• PNF and Movement
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• v.9 no.3
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• pp.41-48
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• 2011

Purpose : The purpose of this study was to describe the Inter-expert cooperation strategy for community ambulation in stroke patient. Methods : The data was collected by stroke patient. We applied the Inter-expert cooperation strategy for community ambulation to stroke patient. Parameters of result were collected for using the 10m walk test, 6 minute walk test and ICF assessment sheet. Results : Significant differences were observed the stroke patient for 10m walk test, 6 minute walk test and ICF assessment sheet. stroke patient improved all test. Conclusions : Inter-expert cooperation strategy applied community ambulation is very useful and effective. It is effective in clinical practice.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.176-181
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• 2017

Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.6
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• pp.2788-2794
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• 2013

The study was conducted to determine the effect of community ambulation training and treadmill training on the gait ability and stroke impact scale in patients with hemiplegia due to stroke. Twenty-two patients with hemiplegia due to stroke were assigned to the community ambulation training group(n=11) or treadmill training group(n=11). Both groups were executed conventional treatment for 5 times per week for 6 weeks 30 minutes per session. Each group performed additional exercise for 30 minutes. Post treatment, compared to the treadmill training group, community ambulation training group showed significantly increased velocity, cadence, stroke impact scale(p<.05). These results support the perceived benefits of community ambulation training to augment on the gait ability and stroke impact scale of stroke patients. Therefore, community ambulation training is feasible and suitable for stroke patients.

• Journal of Korean Physical Therapy Science
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• v.16 no.1
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• pp.31-39
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• 2009

Background: Community ambulation has been recently recognized as one of the most essential factors of activities of daily living in patients with post-stroke hemiparesis. This study aimed to compare walking velocity and step number in 5 community situations in patients with post-stroke hemiparesis. Methods: Ten chronic stroke patients volunteered for this study. The main variables analyzed were walking speed and step number, and these were measured in 5 different community situations: a physical therapy room, a parking lot, a bank, a crosswalk, and a hospital lobby. The measurements obtained for walking in the physical therapy room were measured using a 10m walk test and were used as baseline data for comparison with each option. The ambulation distance was set at 300m for the parking lot and the bank and 150m for the crosswalk and hospital lobby. For data analysis, walking speed and step number were standardized with the distance options of each ambulation. Results: Compared to the walking speed in the physical therapy room, those in the other situations, except for the parking lot, were significantly different (p<.05). Moreover, there were significant differences in the speeds between the bank and the parking lot and between the parking lot and the crosswalk (p<.05). Compared to the step number in the physical therapy room, those in all situations except for the crosswalk were significantly different (p<.05). Further, there was a significant difference in the step number between the bank and the crosswalk (p<.05). Conclusion: The walking ability of patients with hemiparesis in real environments within a community could be different from that in a physical therapy room. Therefore, the evaluation of walking should be performed in a variety of community situations.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.137-146
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• 2018

PURPOSE: This study examine the effect of community ambulation training on gait, depression and self - efficacy of stroke patients in order to develop more effective training methods of community rehabilitation. METHODS: In the experimental group, community ambulation training combined with indoor and outdoor walking was performed for 30 minutes three times a week for six weeks. In the control group, general indoor walking training was performed. The physical factors were assessed by a 10-meter walking test, six-minute walking test and community gait test. Psychological factors were assessed by the Korean version of the Epidemiology Center Depression Scale and Activity-Specific Balance Confidence Scale. RESULTS: In the 10-meter walking test, the normal walking speed was significantly improved after the intervention in both the experimental group and the control group (p<.05). However, the fast walking speed was significantly improved only in the experimental group (p <.05). ln the community gait test, the experimental group showed significant improvement (p<.05), but the control group did not. Depression and self-efficacy were significantly improved in the experimental group (p<.05) but not in the control group. CONCLUSION: Community ambulation training may improve the gait ability of stroke patients and reduce their depression and improve self-efficacy.

• 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.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• PNF and Movement
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• v.15 no.3
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• pp.361-371
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• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• The Journal of Korean Physical Therapy
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• v.17 no.1
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• pp.43-68
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• 2005

The purpose of this study was to report the physical status of adult with cerebral palsy who live in local community areas including Seoul, Busan, Daegu in Republic of Korea at 2004. 202-individuals with cerebral palsy(140 male, 62 female; mean age 31.9 years; range 19 to 64 years) were surveyed. Measures included a 29-item self-reported health status measure focusing on musculoskeletal status and functional performances. Adult cerebral palsy required continuous management for musculoskeletal and ambulatory function through therapeutic approach. This survey is restricted to population who had cared in welfare center for cerebral palsy in local community, so it needs to investigate home-residual adults with cerebral palsy and the population in rural community. The results were as follows: 1. Participants reported that they had a limitation of a daily of life activity due to musculoskeletal pain($43\%$), there was significant differences between a limitation of a daily of life activity and the decreased ambulatory function(p<.05). 2. Thirty six point six percentile of participants had the decreased ADL function, it was significant related with the impaired body location(p<.05) 3. Thirty nine point one percentile of participants who can independently gait had the decreased ambulatory function, it was significant differences with the usage of ambulatory assistive devices(p<.05). 4. There was significant differences ambulatory function both the body region with impairment and a grade of disability(p<.05). 5. Sixteen point three percentile of participants could not ambulate any more, there was significant differences between a age and a point of time for non-ambulation(p<.05). 6. There was significant differences between ambulatory function and physical activity(p<.05).

• Physical Therapy Korea
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• v.22 no.4
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• pp.71-78
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• 2015

Previous studies have investigated stepping over obstacles in treadmill walking training (TWT-OS) and treadmill walking training (TWT) alone for walking capacity not considering real physical activity. As such, we investigated the effects of TWT-OS on physical activity and changes in different levels of physical activity based on community ambulation in stroke patients. Thirty subjects were randomly assigned to either the experimental group or the control group, with 15 and 15 subjects, respectively. However, one subject from the control group was excluded because of inadequate treatment sessions. All subjects underwent routine physical therapy in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-stepping while walking on the treadmill for 30 min/day, five times/week, for four weeks. Subjects were given a three-axis accelerometer to wear at the hip on a belt for one-week pre- and post-training physical activity. Step counts for seven days, average daily step counts, and the average of minutes spent in sedentary, light, and above moderate activity were chosen as outcome measures of physical activity. No significant differences between the groups were found in terms of step counts for seven days, average daily activity, or daily activity spent at sedentary levels after four-week interventions. However, the average daily activity spent at light levels (-42.60 min vs. -6.71 min) was significantly lower in the experimental group than in the controls. Conversely, average daily activity spent at above moderate levels was higher (19.86 min vs. 11.07 min) (p<.05) after adjusting for each baseline value. Significant pre- and post-training differences were found in all variables of the experimental group (p<.05). Thus, TWT-OS could improve physical levels above moderate activity as a community-oriented task more than simple repetitive waking on a treadmill, and it could provide an opportunity for patients ambulatory after stroke to participate in the community again.