• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.59-64
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• 2017

Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

• PNF and Movement
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• v.16 no.1
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• pp.7-17
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• 2018

Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.

• PNF and Movement
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• v.17 no.3
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• pp.339-351
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• 2019

Purpose: This study identified the effects of dual-task gait training on balance, gait function, and activity of daily living in patients with Parkinson's disease. Methods: This study used a single-subject design. Two patients with Parkinson's disease participated in this study. Dual-task gait training was performed 1 hour per day 8 times during intervention phase. The subjects were measured 8 times in the baseline phase, 8 times in the intervention phase, and 8 times in the follow-up phase. The outcome measurements included a timed up and go test (TUG), a Berg balance scale (BBS), a 10 meter walk test (10MWT), a 6 minute walk test (6MWT), a dynamic gait index (DGI) and a Korean modified Barthel index (K-MBI). Results: When compared to the average of the baseline process, the data collected during the intervention period showed that the TUG and 10MWT results improved and the tendency line was above the baseline. In addition, BBS, 6MWT, DGI, and K-MBI values for both patients increased remarkably after the training. Conclusion: The results of this study revealed that dual-task gait training may be helpful to improve balance, walking function, and activity of daily living for patients with Parkinson's disease. Further studies need to confirm our findings.

• Physical Therapy Rehabilitation Science
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• v.9 no.2
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.246-254
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• 2017

Purpose: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis Methods: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). Results: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p<0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p<0.05). Conclusion: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.134-141
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• 2014

Objective: The purpose of this study was to compare with different distance across three conditions in stroke survivors with the grading of cognitive state. Design: Cross-sectional study. Methods: Twelve stroke patients who agreed to active participation were included. Participants were allotted to normal cognitive (CN) group (n=7) and cognitive impairment (CI) group (n=5) and then walked on a self-paced walkway at three conditions on the Time Up and Go (TUG) test and the 6 minute walk test (6MWT): 1) walking with your comfortable speed, 2) walking while carrying a tray with glasses, 3) walking with a verbal cognitive task. The TUG test was repeated three successful times on each condition. For the 6MWT, participants were tested one time. Results: The CI group walked slower than the CN group at the three conditions on the TUG test. However, there was no significant difference between two groups to each condition. A significant effect of dual tasking was found only in error of verbal cognitive task condition for the TUG test (p<0.05). On the 6MWT, the participants in the CI group walked short distance rather than the CN group (p<0.05). There were significant differences between two groups not only at all conditions but also at error of verbal cognitive task condition as well (p<0.05). Conclusions: To consider the results of different distances such as the TUG test and the 6MWT, we think that exercises in long distance would be more effective to patients with CI. Those would be improved patient's endurance in cognitive problem.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.53-60
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• 2018

PURPOSE: This study aimed to identify the effect of a backward walking exercise using a mirror on balance and gait in patients with stroke. METHODS: Twenty subjects with post-stroke hemiparesis volunteered to participate in this study. The experimental and control groups performed backward walking exercise plus conventional therapy or conventional physical therapy, respectively, for 6 weeks. Assessment instruments included the Berg Balance Scale (BBS), timed up and go test (TUG), and 10-m walking test (10MWT). Evaluation was performed before and after the 6-week training period. We conducted a paired t-test to compare the within-group changes before and after the intervention. An independent t-test was used to compare between-group differences. The statistical significance level was set at ${\alpha}=.05$ for all variables. RESULTS: The experimental group showed a significant within-group change in the BBS, TUG, and 10MWT (p<.05). The control group also showed a significant change (p<.05). A significant difference was observed between the experimental and control groups with regard to changes in the BBS, TUG, and 10MWT results after the interventions (p<.05). CONCLUSION: This study demonstrated that backward walking exercise using a mirror may be valuable for future research. Further studies with a wider range of pathology and longer experiment duration are required to validate the results of the present study.

• The Journal of Korean Physical Therapy
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• v.30 no.2
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• pp.67-72
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• 2018

Purpose: The purpose of this study was to compare to aquatic treadmill and anti-gravity treadmill gait training to improve balance and gait abilities in stroke patients. Methods: All subjects were randomly divided into three groups where nine subjects were in the aquatic treadmill group, eight subjects in the anti-gravity treadmill group, and ten subjects in the control group. Subjects in the aquatic treadmill group and the anti-gravity treadmill group received gait training during 30 minutes, with 3 sessions per week for 4 weeks, and subjects in all groups received conventional physical therapy during 30 minutes, with 5 sessions per week for 4 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go test (TUG) and 10-meter walk test (10MWT) pre and post intervention. Results: Results showed that BBS, TUG and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas pre-post intervention (p<0.05). In addition, it has been confirmed that aquatic treadmill group and anti-gravity treadmill group had significantly improved in BBS, TUG and 10MWT scores compared with the control group (p<0.05). However, no significant difference was found in the comparison between the aquatic treadmill and the anti-gravity treadmill group. Conclusion: Finding of this study suggested that aquatic treadmill and anti-gravity treadmill improves balance and gait abilities in stroke patients.

• Nuclear Engineering and Technology
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• v.27 no.2
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• pp.165-175
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• 1995

The overpressure protection system for PWR should be designed with sufficient capacity to limit the pressure to less than 110％ of the reactor coolant system design pressure during the most severe abnormal operational transient. In this study, the feasibility of adopting the SEBIM POSRV instead of the current spring loaded pop-opening safety valves to the ABB-CE designed 2825 MWt PWR is investigated for its overpressure protection capability. The required SEBIM POSRV size as well as its opening/closing setpoints are determined through a series of computer analyses using the LTC code which has been used for the overpressure protection analysis for Yonggwang units 3&4. The analysis results show that the overpressure protection system with monobloc SEBIM POS-RV can maintain the RCS pressure below 110％ of the design pressure demonstrating its overpressure protection capability for the ABB-CE designed 2825 MWt PWRs.