• Physical Therapy Korea
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• v.22 no.4
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• pp.71-78
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• 2015

Previous studies have investigated stepping over obstacles in treadmill walking training (TWT-OS) and treadmill walking training (TWT) alone for walking capacity not considering real physical activity. As such, we investigated the effects of TWT-OS on physical activity and changes in different levels of physical activity based on community ambulation in stroke patients. Thirty subjects were randomly assigned to either the experimental group or the control group, with 15 and 15 subjects, respectively. However, one subject from the control group was excluded because of inadequate treatment sessions. All subjects underwent routine physical therapy in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-stepping while walking on the treadmill for 30 min/day, five times/week, for four weeks. Subjects were given a three-axis accelerometer to wear at the hip on a belt for one-week pre- and post-training physical activity. Step counts for seven days, average daily step counts, and the average of minutes spent in sedentary, light, and above moderate activity were chosen as outcome measures of physical activity. No significant differences between the groups were found in terms of step counts for seven days, average daily activity, or daily activity spent at sedentary levels after four-week interventions. However, the average daily activity spent at light levels (-42.60 min vs. -6.71 min) was significantly lower in the experimental group than in the controls. Conversely, average daily activity spent at above moderate levels was higher (19.86 min vs. 11.07 min) (p<.05) after adjusting for each baseline value. Significant pre- and post-training differences were found in all variables of the experimental group (p<.05). Thus, TWT-OS could improve physical levels above moderate activity as a community-oriented task more than simple repetitive waking on a treadmill, and it could provide an opportunity for patients ambulatory after stroke to participate in the community again.

• Physical Therapy Korea
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• v.22 no.4
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• pp.8-16
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• 2015

The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

• Physical Therapy Korea
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• v.21 no.4
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• pp.34-39
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• 2014

The purpose of this study was to examine the effect of three cognitive tasks on gait at a preferred walking speed, and at a fast speed, using dual-task methodology. A total of 29 stroke patients participated in the study. All 29 subjects performed 2 motor tasks (10-meter walk task and timed up and go task each at a preferred and a fast speed) and three cognitive tasks [Stroop, word list generation (WLG), serial subtraction (SS)] under dual-task conditions [cognitive-motor interference (CMI)] in a randomized order. Gait speeds were measured in six different conditions. A repeated-measure analysis of variance was employed to compare the results of the Stroop training, WLG, and SS tasks during preferred and fast walking. A Bonferroni adjustment use for post hoc analysis. The level of statistical significance was set at ${\alpha}=.05$. A CMI effect occurred for performance of a 10-meter walking task at two different speed and a cognitive task (p<.05). Stroop had a significantly greater effect than SS and WLG (p<.05). The timed up and go task was affected when performed with fast walking speed during Stroop cognitive task (p<.05), but was not affected if performed with preferred walking speed during a cognitive task (p>.05). This study showed that CMI of Stroop can be used as a rehabilitation program for stroke patients.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.209-220
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• 2000

Spasticity, an abnormal increase in resting muscle tone, is one of the most common symptoms of stroke, and its management is becoming a major issue in rehabilitation. The aims of this study are to determine the effects of electroacupuncture(EA), TENS and neuromuscular electric stimulation(NMES) on spasticity, as well as the possibility of tissue comliance method as a spasticity scale. 45 stroke patients participated in a study of the effects on hemiplegic spasticity of EA, TENS and NMES. Spasticity was measured by modified Ashworth scale on the upper extremity and tissue compliance measurement, penetration mm/kg, on Susamni(LI10) area at just before and after stimulation, and 30 minutes, 1 hour, 2 hours and 24 hours after stimulation. The acupuncture points were applied to Kokchi(LI11), Susamni(LI10), Hapkok(LI4) and Oegwan(TE5) of the affected limb. The electrodes were placed unilaterally on LI11 to LI10 and TE5 to LI4. EA with biphasic wave, 60Hz, 0.4 msec pulse duration and low intensity was applied continuously for 20 minutes. TENS with high frequency, low intensity was applied. NMES was applied with spasticity program for 20 minutes. Each electric stimulation was done on extensor muscles group of forearm for 20 minutes. EA and NMES groups were found to produce a statistically significant decrease(p〈0.05) of spasticity and these effects lasted up to 30 minutes after stimulation. There was no definite correlation between the modified Ashworth scale and tissue compliance measurement. But tissure compliance method was found to be possible as a quantitative measurement on spasticity. There was no significant correlation between the effects of EA and NMES and the characteristics of patient, but significant correlation between the effects of EA and NMES and the modified Ashworth scale.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.5102-5109
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• 2011

The purpose of the this study was to identify validity and reliability of the Korean version of the London Handicap Scale (K-LHS) measuring participation restriction for stroke survivors within outpatient rehabilitation setting. 54 stroke patients participated. The reliability was good with a Cronbach's ${\alpha}$ and intraclass correlation coefficient of .791 and .983, respectively. The results of exploratory factor analysis was that the K-LHS was constructed two factors and explanation power was 72.32%. There are significant correlation between K-MBI and subitems of K-LHS (r=-.454 ~ -.819)(p<.01), except economic item. Because the K-LHS seems to be a valid and reliable, thus, it is considered to be appropriate as a tool to measure participation restriction of stroke patients in clinical practice.

• The Journal of Korean society of community based occupational therapy
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• v.4 no.2
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• pp.53-61
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• 2014

Objective : The purpose of this study was to examine the effects of video observation training on neglect and ability to perform activities of daily living of stroke patients. Methods : Patients diagnosed with stroke were selected as subjects according to criteria to select the research targets. The additional video observation training besides OT and PT was carried out to 15 patients in an experimental group and sham therapy besides OT and PT was performed to 15 patients in a control group. Line-bisection test were conducted to compare the neglect before and after therapy intervention and FIM was conducted to compare the ability to perform the activities of daily living. Results : The result of this study that we found out that degree of neglect in an experimental group where video observation training was carried out improved neglect and the ability to perform activities of daily living. Conclusion : The video observation training the video observation training is expected to be useful in clinics.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.63-70
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• 2019

Background: The purpose of this study was to determine the effects of a pelvic compression belt on gait abilities and balance in subacute stroke patients. Methods: Twenty two patients with subacute were recruited and randomly assigned into two group: Two group offered conventional physical therapy and occupational therapy for five day. The group was composed of twelve patients. Participants in the experimental group were given the pelvic compression belt and conventional physical therapy, conventional occupational therapy, although conventional physical therapy and occupational therapy provided in the subjects in the control group. To assess the gait ability, the GAITRITE system was used and the Balance system SD was used to test balance. All measurements were performed before and after intervention. Results: The experimental group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05) and show significant increase in the dynamic standing balance (p<.05). However, control group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05), but shows no significant differences in dynamic standing balance. Furthermore, there were significant differences gait velocity, dynamic standing balance between two groups (p<.05). Conclusions: The results demonstrated that the elastic pelvic belt application is effective to improve gait velocity, dynamic balance in the subacute stroke patients. Thus, the elastic pelvic belt is seemed to be one of the potential methods to facilitate the active rehabilitation program for hemiplegia patients.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.55-65
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• 2021

PURPOSE: This study compared the effects of sit-to-stand training with various foot positions combined with visual feedback on the postural alignment and balance. METHODS: Thirty stroke patients were assigned randomly into three groups of standing with a symmetrical foot position (SSF) (n = 10), asymmetrical foot position with the affected foot at the rear (SAF) (n = 10), and visual feedback and asymmetrical foot position (SVAF) (n = 10). Sit-to-stand training with different foot positions was performed for 30 minutes a day, five times a week, for a total of four weeks, and the effects on postural alignment and balance were assessed. RESULTS: The angle between the midline and scapula peak of the affected side was decreased significantly at sitting and thigh-off in the SAF group and at sitting, thigh-off, and standing in the SVAF group (p < .05). The angle between the midline and scapula peak of the non-affected side was increased significantly at sitting and thigh-off in the SAF group and at sitting, thigh-off, and standing in the SVAF group, the difference in the angle between the scapular peaks of the left and right sides was decreased significantly at sitting and thigh-off in SSF group, and at sitting in SAF group (p < .05). In the SVAF group, the angle at sitting, thigh-off, and standing was decreased significantly (p < .05). A comparison of the balance ability showed that BSS in the SVAF group was improved significantly (p < .05). CONCLUSION: Based on these results, the postural alignment and balance ability were improved in stroke patients who participated in sit-to-stand with visual feedback and asymmetrical foot position training.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.161-167
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• 2022

Purpose: The purpose of this study was to investigate the effects of regular training on the uneven surface that stroke patients encounter in their daily life on their ankle joint muscle activity and balance ability. They were divided into two groups: the gait training group on uneven surfaces and the gait training group on normal surfaces. Methods: In this study, 30 patients diagnosed with stroke and undergoing rehabilitation were selected. 15 people in the uneven surface gait training group and 15 people in the flat gait training group were selected. The muscle activation of the ankle muscles was measured when walking again on a even surface after walking on an uneven surface and on a flat ground. After each gait training, the limit of stability and Romberg test were performed to evaluate the balance ability. Results: As a result of the experimental results before and after walking by group, the tibialis anterior muscle activity of the paralyzed side was significantly decreased in the uneven surface walking group. As a result of measuring balance ability after training, the limit of stability in all directions was significantly increased in the uneven surface gait training group, and the area and length moved significantly decreased in the uneven surface gait training group in the Romberg test as well (p<0.05). Conclusion: After walking on uneven surface, it was confirmed that the muscle activity of the ankle joint decreased in normal flat walking, and thus the efficiency of muscle activity was increased. In addition, it was possible to confirm the improvement of the balance ability of the gait training on the uneven surface, and in conclusion, it could be confirmed that it had an effect on the improvement of the walking ability.

• PNF and Movement
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• v.20 no.1
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• pp.115-123
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• 2022

Purpose: The aim of this study was to investigate the effects of sit-to-stand training with various foot positions combined with visual feedback on muscle onset time and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned into three standing groups: one with a symmetrical foot position (SSF; n = 10), one with an asymmetrical foot position with the affected foot at the rear (SAF; n = 10), and one with visual feedback and an asymmetrical foot position (SVAF; n = 10). Sit-to-stand training with different foot positions was performed for 30 minutes a day, 5 times a week, for a total of 4 weeks. The effects on muscle onset time and balance were assessed. Results: In a comparison of the onset time of muscle contraction, the onset time of the affected side tibialis anterior and less-affected side gastrocnemius muscle and tibialis anterior was significantly shortened in the SAVF group. And onset time of the less-affected side tibialis anterior was shortened in the SAF group. There was a significant difference in the result of functional reach testing in the SVAF group. Conclusion: VRG was effective in improving muscle activity and balance in elderly women aged 65 and older. In this study, sit-to-stand training with visual feedback and asymmetrical foot position showed significant functional improvement.