• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.91-96
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• 2021

Purpose: This study investigated the effects of cryotherapy on the ankle joint muscle strength and balance ability in stroke patients with ankle joint muscles. Methods: In this study, 20 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a cryotherapy group (10 patients) and a control group (10 patients). The cryotherapy group performed sit-to-stand training for 15 minutes and then cryotherapy for the minutes. In the control group, after sit-to-stand training for 15 minutes, blocked cryotherapy was provided for three minutes. In both groups, the interventions were provided five times a week for three weeks. The strength of the ankle joint muscles was measured before and after the training using the Biodex systems 3. The static balance ability was measured using balancia software, and the dynamic balance ability was measured by performing the sit-to-stand test (FTSST) five times. Results: After the training periods, the cryotherapy group showed significant improvement in the ankle dorsiflexor strength, ankle plantarflexor strength, weight distribution of the affected side, and FTSST compared to the control group (p<0.05). Conclusion: Based on these results, cryotherapy could be considered an effective method to improve the strength of ankle joint muscles. Cryotherapy improves muscle strength as it increases the motor neuron excitability. Therefore, cryotherapy may be considered to improve the strength of the ankle joint muscles of stroke patients.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1318-1332
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• 2000

The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.

• Physical Therapy Korea
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• v.22 no.2
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

• PNF and Movement
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• v.19 no.3
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• pp.341-349
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• 2021

Purpose: The purpose of this study was to investigate the effect of soleus muscle stretching on the muscle thickness and muscle tone of the tibialis anterior and peroneus longus muscles in healthy young adults. Methods: This study was an observational, cross-sectional study design in healthy young adults. Thirty healthy young adults participated in the study. To investigate the effect of agonist elongation on the muscles' antagonist and synergist characteristics, this study conducted the dynamic stretching of the soleus and plantarflexor muscles for 20 seconds. This study measured the muscle thickness and muscle tone of the soleus, tibialis anterior and peroneus longus muscles before stretching, immediately after stretching, and five minutes after stretching. Results: After analysis, the muscle tone of the soleus muscle was significantly decreased immediately after stretching (20.91±2.61Hz) compared to before stretching (21.83±2.78Hz). The muscle tone of the tibialis anterior was significantly decreased both immediately after stretching (21.76±2.73Hz) and five minutes after stretching (21.72±3.25Hz) compared to before stretching (22.61±3.29Hz). The muscle thickness of the soleus muscle was significantly decreased immediately after stretching (2.04±0.52mm) compared to before stretching (2.21±0.51mm) and was significantly increased five minutes after stretching (2.14±0.49mm) compared to immediately after stretching. Conclusion: The results of this study showed the static stretching of the soleus muscle changed the muscle tone of the tibialis anterior, but not of the peroneus longus muscle. This study suggests that the dynamic stretching of the agonist muscle would show meaningful muscle tone change in the antagonist.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.5-23
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• 2002

Purpose: To determine the effect of the Fall Prevention Program(EPP) on gait, balance and muscle strength in elderly women at a nursing home. Method: The subjects of this consisted of 38 elderly women between the ages of 70 to 89 years living at a nursing home located in Seoul. Each of the experimental group and control group was composed of 19 subjects. The subjects in experimental group have participated in FPP for the 8 weeks which consisted of exercise, education and foot care. They started to exercise for 40 minutes per session, 3 sessions a week during the 1st week at 40% of age adjusted maximum heart rate. From the 2nd week to the 4th week, they increased the duration of exercise to 50 minutes per session and the intensity to 60% of age-adjusted maximum heart rate. They participated in 50 minutes at 60% of age-adjusted maximum heart rate from the 5th week to the 8th week. Each exercise session consisted of 10 minutes of warming-up exercise, 30 minutes of conditioning exercise and 10 minutes of cooling-down exercise. They participated in education for 20 minutes per week from the 1st week to the 4th week. Then they participated in a 30-minute foot care program per week from the 5th week to the 8th week. Gait, balance and muscle strength for each subject were measured before and after FPP. Gait was evaluated by step length, step width, gait speed and walking distance. Balance was measured by the duration of standing on one leg with their eyes closed and open each, and a get-up and go test. Grip strength was measured by hand dynamometer. Hip extensor and flexor strength, knee extensor and flexor strength and ankle plantarflexor and dorsiflexor strength were measured by manual muscle tester. Data was analyzed using SPSS form Windows. t-test and Chi square test were utilized as a homogeneity test. Repeated measure ANOVA was used to test the effect of FPP. Result: 1) Step width significantly decreased, and step length, gait speed and walking distance significantly increased in the experimental group compared with the control group after FPP(p<0.005). 2) There was no significant change in standing time on one leg with their eyes closed after FPP. The standing time on leg with their eyes open and the time of "get-up and go" significantly decreased in the experimental group compared with the control group after FPP(p<0.005). 3) Muscle strength-grip strength, hip extensor and flexor strength-significantly increased in the experimental group compared with the control group after FPP(p<0.005). 4) There was no significant difference of frequency of fall between the experimental group and control group during the period of FPP. Conclusion: These results suggest that FPP can increase gait, balance and muscle strength of elderly women at a nursing home.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.4
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• pp.1740-1748
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• 2011

The purpose of this study was to investigate effects of the long-term high-frequency transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in chronic stroke patients. Twenty-six subjects with spasticity over lower limbs were allocated randomly into two groups under standard rehabilitation: (1) TENS group, (2) placebo-TENS group. TENS stimulation was applied on the both the gastrocnemius for 30 minutes, 5 days a week for 4 weeks(100 Hz, 0.25 ms, 2 times sensory threshold). The Modified Ashworth Scale(MAS) and Hand-held manual muscle tester were used to assess the ankle plantarflexor spasticity. Balance function under three conditions was measured by using force-plate and the amount of postural sway was assessed; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Both groups showed significant improvement in spasticity and balance function after treatment for 4 weeks(p<.05). Especially, TENS group showed a significant reduction of spasticity compared to placebo-TENS group(p<.05). These results suggested that additional stimulation of a long-term high-frequency TENS to standard rehabilitation induced an improved balance function and a spasticity reduction. The long-term application of high-frequency TENS will be an effective intervention for reducing spasticity and increasing balance ability in the chronic stroke patients.

• 한국노년학
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• v.29 no.1
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• pp.259-273
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• 2009

Purpose: This research was conducted to determine the effects of a multifactorial fall prevention program applying HSEP(Home Support Exercise Program) on physical balance and gait, leg strength, fear of falling and falls efficacy of the community-dwelling elderly. Method: The design of this study was a nonequivalent control group pretest-posttest design. There were 20 subjects in the experimental group and 21 in the control group. The fall prevention program consists of HSEP and fall related education. The intervention was performed for once a week in the senior citizen center and twice a week at home for 8 weeks. Results: There were significant differences in physical balance and gait, leg strength(hip extensor, hip flexor, knee flexor, ankle plantarflexor, ankle dorsiflexor) and falls efficacy between the experimental group and control group. Conclusion : The fall prevention program applying HSEP used in this study was very effective in increasing physical balance and gait, leg strength and falls efficacy. Finally this study would recommended that a fall prevention program applying HSEP should be extended to community facilities such as elderly welfare center and nursing home.