• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.23-33
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• 2021

Purpose : This study aimed to investigate the effects of dual-task training according to the variability of the walking environment on balance, gait, and function in patients with stroke. Methods : Twenty-five patients with stroke were randomly assigned to experimental group I (n=12) and experimental group II (n=13). Experimental group I and II performed obstacle and non-obstacle walking training, respectively, along with cognitive tasks for 21 minutes per session, 3 times a week for 6 weeks. Both groups received additional general physical therapy for 30 minutes per session. The functional reach test (FRT), gait analyzer (G-Walk), and functional independence measure (FIM) were used to evaluate balance, gait and function of pre- and post-interventions, respectively, while gait cadence, gait velocity, and stride length were evaluated using a gait analyzer. Results : In the within-group comparison of FRT, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait cadence, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait velocity, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of stride length, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). In within-group comparison of FIM scores, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). There was a significant difference in the change of FIM scores pre- and post-intervention (p<.05) in the between-group comparison. Conclusion : The results of this study show that dual-task training with cognitive tasks and walking training can improve the balance, gait and function of patients with stroke, and obstacle walking training is effective for improving functions including activities of daily living compared to non-obstacle walking training.

• Journal of the Korea Convergence Society
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• v.9 no.10
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• pp.109-120
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• 2018

The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with mirror therapy on balance and gait ability in chronic stroke patients. Thirty-five subjects who met the inclusion criteria were randomly allocated into three groups: the functional electrical stimulation with mirror therapy group(FMT group, n=11), mirror therapy group(MT group, n=12), and control group (n=12). The exercises were conducted for 30 min per day, five, per week for four weeks. Balance and gait ability were examined at baseline and after 4 weeks of intervention. After training, the FMT group showed significant improvement in berg balance scale (BBS), center of pressure (COP) length, affected step length (ASL), Cadence and average gait speed (AGS) compared MT group and control group(p<0.05). This findings show that FES and MT convergence can be an effective intervention for stroke patients balance and gait ability. Continued development of convergence interventions for stroke patients with balance and gait ability in practice, are suggested.

• Physical Therapy Korea
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• v.22 no.3
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• pp.91-97
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• 2015

This study was conducted to investigate the effects of the removable ankle-foot orthosis (RAFO) which was developed to improve the gait of stroke patients. The subjects of this study were five stroke patients who agreed to participate in this study by signing a written consent form. To verify gait improvement after wearing the orthosis, a Timed Up and Go test and Functional Gait Assessment were performed, and spatiotemporal gait variables such as gait speed, cadence, stride length, double limb support, and the efficient gait test of body sway angle were performed. For every variable, the differences prior to and after wearing the RAFO were compared using the Wilcoxon signed-rank test. Every gait variable improved significantly after wearing the RAFO compared to prior to wearing it. The pilot study will enhance future efforts to evaluate orthotic function objectively during gait in stroke patients.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.183-207
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• 2004

The purpose of this study was to describe and compare the temporo-spatial gait characteristics of healthy elderly people with those osteoarthritis patients. 100 patients reported knee osteoarthritis, diagnosed at the hospital or clinic located in Daegu and Kyungbuk province and 100 normal elderly subjects were participated in this study. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. The system integrates specific components of locomotions to provide a single, numerical representation of gait, the Functional Ambulation Performance score. Differences in gait characteristics between the two groups were examined using a correlated t-test and Pearson Correlation(p<.05). Significant differences were observed between the groups for temporal parameters(step time, double support time, stance phase, mean velocity) and spatial parameters(step length, step/extremity ratio)(p<.05). Also there was difference in the functional ambulation performance score between normal elderly subjects and knee osteoarthritis patients(p<.05). Consequently, it may help detect the abnormal gait pattern indicated the main problem in degenerative knee osteoarthritis patients as well as provide data analysing the pathokinesiologic components by comparing normal elderly.

• PNF and Movement
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• v.9 no.2
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• pp.1-7
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• 2011

Purpose : The purpose of this research was to determine the effects of Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined on gait ability in hemiplegic gait. Methods : The subjects of this study were 13 hemiplegic patients. Each subjects was taken PNF pattern and FES of combined with 5 times per week for 4weeks. Pre- and Post-intervention change in gait ability were measured using an Timed up and Go test, stride length of the affected side, step length of the affected side. The data were analyzed using the paired t-test. Results : The results of this study were showed significantly improvement in TUG, stride length of the affected side, step length of the affected side after intervention. Conclusion : These results suggest that the Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined exercise is an effective way of improving gait ability for hemiplegic patients.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.32-48
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• 2004

The purpose of this study was to evaluate the change of functional ambulation profile(FAP) and temporal-spatial gait parameters in hemiplegic patient by forceful respiratory exercise. 28 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. FAP and temporal-spatial gait parameters was measured at before and after experiments. The results of this experimental study were as follows : 1. In comparison of FAP before and after experiment, the FAP was significantly increased in the FET and FIT group (p<.01). In comparison of difference of FAP among 3 groups, there was the significant difference between the FIT group and the control group (p<.05). 2. The results of temporal-spatial gait parameters are as follows : 1) In comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the FET and FIT group (p<.05). In comparison of difference of the gait velocity among 3 groups, there was the significantly difference between the FIT group and the control group (p<.05). 2) In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in FIT group (p<.05). In comparison of the difference of the gait cadence among 3 groups, there was no significant difference between the FIT group and the control group (p>.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the FAP and temporal-spatial gait parameters in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients.

• Physical Therapy Korea
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• v.18 no.1
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• pp.64-73
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• 2011

After stroke, many people have problems with balance during movement. Balance is essential for the optimal functioning of the locomotor system and the performance of many activities of daily living. The Functional Gait Assessment (FGA) is a clinical tool for evaluating balance ability during walking. The test consists of ten tasks, seven tasks of the Dynamic Gait Index and three additional tasks. The purpose of this study was to evaluate the reliability and internal consistency of data obtained with the Korean version of the FGA when used with people after suffering a stroke. One-hundred participants, at least three months poststroke and able to walk at least six meters with or without a walking aid, participated in the study (age range=30~83 years; $mean{\pm}SD=58.8{\pm}10.9$). Two physical therapists and two physical therapy students rated the FGA. Intrarater and interrater reliability of the FGA were assessed using kappa statistic and intraclass correlation coefficients (2,1). The internal consistency of the FGA was assessed using the Cronbach alpha. The Cronbach alpha was good (${\alpha}$=.86~.93). The intrarater (intraclass correlation coefficient=.92~.95) and interrater reliability (intraclass correlation coefficient=.91, .95) of the total scores administered by the therapists and students were good, whereas the reliability for single item scores when administered by the physical therapists was moderate to good (kapa value=.42~.97). This study found that intrarater and interrater reliability for total FGA scores and internal consistency were good. Therefore, the Korean version of the FGA can be used as a reliable tool to assess the functional gait performance of patients after stroke.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.283-289
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• 2020

Objective: The purpose of this study was to determine the force of lower extremities, the change in walking ability on the ground by applying a walking training program based on perceptual learning to improve gait capacity of chronic stroke patients. Method: This study included Twenty-four patients with chronic stroke. Using a perceptual-based gait training, the experimental group trained twice a day for 30 minutes each time, 5 times a week, for a total of 8 weeks. The control group underwent ground gait training that excluded the element of a perceptual training for 30 minutes, 5 times a week for 8 weeks. Results: In the two groups, the maximum forefoot pressure after intervention was significantly different in both the LEPGT and GGT (p<0.05). The maximum midfoot pressure was significantly different in LEPGT (p<0.05). There was a significant difference in the maximum heel pressure after intervention between the two groups (p<0.05). As a result of comparing the change in step length and stride length after intervention in the two groups, there was a significant difference between the two groups (p<0.05). Conclusion: Both gait training programs was found that gait training based on perceptual learning and ground gait training were the training for improving the functional gait of stroke patient. Perceptual learning gait training utilizing intensive perceptual awareness was the training for improving gait capacity within the period than ground gait training.

• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.25-34
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• 2020

Background: Gait analysis is an important measurement for health professionals to assess gait patterns related to functional limitations due to neurological or orthopedic conditions. The purpose of this study was to investigate the reliability of the newly developed portable gait analysis system (PGAS). Design: Cross-sectional design. Test-retest study. Methods: The PGAS study was based on a wearable sensor, and measurement of gait kinematic parameters, such as gait velocity, cadence, step length and stride length, and joint angle (hip, knee, and ankle) in stance and swing phases. The results were compared with a motion capture system (MCS). Twenty healthy individuals were applied to the MCS and PGAS simultaneously during gait performance. Results: The test-retest reliability of the PGAS showed good repeatability in gait parameters with mean intra-class correlation coefficients (ICCs) ranging from 0.840 to 0.992, and joint angles in stance and swing phase from 0.907 to 0.988. The acceptable test-retest ICC was observed for the gait parameters (0.809 to 0.961), and joint angles (0.800 to 0.977). Conclusion: The results of this study indicated that the developed PGAS showed good grades of repeatability for gait kinematic data along with acceptable ICCs compared with the results from the MCS. The gait kinematic parameters in healthy subjects can be used as standard values for adopting this PGAS.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.292-297
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• 2019

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.