• Physical Therapy Korea
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• v.26 no.2
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• International Journal of Contents
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• v.9 no.1
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• pp.60-64
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• 2013

This study was performed for two of specific reasons, one is for exercise development for improving stroke patient's muscle power, balance and gait and, after verifying the effect of the exercise, the other is for showing that the appling this exercise was more effective on hemi-plegic stroke patients into the clinical trial. The subjects of this study were hemi-plegic patients by stroke, 51 patients were picked up, who were agreed with this research. Close kinetic chain leg exercise using mirrors was applied to study group I, Close kinetic chain leg exercise without mirrors was applied to study group II and general physical therapy was applied to comparison group. The results of this study are as follows. The difference of the groups, study group I showed more effective than study group II on checking rectus femoris, vastus lateralis, biceps femoris, Korean version of Berg Balance Scale, Center of pressure, Functional gait assessment. In this study, Close kinetic chain leg exercise showed more effective and significant on improving for muscle power, balance and gait on stroke patients. Especially, doing exercise using mirrors is considered as more effective method than without mirrors.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.165-179
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• 2019

Purpose : The purpose of this study is to improve the stroke patient's gait ability by applying a closed or kinetic chain lower limb exercise Methods : The study subjects were 48 hospitalized hemiplegic patients who agreed to participate in the study. 48 subjects went through the intervention: 24 in the experimental group and 24 in the control group. One set consisted of 10 repeats of the exercise. The subjects performed three sets of the exercise once a day, 5 times a week, for 6 weeks. Results : TUG and FGA were significantly improved in the experimental group. The spatio-temporal gait variables in the experimental group all showed significant improvement. In the control group, velocity, cadence, and double limb support showed significant improvement, Trunk sway angle showed significant improvement in all three axes in both groups. Conclusion : The results of this study indicate that a more positive effect in terms of improvement of the stroke patient's gait ability will be seen for closed rather than open kinetic chain lower limb resistance exercise.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1914-1920
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• 2019

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.59-67
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• 2022

PURPOSE: This study examined the effectiveness of task gait exercise combined with self-observation training to provide basic clinical data by analyzing the factors that task gait exercise combined with self-observation training has on the leg muscle activity and gait improvement in stroke patients. METHODS: The subjects were assigned randomly to experimental Group I, which mediated task gait exercise combined with self-observation training, and experimental Group II, which mediated task-walking movement. They received 30-minute interventions three times a week for four weeks. The leg muscle activity and 10 m walking test (10MWT) were conducted as pre-intervention tests, and they underwent a post-test four weeks later in the same manner as the pre-test. RESULTS: A statistically significant difference was observed in all muscles and 10MWT (p < .01) in experimental group I (p < .05), while there were significant differences only in the rectus femoris, biceps femoris, and 10MWT (p < .05). In a comparison of the changes between groups, there were statistically significant differences only in the tibialis anterior, soleus muscle, and 10MWT (p < .05). CONCLUSION: Self-observation training in experimental group I was effective in increasing the leg muscle activity and improving walking speed by discovering and correcting incorrect movements and following a normal gait pattern using the ankle joint. Therefore, the task gait exercise combined with self-observation training should be introduced and actively utilized for the rapid social recovery of stroke patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.1
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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.

• Journal of Korean Society of Forest Science
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• v.103 no.3
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• pp.503-509
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• 2014

The purpose of this study was to investigate the effect of Forest-walking exercise on gait pattern in the elderly. The subjects (n=37) were assigned to 2 groups: Forest-walking exercise (FWE) group (n=19, $66.34{\pm}4.31$ years old) and In-door treadmill-walking exercise (ITWE) group (n=18, $67.18{\pm}2.78$ years old). The subjects participated in FWE program or ITWE program (3 times/week, 80 min/day) for 12 weeks. The subjects were tested on functional fitness (strength, endurance, agility/balance, BMI) and gait pattern (cadence, velocity, and stability) at the beginning and the end of the 12-weeks program. For data analysis, mean and standard deviation scores were calculated, and independent t-test and repeated two-way ANOVA were used. The results of this study were as follow: First, FWE group was significantly more improved than ITWE group on functional fitness(lower-body muscular strength, lower-body flexibility, mobility, cardiorespiratory endurance) after 12-weeks exercise program. But both groups showed equally improvements on functional fitness (upper-body muscular strength, upper-body flexibility, BMI). Second, FWE group was significantly more improved than ITWE group on cadence, gait velocity, and gait stability after 12-weeks exercise program. Therefore, this study may suggest that Forest-walking exercise based on sensory-motor functional integration improves efficiently functional fitness and gait pattern in the elderly, and further becomes an effective exercise method that makes more dynamic life, and prevents from falling.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.249-256
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• 2014

Purpose: The aim of this study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using sprinter and skater on balance and gait in the stroke patients. Methods: Twenty-two subjects were randomly assigned to the experimental group (n=11) and the control group (n=11). The experimental group performed PNF pattern exercise using sprinter and skater for 15 minutes with conventional physical therapy for 35 minutes (matt and gait training for 15 minutes + FES stimulation for 20 minutes), while the control group performed only conventional physical therapy for 50 minutes (matt and gait training for 30 minutes + FES stimulation for 20 minutes). Both groups performed therapeutic interventions for five days per week, for a period of four weeks. Functional Reach Test (FRT) and Berg Balance Scale (BBS) were used for assessment of balance, and Timed-Up and Go test (TUG) was used for testing of gait. Results: The experimental group showed significant improvements in the FRT and the BBS, while the control group did not show significant changes in two measurements. The experimental group also showed significant improvements, however, the control group did not show significant changes in the TUG. In post-values of three measurements, significant differences were observed between the two groups (p<0.05). Conclusion: This study demonstrated that PNF pattern exercise using sprinter and skater may be used to improve balance and gait function in stroke patients. Thus, we suggested that PNF pattern exercise using sprinter and skater would be a therapeutic intervention in stroke rehabilitation.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.49-60
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• 2022

Purpose : The purpose of this study was to identify whether gym-ball exercise in standing position was an effective intervention for improving muscle strength, balance, gait, and fall efficacy in stroke patients. Methods : Twenty-four stroke patients were randomized into three groups: experimental group 1 (n=8), experimental group 2 (n=8), and control group (n=8). Experimental groups 1, 2 and the control group performed the gym-ball exercise in standing position, same exercise without a gym-ball, and general physical therapy for 4 weeks, five times a week in 30-minute sessions. Muscle strength, balance, gait, and fall efficacy were assessed using a handheld dynamometer, the Berg Balance Scale (BBS), the wearable BTS G-WALK® sensor, and the Korean version of the Falls Efficacy Scale (K-FES), before and after training, respectively. Comparisons within and between groups were analyzed using the Wilcoxon signed rank test, Kruskal Wallis H test, and Mann-Whitney U test. Bonferroni correction was performed when significant differences between groups were identified (p<.017, .05/3). Results : Regarding muscle strength, BBS score, cadence and FES-K were significantly improved after intervention in all three groups. The weight bearing rate, gait speed and step length in experimental group 1 and 2 were significantly improved after the intervention. The stride length in experimental group 1 were significantly improved after the intervention. Experimental group 1 had significantly improved BBS score and stride length after intervention than experimental group 2 and control group. Experimental group 1 and 2 improved muscle strength, weight bearing rate, and FES-K score more than the control group. Experimental group 1 showed significant improvement in cadence, gait speed, and step length after the intervention than control group. Conclusion : This study showed that exercise with gym-ball in standing position can be an effective intervention to improve balance and gait in stroke patients than the same exercise without gym-ball.

• PNF and Movement
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• v.9 no.4
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• pp.49-55
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• 2011

Purpose : The aim of this study was to identify of bilateral trunk rotation(BTR) exercise and PNF exercise on gait in the individuals with malalignment syndrome. Methods : Subjects were 32 that were divided 2 groups in 20's generation. Interventions were trunk ratation exercise and PNF exercise. We used Medex for trunk rotation exercise. BTR group received exercise for three-sets (10min/set) along with stretching exercise ten-minutes, 3 times per week. PNF group took turns the D1 pattern in upper extremity and the D1 pattern in the opposite side of lower extremity for three-sets (10min/set). The measurement were force metatarsal 1 (FM 1), impulse metatarsal 1 (IM 1), force heel lat (FHL), impulse heel lat (IHL) by using footscan (RS scan). Statistical method was repeated measurement of ANOVA and p value was 0.05. Results : BTR and PNF group were significantly different in time(FM 1, IM 1, FHL, IHL). As different of right/left, BTR and PNF exercise were significantly different in FM 1, IM 1, FHL. Conclusion : BTR exercise was good exercise for malalignment but needs expensive equipment, for example, Medex. PNF exercise doesn't need expensive equipment but good method in malalignment syndrome person for gait ability. If PNF exercise is more experiment, PNF exercise could use variety for more patients.