• The Journal of Korean Physical Therapy
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• 제26권1호
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• pp.1-8
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• 2014

Purpose: The aim of the present study was to understand the relationship between gait symmetry and functional balance, walking performance in stroke patients and to makes recommendation regarding the most suitable measure for standardization of expression of spatiotemporal gait symmetry. Methods: 45 subjects with stroke (31 men, 14 women, $57.3{\pm}10.3$ years old) participated in this study. Gait symmetry was calculated by equations of symmetry ratio (SR) and symmetry criterion (SC) for stance time, swing time, single leg support time (SLST), step length, and stride length. Spatiotemporal parameters were measured respectively by walkway system ($GAITRite^{TM}$ system). Limit of stability (LOS) by using forceplate (Balance Performance Monitor) during voluntary weight displacement and Berg Balance Scale (BBS) were measured as functional balance and Timed Up and Go test (TUG) and Functional Ambulation Category (FAC) were assessed as functional walking. Results: SR in stance time and swing time was correlation with BBS, TUG and FAC (p<0.05). SR in SLST only with BBS (p<0.01), SR in step length only with FAC (p<0.05). SC in stance time was correlation with BBS and TUG (p<0.05). SC in swing time and SLST with BBS, TUG and FAC (p<0.01), SC in step length with TUG and FAC (p<0.01), SC in stride length with BBS and FAC (p<0.01). Conclusion: Gait symmetry in spatiotemporal gait parameters provides meaningful information about functional balance and walking performance in stroke subjects. Our analysis may support the recommendations of the symmetry criterion as equation for standardization of gait symmetry.

• Physical Therapy Rehabilitation Science
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• 제6권3호
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• pp.140-145
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• 2017

Objective: The purpose of this study was to investigate the effect of visual block with ankle joint fatigue on gait and dynamic balance ability. Design: Cross-sectional study. Methods: Thirty healthy young adults (men=15, women=15) between 22 to 25 years of age voluntarily participated in this study. All subjects performed the gait and dynamic balance test successively in two conditions: the visual block and the open eyes condition. Before the gait and dynamic balance test, muscle fatigue on the ankle joint was induced to all subjects by doing ankle dorsiflexion and plantarflexion alternately, and then gait parameters (step length, stride length, cadence, velocity, single limb support, and double limb support) were assessed by walking on the GAITRite system (CIR Systems Inc., USA). Subjects also performed the functional reach test (FRT) for assessment of dynamic balance. This study examined gait parameters and FRT scores in each visual block and open eyes condition. Results: The results showed that FRT scores with the visual block condition significantly decreased compared to without visual blocking (p<0.01). Step length, stride length, cadence, and velocity of gait parameters decreased significantly in the visual block condition (p<0.01) while there was no significant difference for single limb support. However, double limb support increased significantly in the visual block system (p<0.01). Conclusions: Therefore, blocking of visual information with muscle fatigue of the ankle joint can affect gait and balance ability of young adults and increase the risk of falls.

• PNF and Movement
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• 제16권2호
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• pp.249-257
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• 2018

Purpose: This study aimed to explore the effects of additional trunk exercises on an unstable surface on the balance and walking ability of individuals with chronic stroke. Methods: Sixteen patients with chronic stroke participated in this study. The participants were randomly assigned to two groups: experimental group (n=8) and control group (n=8). All the participants underwent a typical physical therapy program for 30 min a day. Moreover, the experimental group participated in a 30 min trunk exercise program on an unstable surface, whereas the control group participated in a 30 min trunk exercise program on a stable surface. Both groups performed the exercises five times a week for three weeks. The Berg Balance Scale (BBS) was used to measure changes in balance. The gait variables were measured using the GAITRite system (CIR System Inc., Clifton, NJ, USA) to examine changes in walking ability. Results: Both groups showed a significant intragroup improvement in balance, gait speed, cadence, stride length, and double support period (p<0.05). In the intergroup comparisons after the intervention, the experimental group showed significant improvements over the control group in balance, gait speed, cadence, stride length, and double support period (p<0.05). Conclusion: This study applied additional trunk exercises on an unstable surface to chronic stroke patients, and the results showed a significant improvement in the patients' balance and walking abilities. Therefore, trunk exercise on an unstable surface may be applicable as an intervention method to improve the balance and walking ability of chronic stroke patients.

• PNF and Movement
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• 제15권1호
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• pp.57-65
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• 2017

Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.

• 대한정형도수물리치료학회지
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• 제25권1호
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• pp.63-70
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• 2019

Background: The purpose of this study was to determine the effects of a pelvic compression belt on gait abilities and balance in subacute stroke patients. Methods: Twenty two patients with subacute were recruited and randomly assigned into two group: Two group offered conventional physical therapy and occupational therapy for five day. The group was composed of twelve patients. Participants in the experimental group were given the pelvic compression belt and conventional physical therapy, conventional occupational therapy, although conventional physical therapy and occupational therapy provided in the subjects in the control group. To assess the gait ability, the GAITRITE system was used and the Balance system SD was used to test balance. All measurements were performed before and after intervention. Results: The experimental group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05) and show significant increase in the dynamic standing balance (p<.05). However, control group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05), but shows no significant differences in dynamic standing balance. Furthermore, there were significant differences gait velocity, dynamic standing balance between two groups (p<.05). Conclusions: The results demonstrated that the elastic pelvic belt application is effective to improve gait velocity, dynamic balance in the subacute stroke patients. Thus, the elastic pelvic belt is seemed to be one of the potential methods to facilitate the active rehabilitation program for hemiplegia patients.

• 대한통합의학회지
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• 제8권4호
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• pp.125-131
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• 2020

Purpose : Lower extremity orthoses have been used as conservative methods to recover gait of the stroke patients. The purpose of this study is to examine how newly designed pelvic belt orthosis can improve gait ability and dynamic balance of adults with Hemiparesis after stroke. Methods : 22 patients who had hemiparesis after stroke participated in this study. Two groups were randomly created by assigning 10 subjects to the experimental group and the rest of the 12 subjects to the control group. The control group was treated by conventional physical therapy and occupational therapy. Identical therapy protocols were used to treat the experimental group who were assigned to wear the pelvic belt orthosis during post measurement. This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The GAITRite system was used to measure spatial-temporal gain parameters and the balance system SD to measure dynamic balance. The data was analyzed using R version 3.3.1. Random forest, boosting algorithm, and MANOVA test were conducted to determine the effects of independent variables on dependent variables. Results : This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The independent variable "group" has the most important value, which is approximately 25.42 (%IncMSE) representing a value three times greater than the second important predictor "height." Conclusion : As a result of this research, the hypothesis is validated with conclusion that Pelvic Belt orthosis could be effectively used for improving gait ability and balance of the patients with post-stroke hemiparesis.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.127-133
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• 2018

Objective: The purpose of this study was to investigate the effects of foam roller (FR) stretching, kinesiotaping (KT), and dynamic stretching (DS) on gait parameters after inducing muscle fatigue in the ankle joint. Design: Cross-sectional study. Methods: The subjects were thirty healthy young adults between the ages of 20 and 31 years at Baekseok University who voluntarily participated in this study. The participants were randomly assigned to either the FR group, KT group, or the DS group after inducing muscle fatigue of the ankle joint. Fatigue induction of the ankle joint muscles was performed by alternating a heel up and down exercise with the standing posture on the ground. The speed was maintained at 40 beats/minute using a metronome. Subsequently, the respective intervention was applied to each group. Gait parameters were measured before and after ankle muscle fatigue induction, and after intervention using the GAITRite system. One-way ANOVA was used to compare gait parameters among groups, while repeated measures ANOVA was used to compare gait parameters within each intervention group. Results: The FR group increased significantly in velocity, step length, and stride length except for cadence after intervention compared to after ankle muscle fatigue induction (p<0.01). Furthermore, the KT group showed significant increases in velocity, cadence, step length, and stride length after intervention, especially in cadence group (p<0.05). All intervention groups showed significant increases in stride length after intervention, especially the DS group (p<0.05). Conclusions: Therefore, we suggest that KT, FR, and DS can be an effective intervention on gait parameters when the ankle joint is unstable and injured.

• 대한정형도수물리치료학회지
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• 제18권1호
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• pp.65-72
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• 2012

Background: The purpose of this study is on finding the effects of the lumbar stabilization exercise applied with the proprioceptive neuromuscular facilitation technique (PNF) to the balance and the gait of chronic stroke patients. Methods: An experiment was conducted using two sets of behavioral measures with 30 chronic stroke hospitalized patients in the rehabilitation center located in Incheon city. The 15 participants in group A were instructed to apply the traditional exercise therapy. And the other 15 participants were assigned to apply the lumbar stabilization exercise with the PNF technique. It was conducted for 30 minutes per three days for six weeks, which had eighteen times. Using the balance system, it was checked about the static and dynamic balance. Using the Gaitrite, it was checked about the ability of the gait. Results: There was a better effect on both groups especially with the static balance. Those who were applied the lumbar stabilization exercise with the PNF technique had a better result on the dynamic balance and the gait than those applied the traditional exercise therapy. Conclusion: This research shows that the Lumbar Stabilization Exercise applied with the PNF technique is more effective on dynamic balance and the gait performance ability of the chronic stroke patients.

• 대한물리의학회지
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• 제5권3호
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• pp.385-394
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• 2010

Purpose : The present study was to examine the difference and severity of asymmetry in independently ambulating stroke survivors and to establish the association between gait asymmetry, velocity, and the motor function of lower extremity. Methods : The subjects used in this study were 43 subjects with hemiparesis being able to walk independently. Motor function of lower extremity was measured clinically with the Fugl Meyer-Lower /Extremity Assessment. Overground gait velocity and spatia-temporal parameters were collected by the GAITRite system. Results : Thirty(69.77%) patients showed statistically significant temporal asymmetry while 28(65.1%) exhibited statistically significant spatial asymmetry. One-way ANOVA results showed a main effect of temporal asymmetry group(normative, mild, severe) for gait velocity(F=74.129), FM-L/E(F=17.270), swing-stance symmetry(F=66.869, F=13.485, respectively), spatio-temporal asymmetry(F=13.166, F=31.800, respectively) 66, F=31.800, respectively). Gait velocity was negatively associated with temporal asymmetry(r=-.83), spatial asymmetry(r=-.60). Motor function of lower extremity was also associated with temporal asymmetry(r=-.58), and spatial asymmetry(r=-.50). Conclusion : The study attempted to establish the standard assessment of hemiparesis gait symmetry in light of the complex relationship with motor impairment and gait velocity. More future work will need to link the degree of gait asymmetry to clinically relevant outcomes to better establish the clinical significance of such observations.

• 대한물리의학회지
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• 제12권4호
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• pp.11-18
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• 2017

PURPOSE: The purpose of this study was to examine the effects of sciatic nerve mobilization techniques on straight leg raising (SLR) and walking ability in elderly women aged over 65. METHODS: Seventy women aged over 65 were examined using SLR test and forty women were selected as subjects. They were divided into Group I (under $70^{\circ}$ of SLR test of both legs, n=20) and Group II (over $70^{\circ}$ of SLR test of both legs, n=20). Nerve mobilization was applied to both groups (three times a week for 4 weeks). SLR angle was measured using digital goniometer and walking ability was measured by step length, stride length, velocity, double support, using GAITRite System. After 4 weeks, paired t-test was used to compare the changes of SLR test and walking ability within Group I and Group II. RESULTS: In Group I, SLR test, step length, stride length and gait velocity were significantly increased but double support was significantly difference. In Group II, SLR test, step length and stride length were significantly increased but gait velocity was not significantly increased and double support was significantly decreased. CONCLUSION: This study showed that sciatic nerve mobilization techniques had positive effects on the SLR angle and walking ability in elderly women.