• Physical Therapy Korea
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• v.24 no.3
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• pp.1-9
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• 2017

Background: The method of measuring the walking function of patients with chronic stroke differs depending on patients walking capability and environmental conditions. Objects: This study aimed to demonstrate the influences of walking capacity and environmental conditions on the results of short- and long-distance walk tests in patients with chronic stroke. Methods: Forty patients with chronic stroke volunteered for this study, and allocated to group-1 (<.4m/s, household walking, $n_1=13$), group-2 (.4~.8m/s, limited community ambulation, $n_2=16$), and group-3 (>.8m/s, community ambulation, $n_3=11$) according to their walking capacity. The 10-meter walk test (10MWT) and 6-min walk tests, (6MWT) were used to compare the short- and long-distance walk tests results, which were randomly performed under indoor and outdoor environmental conditions. Results: The comparison of the results obtained under the indoor and outdoor conditions revealed statistically significant differences between the groups in the 6MWT and 10MWT (p<.05). Post-hoc tests' results showed significant differences between groups-1 and -2 and between groups-1 and -3 in the 10MWT, and between group-1 and -3 in the 6MWT. Furthermore, in group-2 the 10MWT and 6MWT results significantly differed between the indoor and outdoor conditions, and the values measured under the indoor and outdoor conditions significantly differed between 10MWT and 6MWT (p<.05). Group-3 showed a significant difference in 10MWT results between the indoor and outdoor conditions (p<.05). Conclusion: These findings suggest that the results of the short- and long-distance walk tests may differ depending on the walking capacity of patients with chronic stroke and the environmental condition under which the measurement is made, and these effects were greatest for the patients with the limited community ambulation capacity.

• PNF and Movement
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• v.10 no.4
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• pp.1-7
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• 2012

Purpose : The purpose of this study was to evaluate the relationship between physical performance, such as gait and postural control, and cognition on as assessed by clinical tools in individuals with chronic hemiparetic stroke. Methods : Twenty-six patients who had hemiparetic stroke participated in this study, and were evaluated four common clinical measurements, including the Berg balance scale (BBS), 10 meter walk test (10MWT), 6 minute walking test (6MWT), and Montreal cognitive assessment (MoCA). Multiple regression analysis was used BBS score, 10MWT, and 6MWT as the dependent variables; MoCA score, post-stroke duration, age, and affected side as independent variables. Results : In the regression equation of the BBS score, the correlation coefficient (r) was 0.875, the coefficient of determination (R2) was 0.786, and the MoCA score was the most important variable for determining the BBS score. In the regression equation for the 10MWT, ther was 0.888, the R2 was 0.999, and the MoCA score was the most important variable for determining 10MWT. Finally, the r was 0.777, the R2 was 0.998, and the MoCA score was the most important variable for determining 6MWT in the regression equation of the 6MWT. Conclusion : The results show that cognitive abilities affect gait proficiencies in individuals with chronic hemiparetic stroke. Therefore, these results suggest that cognitive tests are necessary for examining and evaluating the abilities of postural control and gait performance for chronic stroke patients in research and clinical environments.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.595-609
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• 2016

Objective: The purpose of this study was to develop and validate the guidelines for Medic Work Table (MWT) based on the anthropometric data of medical technologists. Background: Users' anthropometric data such as sitting height, sitting elbow height, knee height, and so on are significant factors for designing comfortable and useful furniture. Thus, many guidelines for different types of desks and chairs based on the users' anthropometric data have been suggested to many researchers. However, few researches have been conducted to provide design guidelines for MWT for blood collecting task. Medical technologists often use their upper extremities to perform blood collecting task with high repetitions. These repeated motions could be a critical factor in the prevalence rate of Work-related Musculoskeletal Disorders (WMSDs). Therefore, a study on ergonomic design of MWT would be essential in preventing the WMSDs and improving the quality of the working environment of medical technologists. Method: This study suggested design guidelines for ergonomic MWT by focusing on the heights of the upper side and underside, depths of the inside and outside, and width of MWT through anthropometric studies and literature reviews. Afterwards, a new MWT was made using the suggested design guidelines for this study. Five healthy medical technologists participated to evaluate the original MWT and new MWT. All participants took part in the range of motion (ROM) test, electromyography (EMG) muscle activity test, and usability test to validate the suggested guidelines in this study. EMG signals of related muscles (Flexor Carpi Ulnaris, Extensor Carpi Ulnaris, Deltoid Anterior, and Biceps Branchii) were recorded through the surface electromyography system from both the original MWT and the new MWT. The ROM test of the shoulder and elbow flexion was also assessed using motion sensors. Results: The newly designed MWT showed decreased ROMs of the shoulder and elbow up to 22% and 18% compared to the original MWT. The muscle activities in the new MWT also showed a decrease of 13% in Anterior Deltoid, 6% in Biceps Brachii, 5% in Flexor Carpi Ulnaris, and 8% in Extensor Carpi Ulnaris muscle groups, compared to the original MWT. In the usability test, the satisfaction score of the new MWT was also 56.1% higher than that of the original MWT. Conclusion: This study suggested guidelines for designing MWT and validating the guidelines through qualitative and quantitative analyses. The results of motion analysis, muscle activity, and usability tests demonstrated that the newly designed MWT may lead to less physical stress, less awkward posture, and better physical user interface. Application: The recommended guidelines of the MWT would be helpful information for designing an ergonomic MWT that reduces physical loads and improves the performance of many medical technologists.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.470-478
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• 2021

Objective: This study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) balance exercise on the ability to balance and walk in patients with hemiplegia caused by stroke. Design: A randomized controlled trial Methods: Following baseline measurements, patients (n=24) with hemiplegia caused by stroke were randomized into two groups: the PNF balance group (n=12) that received PNF balance exercise and the balance group (n=12) that received general balance exercise. Each group joined the intervention for 30 minutes, 5 times per week for 6 weeks. Both groups performed the Timed Up and Go test (TUG) and Berg Balance Scale (BBS) for balance, as well as the 10-meter walking test (10MWT) and 6-minute walk test (6MWT) for walking. The data were collected both before and after the intervention. The paired t-test was used to compare the post-intervention changes compared with pre-intervention data. An independent t-test was used to analyze the differences in the dependent variables between the two groups. Results: After the 6-week intervention, both groups showed significant improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) parameters (p<0.05). The patients in the PNF balance group showed greater improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) than those in the balance group (p<0.05). Conclusions: PNF balance exercise shows improvements in balance and walking parameters in patients with hemiplegia caused by stroke.

• The Journal of Korean Physical Therapy
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• v.30 no.3
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• pp.79-83
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• 2018

Purpose: The purpose of this study was to investigate the effects of combined training using proprioceptive neuromuscular facilitation (PNF) patterns and treadmills on the balance and walking ability of stroke patients. Methods: Twenty-three stroke patients were randomized into a control group (n=11), receiving only treadmill training and an experimental group (n=12) receiving combined training. The use of both PNF exercise and treadmill were implemented in the combined training. Interventions were performed 5 times a week for 6 weeks. Balance ability was measured by a timed up and go (TUG) test. Walking ability was measured by a 10-meter walk test (10MWT) and a 6-minute walk test (6MWT). A paired t-test was used to compare differences between pre- and post-intervention and independent t-tests were used to compare between groups. Results: Changes in TUG, 10MWT, and 6MWT before and after interventions were significantly different for both the experimental group and the control group (p<0.05). In addition, within-group changes in the TUG, 10MWT, and 6MWT were more effective in the experimental group than in the control group (p<0.05). Conclusion: Combined training using PNF techniques and treadmills may be useful in improving the balance and walking ability of stroke patients.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.2
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• pp.63-70
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• 2021

PURPOSE: This study aimed to analyze the factors influencing the improvement of global synkinesis (GS) and gait in stroke patients by the weight shift exercise. METHODS: Twenty stroke patients were randomly assigned to experimental group I (n = 10) and experimental group II (n = 10). In experimental group I, weight shift with upper extremity exercises in a standing position were mediated and in experimental group II, upper extremity exercises in a standing position were mediated. These interventions were conducted in both groups for three sessions per week, 30 minutes per session over four weeks. Before the interventions, leg GS was measured using surface electromyography and the 10m walk test (10MWT). The same parameters were measured four weeks later. RESULTS: The GS and 10MWT of the experimental group I showed that there was a statistically significant difference between dorsiflexion (p < .05) and plantarflexion (p < .01) and 10MWT (p < .01). In experimental group II, there was a statistically significant difference only in 10MWT (p < .01). The comparison between the changes in both groups showed that in the case of GS, there was a statistically significant difference in the dorsiflexion (p < .01) and plantarflexion (p < .05), and in the 10MWT too (p < .05). CONCLUSION: GS of the lower extremities was decreased by improving posture control and enlarging soft tissues due to the symmetrical weight shift in experimental group I, which turned out to be effective in improving the gait speed.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.77-85
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• 2014

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

• PNF and Movement
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• v.13 no.3
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• pp.127-134
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• 2015

Purpose: The current study seeks to examine the effect of coordinative pattern exercises of the upper and lower extremities using harnesses and walking rails on the walking and balance abilities of chronic stroke patients, and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 16 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=8), on which coordinative pattern exercises of the upper and lower extremities were conducted, and a comparison group (n=8) that received typical exercise therapy. The experimental group underwent 30 minutes of typical exercise therapy and 30 minutes of coordinative pattern exercises of the upper and lower extremities, while the comparison group underwent typical exercise therapy for 30 minutes twice a day, five days per week for a six-week period. To evaluate walking ability, 10-m walking tests (10MWT) and 6-m walking tests (6MWT) were conducted. To assess balance ability, timed up and go tests (TUG) were performed. Results: After the intervention, significant (p<0.05) differences were seen in the 10MWT, 6MWT, and TUG in both the experimental and comparison groups. As for the 10MWT, the experimental group showed more significant improvement than the comparison group (p<0.05). In terms of the 6MWT, no significant differences were found between the groups, while the experimental group showed more significant differences than the comparison group in the TUG (p<0.05). Conclusion: The results from the current research indicate that training programs that apply coordinative pattern exercises of the upper and lower extremities with harnesses are extremely effective for improving the walking and balance abilities of chronic stroke patients.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.270-277
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• 2021

Objective: The purpose of this study is to compare the effect of static balance, lower extremity function, and gait ability between a lower extremity restrain robot gait training and a general robot gait training in subacute stroke subjects. Design: Two-group pretest-posttest design. Methods: A total of 12 subacute stroke patients were randomly divided into an Experimental group (n=6) and a control group (n=6). Both groups were performed for four weeks, three times a week, for 20 minutes. To compare the Static balance function, the center of pressure (COP) path-length and COP velocity were measured. The Fugl-Meyer assessment lower extremity (FMA-LE) were evaluated to compare the Lower Extremity function. 2D Dartfish Program and 10 Meter Walking Test (10 MWT) on Gait ability were evaluated to compare the gait function. Results: In the intra-group comparison, Experimental groups showed significant improvement in COP path-length, velocity, Lower Extremity Function, 10 MWT, Cadence, by comparing the parameters before and after the intervention (p<0.05). Comparison of the amount of change between groups revealed significant improvement for parameters in the COP path-length, velocity, Lower extremity function, 10 MWT by comparing the parameters before and after the intervention (p<0.01). Conclusions: The Experimental group showed enhanced efficacy for variables such as COP path-length, velocity, Lower extremity function, 10 MWT as compared to the control group.