• The Journal of Korean Physical Therapy
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• 제36권1호
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• pp.33-38
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• 2024

Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.

• PNF and Movement
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• 제19권2호
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• pp.287-301
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• 2021

Purpose: Gait training for stroke patients focuses on adjusting to new environments to facilitate outdoor walking. Therefore, the purpose of this study was to identify the effects of various ground obstacle walking combined with treadmill walking on the gait parameters and functional gait ability of chronic stroke patients. Methods: Twenty-four chronic stroke patients were divided into two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group received a combined gait training using various ground obstacle walking and treadmill walking (VGOW) five times/week for four weeks. The control group received traditional treadmill training (TW) five times/week for four weeks. Patients were evaluated using the figure-8 walk test (F8WT) and the Functional Gait Assessment (FGA) before and after each intervention. Results: The ANCOVA results showed that both treatments significantly influenced F8WT steps, F8WT time, and FGA score. The paired t-test results showed a significant improvement in F8WT steps, F8WT time, and FGA score in the experimental group compared to those in the control group. Conclusion: Combined gait training using various ground obstacle walking and treadmill walking can improve gait ability in chronic stroke patients.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• 대한물리의학회지
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• 제11권2호
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• pp.93-102
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• 2016

PURPOSE: The purpose of this study is to evaluate the functional effects of action observation plus functional electrical stimulation (FES) treatment on the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities, and stride lengths of stroke patients. METHODS: The subjects, who were all more than six months post stroke, were randomly divided into two groups of ten each: an experimental group and a control group. TETRAX (Tetrax Interactive Balance System) and GAITRite (GAITRite$^{TM}$ computerized gait analysis system) were measured at baseline, six weeks after treatment. Participants in both the groups received functional electrical stimulation treatment, but the experimental group was provided with additional action observation. Independent t-tests were used to compare the differences between the groups, and repeated measured two-way ANOVA was used to compare the interaction between the groups. RESULTS: The result of the interactions between the groups and the periods showed significant increases in the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities and stride lengths (p<0.05). However, a comparison between the groups showed no significance in the weight distribution indexes (heel and toe), stability indexes, and stride lengths (p>0.05). CONCLUSION: Action observation plus functional electrical stimulation treatment should be considered as a therapeutic method for physical therapy for stroke patients to improve the weight distribution indexes, stability indexes, gait velocities, and stride lengths.

• 한국전문물리치료학회지
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• 제17권2호
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• pp.33-42
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• 2010

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

• 대한물리의학회지
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• 제18권4호
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• pp.133-144
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• 2023

PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.

• 대한골관절종양학회지
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• 제18권2호
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• pp.51-58
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• 2012

목적: 슬관절 주위에 발생한 골종양 환자에서 종양 대치물을 이용한 재건술의 결과와 보행 분석의 유용성을 알아보고자 하였다. 대상 및 방법: 2001년부터 2010년까지 슬관절 주위에 발생한 골종양에 대하여 광범위 절제술 후 종양 대치물을 이용한 재건술을 시행 받은 30명 중 7명을 대상으로 하였으며 기능적 결과 및 보행 분석 검사를 평가하였다. 결과: SF-36 점수는 신체적, 정신적 역할제한 항목에서 각각 100% (100점)으로 높은 점수를 보였으며 일반 건강상태, 신체적 기능 정도, 활력, 사회적 기능에서 낮은 점수를 나타냈다. 또한 MSTS 평가의 종합 평균 점수는 88.1% (23.8점[17-27])였다. 보행 분석 검사상 평균 보행속도 97.2 m/s, 평균 분속수 105.6 step/min, 평균 활보장 111.3 m, 평균 보장 61.5 cm, 유각기 39.8%cycle, 입각기 60.1%cycle, 평균 단하지 지지기 37.1%cycle, 평균 양하지 지지기 13.0%cycle, 평균 발 들림시기 60.7%cycle였다. 결론: 슬관절 주위 종양에 대한 광범위 절제술 후 종양 대치물을 이용한 재건술은 좋은 기능적결과를 기대할 수 있으며, 보행 분석 검사는 술후 환자의 상태를 정량적으로 평가함으로써 보행 모습 및 기능을 객관화 할 수 있는 한 방법으로 사료되며 기능적 평가 방법과 함께 치료 및 술 후 재활 계획을 세우는데 도움이 되리라 생각된다.

• 대한물리의학회지
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• 제12권1호
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• pp.35-42
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• 2017

PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.55-62
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• 2014

Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.

• 대한물리의학회지
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• 제15권1호
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• pp.123-132
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• 2020

PURPOSE: This study examined the effects of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patients. METHODS: Ten patients with stroke were divided randomly into two groups of five patients each who met the selection criteria. The training was conducted five times a week, for 60 minutes. The experimental group received both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation while the control group received general physical therapy with functional electrical stimulation. RESULTS: The timed Up-and-Go (TUG) test result was statistically significant after the intervention in the experimental group (p<.041). Berg Balance Scale (BBS) assessment was statistically significant after the intervention in the experimental group (p<.047) and between the experimental and control groups (p<.012). The cadence assessment was statistically significant after intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). The stride length assessment was not statistically significant after intervention in the experimental group and between the experimental and control groups. Gait velocity assessment was statistically significant after the intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). CONCLUSION: Both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation had positive effects on the balance and gait of stroke patients.