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An Analysis of Effects of Water Perturbation Exercise on Physiological Cost Index and Gait Ability in Stroke Patients (수중 동요 훈련이 뇌졸중 환자의 생리학적 소비지수와 보행 능력에 미치는 효과 분석)

  • Park, Seungkyu;Park, Samheon
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.3
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    • pp.39-47
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    • 2016
  • PURPOSE : This study attempts to find the effects of water perturbation exercise performed on stroke patients in their physiological cost index and gait ability tests. METHOD : The subjects were 30 stroke patients, water perturbation exercise group was performed 3 day per week, for 40 minutes a day, for a period of eight weeks. The physiological cost index and gait of all subjects were assessed by using the polar, 6 Minute Walk Test (6MWT), and 10 meter Walk Test(10mWT) at pre training and post training. Paired t-test was used to analyze change before and after intervention in group. Pearson's correlation was used to analyze correlation of all variables. RESULT : Water perturbation exercise group showed increased physiological cost index. Water perturbation exercise increased gait ability, showing a significant difference. Showing the correlation between the relatively high amount between physiological cost index and 6 minutes walking test. CONCLUSION : From the result of the study, we found that water perturbation exercise was effective in improving physiological cost index and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the cardiovascular system and ability to walk. Through underwater training for stroke patients in the future on the basis of this study it is considered to require additional clinical studies on the impact on daily living and quality of life of stroke patients.

Analysis of Research about Pulmonary Rehabilitation of Patients with COPD (만성폐쇄성 폐질환 환자의 호흡재활 프로그램 관련 논문분석)

  • Park, Kyung-Min;Jang, Hee-Jung
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.312-322
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    • 2003
  • Purpose: This study is aimed to analyze the trend of research on pulmonary rehabilitation of patients with COPD (Chronic Obstructive Pulmonary Disease), and to suggest a direction for future research of pulmonary rehabilitation of COPD. Method: A total of 39 studies published from 1991 to 2002 were examined according to the year of publication, type of journal, characteristics of patients, rehabilitation program, research design, and instruments and research findings. Results: 1) The number of studies related to pulmonary rehabilitation of COPD patients has rapidly increased since 1996's (87.18%) 2) There were 10 studies published in the chest. There were 6 studies published in domestic journals and 33 studies published in international journals. 3) The samples in the studies were mostly outpatients whose lung function was moderate. 4) The total period of the pulmonary rehabilitation program shown in the literature was 5 to 12 weeks. The programs included exercise interventions, educational interventions and psychosocial interventions. 5) The outcomes of the pulmonary rehabilitation were measured with lung function, 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire. Research findings were found to be effective on 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire but not on lung function. Conclusion: Based on these findings, pulmonary rehabilitation should be further emphasized, and standardized protocols and community based pulmonary rehabilitation programs need to be provided. More qualitative research should also be conducted in the future to describe the experiences of the pulmonary rehabilitation of patients with COPD.

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Fall experience and dual-task during gait performance for community-dwelling persons with stroke

  • Kim, Min-Kyu;Kim, Eunjeong;Hwang, Sujin;Son, Dongwook
    • Physical Therapy Rehabilitation Science
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    • v.7 no.3
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    • pp.109-113
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    • 2018
  • Objective: The purpose of this study was to investigate the effects of fall experience and task complexity on gait performance in community-dwelling persons with chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Thirty-three persons who had a history of stroke participated in this study. The participants included 18 persons (aged mean 54.0, mean score of 24.6 points on the Montreal Cognitive Assessment, MoCA) with fall experience (faller group) and 15 persons (aged mean 53.7, mean score of 24.7 points on the MoCA) without fall experience (non-faller group) in the previous six months. This study measured balance and gait performance at two different conditions (with/without 70% of water filled in a 200 cc cup). The participants were clinically assessed using the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Berg Balance scale (BBS), Dynamic Gait Index (DGI), and Timed Up-and-Go (TUG) test. Results: After analyzation, persons in the faller group performed significantly better on the 10MWT, 6MWT, BBS, DGI, and the TUG test in the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). The persons in the non-faller group also performed significantly better in all outcome measures with the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). However, there was no interaction between fall experience and task complexity in the two groups. Conclusions: Our results showed that balance and gait performance depended on fall experience and task complexity but fall experience did not interact with task complexity. Clinicians should consider fall prevention and task complexity during therapeutic approaches in persons with hemiparetic stroke.

The Effect of the PNF Pattern Combined with Whole-Body Vibration on Muscle Strength, Balance, and Gait in Patients with Stroke Hemiplegia (전신진동자극훈련을 병행한 PNF 결합패턴 훈련이 뇌졸중환자의 근력, 균형 및 보행에 미치는 효과)

  • Choi, Kwang-Yong;Jeong, Hee-Yeon;Maeng, Gwan-Cheol
    • PNF and Movement
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    • v.15 no.2
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    • pp.185-194
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    • 2017
  • Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P<0.05). Significant differences between the PWBV and WBV groups were found (P<0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.

Effects of forward & backward walking training with progressive body weight supported on stroke patients' ambulatory ability

  • Kim, Kyung-Hoon;Lee, Suk-Min
    • 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.

The Effect of Dual-task Gait Training on Balance, Gait, and Activities of Daily Living for Patients with Parkinson's Disease -A Single-subject Experimental Design- (이중과제 보행훈련이 파킨슨병 환자의 균형, 보행능력 및 일상생활동작에 미치는 효과 -단일사례연구-)

  • Park, Hyun-Ju;Lee, Eon-Ju;Na, Gyu-Min;Kang, Tae-Woo
    • PNF and Movement
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    • v.17 no.3
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    • pp.339-351
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    • 2019
  • Purpose: This study identified the effects of dual-task gait training on balance, gait function, and activity of daily living in patients with Parkinson's disease. Methods: This study used a single-subject design. Two patients with Parkinson's disease participated in this study. Dual-task gait training was performed 1 hour per day 8 times during intervention phase. The subjects were measured 8 times in the baseline phase, 8 times in the intervention phase, and 8 times in the follow-up phase. The outcome measurements included a timed up and go test (TUG), a Berg balance scale (BBS), a 10 meter walk test (10MWT), a 6 minute walk test (6MWT), a dynamic gait index (DGI) and a Korean modified Barthel index (K-MBI). Results: When compared to the average of the baseline process, the data collected during the intervention period showed that the TUG and 10MWT results improved and the tendency line was above the baseline. In addition, BBS, 6MWT, DGI, and K-MBI values for both patients increased remarkably after the training. Conclusion: The results of this study revealed that dual-task gait training may be helpful to improve balance, walking function, and activity of daily living for patients with Parkinson's disease. Further studies need to confirm our findings.

Evaluation Tools for Patients with Neurologic Disorders Based on the ICF Model: A Survey of Korean Physical Therapists (ICF 모델 기반 신경계 환자 물리치료 평가 도구 사용 조사)

  • Lee, Ji-ah;Woo, Yong-Keun;Won, Jong-Im;Kim, Su-jin
    • PNF and Movement
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    • v.20 no.3
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    • pp.359-370
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    • 2022
  • Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.

Analysis of Body Composition and Functional Physical Performance in Urban-Dwelling Elderly Women with or without Obesity (도시 거주 여성 노인의 비만 유무에 따른 신체구성, 상⋅하지 근력 및 신체활동 능력 분석)

  • Choi, Seung-Jun
    • PNF and Movement
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    • v.19 no.3
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    • pp.331-340
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    • 2021
  • Purpose: The purpose of this study was to investigate the differences in body composition, upper and lower limb muscle strength, and functional physical ability in urban-dwelling elderly women with or without obesity. Methods: All study participants were assigned to the normal weight group (n=8, BMI<25) and the obesity group (n=7, BMI>25) based on their obesity rate. Anthropometric measurement was conducted and body composition was measured. For the upper and lower limb strength, grip strength and maximal isometric knee extension and flexion were evaluated by a dynamometer. The senior fitness test was performed to measure functional ability. Data analysis was conducted by the independent t-test and the alpha level was set at 0.05. Results: The waist, hips, and thighs of obese elderly women were thicker than those of normal-weight elderly women. This physical difference resulted from body fat mass, not muscle mass. Despite a similar level of limb muscle mass between the two groups, the upper limb grip strength was higher (24.00% for left, 19.95% for right) in the normal-weight women than the obese women (p<0.05), but otherwise there was no difference in maximal knee flexion or extension isometric strength. Functional physical ability showed no difference in a 30-second chair sit and stand test and a six-minute walk test, but a 30-second arm-curl (11.00% for left, 14.81% for right), back stretch (8.54cm for left, 8.99cm for right), chair sit and reach (9.22cm for left, 6.24cm for right), and 2.44 meter round trip walk (0.62 sec, 9.39%) were faster in performance for normal-weight elderly women than obese elderly women (p<0.05). Conclusion: Taken together, despite similar levels of upper and lower extremity muscle mass, normal-weight elderly women showed higher performance in upper limb strength, flexibility, and agility than obese elderly women, but there was no difference in lower extremity functional muscle strength and cardiopulmonary endurance.

Relationship of Cognitive Functions and Physical Activities in Persons with Chronic Stroke

  • Woo, Young-Keun;Hwang, Su-Jin
    • 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.

Comparison of sensorimotor training and cycling exercise for dynamic balance and gait function stroke patient: Single subject design (뇌졸중 환자의 동적균형 및 보행에 대한 감각운동 훈련과 사이클링 운동의 효과 비교 : 개별사례연구)

  • Yang, Hae-Duck;Oh, Duck-Won
    • Journal of Korean Physical Therapy Science
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    • v.17 no.1_2
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    • pp.1-9
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    • 2010
  • Background: The objective of this study was to determine whether sensorimotor training using an unstable surface affects dynamic balance and gait function in patients with hemiparesis, and to compare the effect of sensorimotor training with that of cycling exercise. Methods: Two subjects with post-stroke hemiparesis volunteered to participate in this study. Single-subject A-B design with alternating treatment was used for this study. Baseline(A) and intervention(B) phases were performed for 7 and 8 sessions, respectively. Sensorimotor training and cycling exercise were performed for 20 minutes in randomized order. Assessment tools were made by using a step test, timed up and go(TUG) test, and 6-minute walk test(6MWT). Results: Each of the participants improved in all three tests after the two interventions. Participants 1 and 2 showed the improvement for their assessment score after sensorimotor training in the step test by 42.1%(p<.05) and 58%, in the TUG, 31% and 19.5%, and in the 6MWT test, 32.3% and 10.6%(p<.05), respectively. After cycling exercise, participants 1 and 2 also improved in the step test by 32.5% and 53.1%, in the TUG, 27.4% and 18%, and in the 6MWT test, 28.8% and 3%. In statistical analysis between the two interventions, sensorimotor training showed a significant increased values in the step test for participant 1 and the 6MWT for participant 2 as compared with those of cycling exercise. Conclusion: Sensorimotor training and cycling exercise are helpful for improving dynamic balance and gait capacity. Furthermore, sensorimotor training may be more helpful than cycling exercise.

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