• PNF and Movement
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• v.14 no.3
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• pp.237-244
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• 2016

Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

• PNF and Movement
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• v.15 no.2
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• pp.133-140
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• 2017

Purpose: This study compares the effects of treadmill gait training accompanied by visual feedback and general treadmill gait training on the gait and balance ability of patients with chronic stroke. Methods: A total of 11 patients with chronic stroke were randomly divided into either the treadmill gait training accompanied by visual feedback group (six patients) or the general treadmill gait training group (five patients). The gait and balance ability of the two groups were measured before and after the interventions using the functional reach test, the Timed Up and Go (TUG) test, Berg's balance test, and the Biodex balance test. The treadmill gait training accompanied by visual feedback group performed the exercise under the supervision of a therapist after first being provided with a hat and a goal that was devised for the purpose of providing visual feedback information. The interventions were applied to the respective groups for four weeks. For the statistical analysis, we conducted a Mann-Whitney test to compare the results between the two groups. Additionally, the Wilcoxon test was used to compare the results from before and after the intervention in each group. Results: The treadmill gait training accompanied by visual feedback group showed a significant difference in terms of the functional reach test after the intervention when compared to the general treadmill gait training group (p<0.05). Although there was no significant difference, the treadmill gait training accompanied by visual feedback group showed a larger improvement in the TUG test, Berg's balance test, and the Biodex balance test than the general treadmill gait training group (p>0.05). Conclusion: The results of this study suggest that treadmill gait training accompanied by visual feedback can be used as a beneficial intervention scheme for the recovery of the gait and balance ability of patients with chronic stroke.

• Physical Therapy Korea
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• v.21 no.3
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• pp.45-54
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• 2014

Fall is one of the most intimidating health conditions in elders. Comprehensive assessment is necessary to understand the individual and environmental aspects of the falls such as balancing abilities, depression, and quality of life. The purpose of this study was to compare the balancing ability, depression, and quality of life between elderly fallers and elderly non-fallers. Thirty-two community-dwelling elders (fifteen males and seventeen females between 65 and 83 years old), who have experienced fall on walking during last twelve months, were involved in the elderly fallers group. And twenty-four males and twenty-two females between 65 and 83 years old of community-dwelling elders, who have no experienced fall on walking during last twelve months, were involved in the elderly non-fallers group. Berg balance scale (BBS), timed up and go test (TUG), and functional reach test (FRT), were used to evaluate the ability of the physical balance. 'Beck depression scale in Korean' questionnaire was used to assess the depression. 'Korean version of World Health Organization Quality of Life Assessment Instrument-Bref' questionnaire was used to assess the quality of life. The results were as follows: 1) Balancing abilities measured by the BBS, TUG in the elderly fallers group were meaningfully lower than that of the elderly non-fallers group (p<.05), whereas no significant difference in the FRT was found (p>.05). 2) Depression level in the elderly fallers group was significantly higher than that of the elderly non-fallers group (p<.05). 3) Quality of life in the elderly fallers group was significantly lower than that of the elderly non-fallers group, excluding environment domain (p<.05). Therefore, in order for clinical evaluation of the community-dwelling elders those with reduced balancing ability, it is necessary to evaluate and understand the fall experience, depression, and quality of life.

• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.25-35
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• 2020

Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.90-95
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• 2017

Objective: The purpose of this study was to investigate the physical therapists' perception of the use of gait measures, the frequency of the gait measures used, and also to identify the barriers that limit the use of these assessment tools. Design: Cross-sectional study. Methods: Physical therapists from the Seoul, Gyeonggi area from March to July 2016 were included in the study. Over the course of 18 weeks, a cross-sectional study was conducted with a self-report questionnaire. A total of 700 questionnaires were distributed and 350 questionnaires (50%) were collected, however with the exclusion of 140 questionnaires due to non-consent, a total of 210 questionnaires (30%) were analysed. Results: Out of the 10 standardized assessment tools, the therapists showed the highest perception for the timed up and go test (TUG [n=153, 72.9%]) and they also had high perception for the 10 meters walk test (10MWT [n=149, 71.0%]), and 6-minute walk test (6MWT [n=123, 58.6%]). The respondents answered that the TUG (n=116, 55.2%), 10MWT (n=100, 47.6%), and 6MWT (n=51, 24.3%) was used the most often. On the contrary, only four (1.9%) therapists have used the Chedoke-McMaster stroke assessment and the Rivermead Mobility Index. The lack of time was considered as the most important barrier to the use of assessment tools in clinical practice. Conclusions: Through this study, it has been shown that the domestic physical therapists used the TUG and the 10MWT mainly due to high recognition and evaluation status; however, the lack of time was the greatest impediment to the clinical application of the gait assessment tools.

• Physical Therapy Korea
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• v.21 no.4
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• Journal of Digital Convergence
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• v.13 no.1
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• pp.367-373
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• 2015

The purpose of this study was to examine the effect of backward walking training on the balance capability(Functional Gait Assessment; FGA, Timed Up & Go Test; TUG) and gait performance(10 meter Walking Test; 10 mWT) of stroke patients. Eighteen with stroke patients were randomly allocated to an experimental and contral group of nine patients each. both groups received general neurorehabilitative physical therapy for 45 minutes per day 5 times per week during 4 weeks. The experimental group also performed additional backward walking training for 20 minutes per day 3 times per week during 4 weeks. There were signicantly increase by backward walking training in outcome of the balance capability from the FGA was increase from $17.67{\pm}1.00scores$ to $19.22{\pm}1.00scores$(p<.05), TUG was decrease from $26.45{\pm}1.37sec$ to $23.28{\pm}1.35sec$(p<.05) and 10 mWT was decreased from $21.74{\pm}1.35sec$ to $18.33{\pm}1.10sec$ (p<.05). These result suggest that backward walking training for stroke patients is effective in improving balance capability(FGA, TUG) and gait performance(10 mWT).

• Journal of the Korea Convergence Society
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• v.11 no.5
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• pp.87-96
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• 2020

The purpose of this study is to evaluate the convergence effectiveness of treadmill training in patients with chronic stroke through a meta-analysis. After searching the literature based on the patients, intervention, comparison, outcome criteria, and study desigan, a total of 22 studies related to "stroke" and "treadmill" were eligible for inclusion. Effect size was calculated using the comprehensive meta-analysis program for the meta-analysis. Based on the forest plot results, the overall effect size of treadmill training was 0.661 (95% confidence interval: 0.456-0.865), which was statistically significant with a medium effect size (p < 0.05). The effects of treadmill training on patients with stroke were separated by dependent variables of interest-plantar pressure (1.147), lower limb muscle function (0.875), and balance (0.664). The effect sizes were evaluated for the subdomains of timed up and go test (0.553), Berg Balance Scale (0.760), and static balance index (0.654) for balance. Therefore, treadmill training can be expected to have a positive impact on improving the quality of life of patients with chronic stroke. This meta-analysis of treadmill training may the lead to an industry paradigm shift toward healthcare convergence of information, communication, and medical technology.

• Journal of Convergence for Information Technology
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• v.8 no.4
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• pp.73-80
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• 2018

The purpose of this study was to investigate the effect of motion-based dance game on static and dynamic balance in elderly women. The participants were randomly divided into 2 group, Motion Based dance game group(n=10), control group(n=10). After they were divided into an Motion Based dance game group and a control group the Motion Based dance game group participated in six-week period of time, three times a week, 60 minutes each, and the control group didn't exercise outside of their daily lives. To evaluated the balance ability of exercise, it was evaluated by using Berg Balance Scale(BBS), Functional Reach Test(FRT), Timed Up and Go test(TUG). The data was analysis using a paired t-test and independent t-test to determine the statistical significance. The results of this study between BBS, FRT, TUG and Motion Based dance game group had statistically significant difference rather than control group(p<.05). In conclusion, the Motion based Dance Game showed improvement on the balance ability in the elderly. Regular maintenance of the Dance Game "Dance Central" program for the elderly will assistance improve the balance. Consequently, studies on the development of dance games suitable for the elderly are believed to be necessary.

• 재활복지
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• v.17 no.4
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• pp.383-399
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• 2013

The purpose of this study was to comparison the effects of aqua-and-land based obstacle training on balance of chronic stroke patients. Subjects were randomly divided into an aqua group(n=15) and d land group(n=15). Both group received obstacle training for 40 minutes, 3 times a week during 12 weeks. Static balance was assessed by measuring the mean velocity of mediolateral, anteroposterior and sway area with the eyes open using Good Balance System. Dynamic balance was assessed by measuring Functional Reaching Test(FRT) and the Timed Up and Go test(TUG). Following the intervention, both groups showed significant changes static balance(the mean velocity of mediolateral, anteroposterior and sway area) and dynamic balance(FRT and TUG). There were significant difference in the mean velocity of mediolateral, anteroposterior, sway area, FRT and TUG between the two groups after the interventions. The results of this study suggest that the aqua group and land group were increase balance functions of chronic stroke patients. The aqua group was significantly higher than the land group for patients with chronic stroke patients. We hope that aquatic training can be useful for patients with chronic stroke patients to improve balance functions and the aqua training research for improve balance functions will be conducted continuously.