• The Journal of the Korea Contents Association
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• v.12 no.1
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• pp.318-328
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• 2012

The purpose of present study was to determine effects of a PNF combination pattern training on muscle activity of lower extremities and gait ability in hemiparetic subjects. Twenty chronic stroke patients participated. Participants were randomly divided into either control group and experimental group. Experimental group received PNF combination pattern training, four times per a week for six weeks and control group received general exercise training. For the lower limbs muscle activity, RMS of action potential were analyzed and gait ability tests was conducted with 10MWT, DGI and F8WT. For the significance test of control and experimental group for measuring time by exercise application method, two-way repeated measure ANOVA. As the result, muscle activity of RF(p<.05), VM, TA, LH, LG was significantly increased between measurement period(p<.001), In VM, TA, LH, LG, there were interactions each measurement time and between group. 10MWT, DGI, F8WT in gait ability was significantly improved between measurement periods(p<.001) and In 10MWT, DGI, F8W, there were interaction each measurement time and between group. In conclusion, the PNF combination pattern application will be effective strategy to increasing the muscle activity and improving gait ability in the rehabilitation of stroke patients.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.170-176
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• 2016

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.109-113
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• 2018

Objective: The purpose of this study was to investigate the effects of fall experience and task complexity on gait performance in community-dwelling persons with chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Thirty-three persons who had a history of stroke participated in this study. The participants included 18 persons (aged mean 54.0, mean score of 24.6 points on the Montreal Cognitive Assessment, MoCA) with fall experience (faller group) and 15 persons (aged mean 53.7, mean score of 24.7 points on the MoCA) without fall experience (non-faller group) in the previous six months. This study measured balance and gait performance at two different conditions (with/without 70% of water filled in a 200 cc cup). The participants were clinically assessed using the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Berg Balance scale (BBS), Dynamic Gait Index (DGI), and Timed Up-and-Go (TUG) test. Results: After analyzation, persons in the faller group performed significantly better on the 10MWT, 6MWT, BBS, DGI, and the TUG test in the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). The persons in the non-faller group also performed significantly better in all outcome measures with the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). However, there was no interaction between fall experience and task complexity in the two groups. Conclusions: Our results showed that balance and gait performance depended on fall experience and task complexity but fall experience did not interact with task complexity. Clinicians should consider fall prevention and task complexity during therapeutic approaches in persons with hemiparetic stroke.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.63-70
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• 2016

PURPOSE: The aim of this study was to conduct an Otago exercise program with stroke patients in a clinical setting and ascertain its effects on balance and walking ability. METHODS: The participating subjects were 45 people who had been diagnosed with stroke. They were assigned to two groups (Otago exercise; OE, n=22; balance exercise; BE, n=23), and the exercises were conducted for three sessions per week for eight weeks. The main balance outcomes were evaluated using the timed up and go test (TUG) and the four step square test (FSST), while walking ability was evaluated using the 10 m walk test (10MWT), direction change ability was measured using the figure 8 of walk test (F8WT), and the decrease of fear was evaluated using the modified falls efficacy scale (MFES). RESULTS: In the analysis results, the Otago exercise group showed significant increases in TUG, FSST, 10MWT, and F8WT within the both groups. There were significant differences in all variables between the OE group and the BE group at the post-intervention evaluation, but there was no significant difference between the groups with respect to the 10MWT. This study showed that conducting Otago exercise in stroke patients increased the main outcomes for TUG, FSST, F8WT scores, but not for 10MWT. CONCLUSION: The results of this study demonstrated that Otago exercise would be useful to improve balance and gait for stroke patients who want to improve their abilities and activities of daily living.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.549-558
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• 2013

PURPOSE: This study is designed as a retrospective study, and identified the clinical usability of Sit to Stand (STS) test for predicting of fall incidence in stroke patients who experienced a fall within 1 year. METHODS: Between July 2011 and November 2012, 69 inpatients with stroke in K rehabilitation hospital were participated under voluntarily signing the informed consent form. STS test and 10m walk test (10MWT) were used to assess the muscle strength of lower-extremity and walking velocity, respectively. Also, we tested dynamic balance and motor function of lower-extremity in affected-side using with the Berg balance scale (BBS) and the Fugl-Meyer assessment of lower extremity (FM-L/E). METHODS: There were significant differences between subjects with fall-experienced group and without subjects without fall-experienced group in STS test, 10MWT, BBS scores and FM-L/E. STS test significantly showed a negative correlation between 10MWT (r=-.657), BBS (r=-.512), and FM-L/E (r=-.563). And, 10MWT have a influence on the performance of STS test (the capacity of explanation = 20%). The cut-off value of STS performance predicting falls experience is ${\geq}14.36$ seconds (sensitivity=76%; specificity=79%, area under curve=.785). According to logistic regression analysis of falls experience, subjects ${\geq}14.36$ s showed that 4.164 times (odd ratio) increased in falls than subjects < 14.36 s in STS test. CONCLUSION: This study demonstrated that STS test may be a useful tool predicting and measuring falls in patients with stroke. Further study will be needed to elucidate the kinematic analysis of STS test and the relationship between physical activity level and falls in stroke patients.

• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.1-9
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• 2010

Background: The objective of this study was to determine whether sensorimotor training using an unstable surface affects dynamic balance and gait function in patients with hemiparesis, and to compare the effect of sensorimotor training with that of cycling exercise. Methods: Two subjects with post-stroke hemiparesis volunteered to participate in this study. Single-subject A-B design with alternating treatment was used for this study. Baseline(A) and intervention(B) phases were performed for 7 and 8 sessions, respectively. Sensorimotor training and cycling exercise were performed for 20 minutes in randomized order. Assessment tools were made by using a step test, timed up and go(TUG) test, and 6-minute walk test(6MWT). Results: Each of the participants improved in all three tests after the two interventions. Participants 1 and 2 showed the improvement for their assessment score after sensorimotor training in the step test by 42.1%(p<.05) and 58%, in the TUG, 31% and 19.5%, and in the 6MWT test, 32.3% and 10.6%(p<.05), respectively. After cycling exercise, participants 1 and 2 also improved in the step test by 32.5% and 53.1%, in the TUG, 27.4% and 18%, and in the 6MWT test, 28.8% and 3%. In statistical analysis between the two interventions, sensorimotor training showed a significant increased values in the step test for participant 1 and the 6MWT for participant 2 as compared with those of cycling exercise. Conclusion: Sensorimotor training and cycling exercise are helpful for improving dynamic balance and gait capacity. Furthermore, sensorimotor training may be more helpful than cycling exercise.

• Physical Therapy Korea
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• v.20 no.3
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• pp.9-18
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• 2013

The study aimed to compare the effect of the treadmill walking training combined with obstacle-crossing (TWT-OC) and treadmill walking training (TWT) on the walking function of patients with chronic stroke. 29 subjects volunteered to participate in this study; they were randomly assigned to either TWT-OC group (15 subjects) or TWT group (14 subjects). Subjects from the TWT-OC group underwent a treadmill walking combined with obstacles-crossing for 30 minutes daily, three days a week for four weeks, whereas subjects from the TWT group received only a treadmill walking. The 10 m walk test (10MWT), 6-min walk test (6MWT), berg balance scale (BBS), timed up and go test (TUG), activities-specific balance confidence-Korean version (ABC-K), and walking ability questionnaire (WAQ) were measured before and after the 4-week training. The TWT-OC group showed significantly better functional mobility of walking and balance measured by 6MWT (p<.01), BBS (p<.01), and TUG scores (p<.05) when compared with those of the TWT group. Further, within-group comparison showed significant improvement in all variables (p<.01) except for 10MWT. These findings suggest that the TWT-OC and TWT may be helpful for improving the walking function of patients with chronic stroke, and the TWT-OC has probably more favorable outcomes for chronic stroke, however, further trials with wider range of subjects are warranted for generalization and clinical relevance.

• PNF and Movement
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• v.15 no.2
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• pp.185-194
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• 2017

Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P<0.05). Significant differences between the PWBV and WBV groups were found (P<0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.

• PNF and Movement
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• v.15 no.3
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• pp.333-341
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• 2017

Purpose: This study was to explore the effects of trunk exercise using PNF combined with treadmill training on balance and walking ability in patients with Parkinson's disease. Methods: This study included 16 patients with Parkinson's disease. Participants were randomly assigned to 2 groups: an experimental group (n=8) and a control group (n=8). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (trunk exercise using PNF) and control group (conventional training) participated in a 30-minute exercise program. Both groups performed the training 5 times per week for 4 weeks. Disease severity (determined using the unified Parkinson's disease rating scale motor subscale, UPDRS-3), balance (determined using the Berg balance scale, BBS), walking speed (determined using the 10-meter walking test, 10MWT), and walking endurance (determined using the 6-minute walking test, 6MWT) were measured at baseline and after 4 weeks. Results: Pre- to post-intervention improvement was noted on all outcome measures for both groups (p<0.05). Post-intervention, there was a significant improvement in the experimental group as compared to the control group for the following measured outcomes (p<0.05): UPDRS-3 (p=0.03; 95% CI, -5.52 to -0.24), BBS (p=0.04; 95% CI, 0.59 to 6.45), 10MWT (p=0.01; 95% CI, -2.19 to -0.42), and 6MWT (p=0.04; 95% CI, 1.81 to 96.72) Conclusion: The results of this study revealed that trunk exercise using PNF plus treadmill training improves balance and walking ability as compared to conventional training plus treadmill training in patients with Parkinson's disease.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.3
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• pp.57-65
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• 2015

PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.