• PNF and Movement
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• v.21 no.1
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• pp.119-128
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• 2023

Purpose: Obstacle crossing training is being used to improve the walking ability of stroke patients, but studies on which method is more effective when performing obstacle crossing training with an unaffected limb lead (OCT-ULL) and an affected limb lead (OCT-ALL) are not well known. As such, this study aims to compare the intervention effects of obstacle crossing training using unaffected limb leads (OCT-ULL) and obstacle crossing training using affected limb leads (OCT-ALL). Methods: In total, 25 patients with chronic stroke were studied and assigned randomly to the obstacle crossing training with unaffected limb leads (OCT-ULL) group or the obstacle crossing training with affected limb leads (OCT-ALL) group. A lower extremity strength test, balance and gait test, and fall efficacy test were conducted as preliminary tests, and all patients participated in the intervention for 30 minutes a day, five days a week for four weeks, and the same preliminary tests were conducted post-intervention. Results: Compared with the OCT-ALL group, the OCT-ULL group showed a significant improvement in the strength of the affected hip abductor muscle and in balance and gait, as well as in fall efficacy (p<.05). Conclusion: This study suggested that applying the OCT-ULL training method in the obstacle crossing training of stroke patients is more effective for improving balance and gait functions than OCT-ALL.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.112-117
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• 2015

Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.139-150
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• 2019

PURPOSE: This study was conducted to determine the effects of treadmill gait training with obstacle-crossing on the static and dynamic balance ability of patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into three groups as: treadmill gait training with obstacle-crossing (TOG, n=7), treadmill gait training without obstacle-crossing (TGG, n=7) and a control (CON, n=7). TOG and TGG performed exercise for 20 minutes, three times a week for 8 weeks. Static balance ability (stability typical, ST; weight distribution index, WDI; fourier harmony index, FHI; and fall index, FI) and dynamic balance ability (berg balance scale, BBS and timed up and go test, TUG) were measured before and after 8 -weeks in each exercise group. Statistical analyses were conducted using two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Tukey's HSD. RESULTS: FHI and BBS were significantly increased at TOG (p<.01) and TGG (p<.05) after 8-weeks compared to before treadmill gait training with obstacle-crossing. FHI and BBS were significantly increased at TOG compared with CON and TGG (p<.05). CONCLUSION: Treadmill gait training with obstacle-crossing was more effective than that without obstacle-crossing to improve posture control and independent daily life performance of hemiplegia patients.

• Physical Therapy Korea
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• v.15 no.4
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• pp.27-33
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• 2008

The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.55-62
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• 2019

PURPOSE: This study examined the muscle activity while stepping over obstacles with various heights and widths to provide basic data for training and preventing falls. METHODS: Fifteen normal young adults (seven males and eight females) were recruited. The participants walked on a 5m walkway with six obstacles. The heights of obstacles were 0%, 10%, and 40% of the subject's leg length, and the width of the obstacles was 7cm and 14cm. The participants traversed the course twice per obstacle. The muscle activities of the soleus, tibialis anterior (TA), vastus medialis (VM), and vastus lateralis (VL) were measured using surface electromyography. A Mann-Whitney test and Kruskal-Wallis test were used to examine the differences between obstacles. RESULTS: The muscle activities of the VL and the soleus of the stance leg and lead leg after crossing over the obstacles increased with increasing width, and there were significant differences in muscle activities between obstacle width (p<.05) except for the muscle activity of TA of the stance leg after crossing over the obstacles. A significant difference in muscle activities was observed according to the height of the obstacles with 14 cm (p<.05) except for the muscle activity of the VL, soleus of the leading leg, and TA of the stance leg CONCLUSION: The role of the VL and Soleus increased with increasing obstacle width, and the overall muscle activities of the lower extremities increased with increasing obstacle height. These results can be used to suggest a program to prevent falls.