Kim, Jin-Cheol;Lee, Moon-Kyu;Lee, Jeong-A;Ko, Hyo-Eun
PNF and Movement
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v.16
no.1
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pp.7-17
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2018
Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.
Purpose: This study examined the effects of backward walking training with task orientation on the functional walking ability of children with cerebral palsy. Methods: This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation facility with cross-over to the other intervention arm following a two-week break. For a total of 12 children with spastic hemiplegia cerebral palsy, the forward walking training group (n=6) underwent training three times a week for three weeks, 40 minutes a day, and the backward walking training group (n=6) was also trained under the same conditions. To identify the functional walking ability, variables, such as the walking speed, stride length, and step length, were measured using a walk analyzer (OptoGait, Microgate S.r.l, Italy). Results: Both groups showed significant increases in walking speed, stride length, and step length (p<0.01). The backward walking group showed more significant improvement in the walking speed from pre- to post-test (p<0.05). The gait characteristics were similar in the two groups (stride length and step length) but the walking speed in the backward walking group showed a mean difference between the positive effects higher than the forward walking group. Conclusion: Task-oriented backward walking training, which was conducted on the ground, may be a more effective treatment approach for improving the walking functions of spastic hemiplegia children than forward walk training.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.18
no.2
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pp.67-75
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2012
Background: Hemiplegic patients have the problems of the balance and weight shifting to the affected leg in walking. The aim of this study was to investigate the effect of unilateral stepping exercise combined with auditory feedback on balance and walking ability of the hemiplegic patients. Methods: Thirty hemiplegic patients were allocated in study group (n=15) or control group (n=15). General exercise and weight supporting exercise were conducted for the control group, and general exercises and unilateral stepping exercise combined with auditory feedback were conducted for the study group. Exercise were conducted three times a week for six weeks. Balance ability was measured by Berg Balance Scale (BBS), postural assessment scale for stroke (PASS), and performance-oriented mobility assessment (POMA). Walking ability was measured by time up and go test (TUG), 10m walk test (10mWT), and six minutes walk test (6MWT). Results: Balance and walking ability were significant increased in both group (p<.05). Balance and walking ability of the study group were more increased than that of the control group (p<.05). Conclusions: Unilateral stepping exercise combined with auditory feedback is more effective than weight supporting exercise to increase on balance and walking ability for the hemiplegic patients.
Background: Many studies regarding task-oriented training have recently demonstrated functional improvement in patients with post-stroke hemiparesis. The task-oriented approach is very diverse, and chronic stroke patients must have access to a sustained systematic treatment program to enhance their walking ability. Objectives: This study aimed to compare the effects of the task-oriented circuit training and treadmill training on walking function and quality of life in patients with chronic stroke. Methods: Fourteen patients with chronic stroke volunteered for this study. The subjects were randomly divided into a task-oriented circuit training group and a treadmill training group with 7 patients in each. Each training regimen was performed for 30 min a day and 3 days a week for 4 weeks. Assessment tools included the Timed Up-and-Go Test (TUGT), 10-m Walk Test, 6-min Walk Test (6MWT), and the Stroke Impact Scale (SIS). Results: The change in results of the TUGT, 6MWT, and SIS measured prior to and following the training regimens appeared to be significantly different between the two groups (p<.05). In addition, after the intervention, significant differences were found for all parameters in the task-oriented circuit training group and for the TUGT, 6MWT, and SIS in the treadmill training group (p<.05). Conclusion: The findings suggest that task-related circuit training and treadmill training may be helpful to improve walking function and quality of life of patients with post-stroke hemiparesis. Additionally, a task-related circuit training program may achieve more favorable outcomes than a treadmill program.
Purpose: This study aimed to determine how inclined-treadmill walking training with rhythmic auditory stimulation affects balance and gait in stroke patients. Methods: Ten chronic stroke patients, admitted to B hospital in Gangwon-do between August and October 2015, were trained 5 times per week for 4 weeks; each session lasted 30 minutes. To assess balance and gait before and after the training, the timed up and go (TUG) test, Berg balance scale (BBS), six minute walking test (6MWT), and three-dimensional spatiotemporal gait ability were used to measure the relevant variables. The data were analyzed using the paired t-test, and the statistical significance level was 0.05. Results: There were significant differences in the TUG, BBS, 6MWT, gait speed, cadence, single limb support (SLS), and symmetric index (SI) before and after training (p < 0.05). Conclusion: The results showed that the inclined-treadmill walking training with rhythmic auditory stimulation was effective at improving the balance and walking ability of stroke patients. Hearing training, using one of the basic procedures of proprioceptive neuromuscular stimulation, is considered to be an important aspect.
The purpose of this study was to determine if an 8-week therapeutic riding (TR) program was effective in improving the walking ability of students with intellectual disabilities. Thirteen students diagnosed with intellectual disabilities participated in the TR program. TR sessions were conducted twice a week (30 min per session), with a total of 16 rides taking place over an 8-week period. A gait measurement analyzer was used to measure progress based on a turn test (6-m walking and turning test), walk test (10-m walking), and timed up and go (TUG) test. Measurements were made three times: before horse-riding (P0), after 4 weeks (8 rides) of horse-riding (P1), and after 8 weeks (16 rides) of horse-riding (P2). Data analysis was conducted using SPSS software (ver. 22.0). Descriptive statistics were generated on the general characteristics of the subjects, and the Kolmogorov-Smirnov test was used to verify the normality of the data. Because of the lack of normality, the data were analyzed using a nonparametric method and the significance level was set to 0.05. Measurements of the duration of the forward gait cycle (s) in the turn test and the forward gait speed (m/s) in the walk test indicated improved walking ability after the TR program (p < 0.001); the stride length (% height) also increased significantly (p < 0.05). The walk test revealed a significant effect of the program on the duration of the forward gait cycle (p < 0.05), while there were significant improvements on the left and right of the elaborated strides (p < 0.001). No significant improvement in TUG test performance was observed after the TR program. In this study, an 8-week TR program had positive results on gait. Therefore, further research is merited, where TR programs are likely to improve the walking ability of individuals with intellectual disabilities.
This study was to determine the effect of 12-week balance training with visual feedback on balance and walking functions in patients with post-stroke hemiparesis. Twenty individuals with chronic stroke volunteered to participate in this study. They were randomly allocated to either experimental group (EG) or control group (CG), with 10 subjects in each group. Subjects from the group 1 underwent 15-min balance training with visual feedback and 15-min routine-scheduled physical therapy, and subjects from the group 2 performed 30-min routine-scheduled physical therapy only, which comprised mat exercise, strengthening, postural correction, and functional practice. Assessment tools were made with the Functional Reach Test (FRT), Timed Up and Go Test (TUGT), and 6 Min Walk Test (6MWT). In within-group comparison, the EG showed significant differences in all parameters (p<0.05), while significant differences were not found for the CG (p>0.05). In between-group comparison, the change values of the FRT and 6MWT appeared to be significantly greater for the EG than those of the CG (p<0.05). These findings suggest that balance training with visual feedback may be favorably used to improve balance and walking functions in patients with chronic post-stroke hemiparesis. Further studies with larger sample and long-term follow-up period need to generalize the results of this study.
Journal of the Korean Society of Physical Medicine
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v.5
no.2
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pp.193-201
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2010
Purpose : This study achieved to search the effect of the circuit exercise and conventional exercise on walking ability(walking speed, endurance, dynamic balance, speed, endurance and pedestrian crossing) in chronic stroke. Methods : Since is diagnosed by stroke, to 30 chronic stroke patients who more than 1 year past the 15 circuit exercise group, the 15 conventional exercise group random the circuit exercise group applied circuit exercise 3th 8 weeks each week after neurological treatment because assigning and the conventional exercise group executed round trip walk exercise in parallel bar 3th 8 weeks each week after neurological treatment. The data of 25 patients who complete experimental course were statistically analysed. Results : The results of this dissertation were as following : 1) There were significantly increased after experimental of 10 meter walk test, 6 minutes walk test and Timed "Up and Go" test in circuit exercise group (p<.001). 2) There were significantly increased after experimental of 2, 4 and 6 lane road crossing mobility in Walking circuit exercise group(p<.01). 3) There were significantly differences after experimental of 10 meter walk test, 6 minutes walk test and Timed "Up and Go" test change quantity between circuit exercise group and conventional exercise group(p<.05). 4) There were correlations were found between the TUG test and 2, 4 and 6 lane road (2 lane road; r=.463, p<.01., 4 lane road; r=515, p<.01., 6lane road; r=.710, p<.01), and there were correlations were found between the 10 meter walk test and 6 minutes walk test(r=.595, p<.01), TUG test(r=.662, p<.01) and 6 lane road(r=.527, p<.01). Conclusion : Even if improvement of walk function through training consists in room, transfer of actuality pedestrian crossing is no change outside the room. Because it is much variable of the weather, seasonal factor, temperature, pedestrian number, state of underneath etc. outside the room. Then, in room after direction promotion of walk function to be promotion of walk function in actuality life and need development of connectable training method consider.
Purpose : The neurologically impaired patients have sensory, motor, cognition, perception problems which cause reduction of body schema, balance control and postural control provoke disfunction. The purpose of this case report was to evaluate effects on gait&balance upon improvement of postural control for left hemiplegia. Methods : This study has performed single subject design from March to April 2013 for 6 weeks. The subject of this study was a 67years old female patient with left hemiplegia. Timed Up and Go (TUG) test and Functional Reach (FR) test were used as evaluation tool. The subject was treated 5 times a week for 30 minutes each. Results : The result is that the walking velocity was decreased, the ability of gait was improved than before the training. The length of FR was increased from 8.33cm to 22.67cm. Conclusion : According to the results, the treatment improves subject's ability of walking in this study.
Purpose: The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes. Methods: A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks. Results: Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost-test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program. Conclusion: The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.
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