnemius were significantly increased after the training period, and they also were statistically significant in interaction. Moreover, tibialis anterior was also significantly increased. Therefore, compared to the average-speed treadmill training, speed variations had a greater effect on thickening the lower extremity muscles. In the near future, we will conduct a study applying the findings from this study in a rehabilitation program for patients with gait disturbance due to nervous or musculoskeletal system disease.

A Systematic Review on Accelerometer to Measure Activity of Daily Living of Patients with Stroke (뇌졸중 환자의 일상생활활동 평가도구인 가속도계에 대한 체계적 고찰)

  • Lee, Joo-Hyun;Park, Jin-Hyuck;Kim, Yeonju;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.57-69
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    • 2016
  • Objective: The purpose of this study was to systematically review the articles using accelerometer to measure activity of daily living of patients with stroke. Methods: Depending on selection criteria, 13 studies were searched for PubMed, EMBASE, and Cochrane library database from February 2014 to March 2014. A total of 331 papers were searched, and 13 of these were selected. Results: In studies of 13 selected, acute, subacute, and chronic patients with stroke were enrolled. The kind of accelerometer was uniaxial, biaxial, and triaxial, activity monitor. Measurement activities were mainly arm activity, walking activity, and attachment sites were also various depending on the measurement activities. A measured variable was the total number of activities, the movement speed of the patients, ratio between affected and non-affected, and motion analysis. The result indicated that significant correlation with the other assessment tools in all studies. Conclusions: Accelerometer will be applied with a tool for measuring activity of daily living of patients with stroke, depending on activities characteristics. Further, we need accelerometer studies to apply with a variety of assessment in clinical practice or community settings.

Clinical Features according to the Frequency of Acute Exacerbation in COPD

  • Lee, Seung-Jun;Lee, Seung-Hun;Kim, Yu-Eun;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Kim, Jin-Hyun;You, Jin-Jong;Yoon, Chul-Ho;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.367-373
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    • 2012
  • Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010, were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients' medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [$FEV_1$], 45% vs. 65.3%, p=0.001; $FEV_1$/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p<0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.