• 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.

• Korean Journal of Applied Biomechanics
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• v.32 no.4
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• pp.111-120
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• 2022

Objective: This study investigated the effect of pelvic tiltng according to the paralytic side on gait in stroke patients during a 10 m functional movement timed up and go (TUG) test. Method: In this study, gait parameters were measured using a gait analyzer for 20 stroke patients and their gait was analyzed during a 10 m TUG test. For statistical analysis, an independent sample t-test were performed for age, height, and weight among general characteristics of subjects and homogeneity was tested by performing a chi-square test for gender, paralysis side, period of onset, and K-MMSE score. In order to understand the relationship between each variable, Pearson correlation analysis was performed on the variables. Results: First, the right-hand paralyzed group showed correlations in cadence and gait velocity in the up and down tilt of the pelvis, and the left-hand paralyzed group showed correlations in cadence and step length in the anterior and posterior tilt of the pelvis. Second, the tilt of the pelvis was correlated with the Sit to stand, walk forward, walk backwards, turn around at the end point, sit on a chair and the total TUG time in the right hemiplegic group compared to the left hemiplegic group. Conclusion: In this study, a significant correlation was confirmed as a result of gait analysis of right-handed stroke patients divided into a right paraplegic group and a left paraplegic group. In the future, it is suggested that treatment for improving gait of stroke patients should be treated differently for the right and left paralyzed side.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.15-22
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• 2012

Purpose : We investigated the effects of the combined use of FES and over ground walking with partial body-weight support (PBWS) on walking function and balance control in people with chronic strokes. Methods : Twenty-seven people who were ambulatory after chronic strokes were evaluated. The exercise's intervention consisted of the combined use of FES and over ground walking with PBWS and general exercise groups. The FES + PBWS group and general exercise group consisted on a-20-minute session per day, 3 times a week during a 4 week period. The evaluation was carried out before, after, and two weeks after the exercise intervention. Outcome measures were a 6 Minute Walk Test, 6-Meter walk Test, Timed Up and Go Test, and a Balance Test, measured before and after the exercise interventions at a-2 week follow up. Results : The endurance was significantly increased in both the FES+PBWS group and general exercise group (p<0.05). Significant increase on the gait velocity was observed in both the FES+PBWS group and general exercise group (p<0.05). The TUG was significantly different in both the FES + PBWS group and general exercise group (p<0.05). However there were no differences in both the between-group & interaction. The stability index was significantly different in both the FES + PBWS group and general exercise group (p<0.05). Conclusion : In conclusion, the combined use of FES and over ground walking with PBWS led to an improvement in walking function and balance control. Thus, it is possible to combine the use of FES and over ground walking with PBWS for physical therapy intervention to improve walking function and balance control. It is suggested to apply this intervention in the clinical field.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.259-265
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• 2012

Purpose : Patients with Parkionson's disease have a temporal and spatial restriction for their's exercise treatment. The aim of this study is to verify the effectiveness of e-exercise program on balance, gait, and endurance ability in people with Parkinson's disease. Methods : Eighteen participants, with Parkinson's disease that ranged from stage to on the Hoehn & Yahr scale, were assigned to two group. Two group were divided into on-line group that exercised in home by computer video, and off-line group that exercised in clinical center. Exercise program that included 3 sections (warm-up, main exercise, cool down)-5 parts(stretch, strength, balance, gait, stretch) was used to train for participants. We used the functional reach test for balance ability, timed up and go test for gait ability, 6 minute walking test for endurance ability. Wilkoxon sign lank tests were used to assess the difference of balance, gait, and endurance ability in pre-and post test each groups. Mann-whitney tests were used to assess the difference of balance, gait, and endurance ability between groups. Results : Wilkoxon sign lank tests revealed that both group were improved the balance, gait and endurance agility by e-exercise program intervention. Mann-whitney tests showed that there were no differences between groups in the variation of balance, gait, endurance ability. Conclusion : We believe that exercise program with on-line(e-exercise program) is an effective intervention for people with Parkinson's disease and is no different than off-line exercise group in the variation of balance, gait, endurance ability.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.29-37
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• 2012

Purpose : The purpose of this study was to establish intra-rater, inter-rater, test-retest reliability, and concurrent validity of figure-of-8 walk test in people with stroke. Methods : The subjects of this study were 17 patients who were diagnosed with a stroke. Subjects were tested twice by the same raters, with 1 day between tests. Subjects were assessed by two physical therapists. Test-retest reliability was calculated using intraclass correlation coefficients (ICC). The concurrent validity was demonstrated by spearman correlation of F8WT with 10m walking test (10MWT), timed up and go test (TUG), Berg balance scale (BBS), dynamic gait index (DGI) and four square step test (FSST). Results : Intra-rater, inter-rater, test- retest of F8WT time, showed high reliability. Intra-rater, inter-rater, test-retest of F8WT steps demonstrated high reliability. Intra-rater, inter-rater, test-retest of F8WT total smoothness score showed below moderate reliability. There was a significant positive correlation of F8WT time with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT time with DGI, BBS. There was a significant positive correlation of F8WT steps with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT steps with DGI. There was a significant positive correlation of F8WT test total smoothness score with BBS. Conclusion : The time, and number of steps in F8WT show high inter, intra-rater, test-retest reliability. The F8WT smoothness shows below moderate reliability. The F8WT shows high concurrent validity with other comparable balance, and walking tests. The F8WT is a valid and reliable measure for assessing walking function in patients with a stroke.

• PNF and Movement
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• v.13 no.4
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• pp.181-188
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• 2015

Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.9-18
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• 2008

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

• 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.

• Journal of Korean Physical Therapy Science
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• v.17 no.1_2
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• pp.1-9
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• 2010

Background: The objective of this study was to determine whether sensorimotor training using an unstable surface affects dynamic balance and gait function in patients with hemiparesis, and to compare the effect of sensorimotor training with that of cycling exercise. Methods: Two subjects with post-stroke hemiparesis volunteered to participate in this study. Single-subject A-B design with alternating treatment was used for this study. Baseline(A) and intervention(B) phases were performed for 7 and 8 sessions, respectively. Sensorimotor training and cycling exercise were performed for 20 minutes in randomized order. Assessment tools were made by using a step test, timed up and go(TUG) test, and 6-minute walk test(6MWT). Results: Each of the participants improved in all three tests after the two interventions. Participants 1 and 2 showed the improvement for their assessment score after sensorimotor training in the step test by 42.1%(p<.05) and 58%, in the TUG, 31% and 19.5%, and in the 6MWT test, 32.3% and 10.6%(p<.05), respectively. After cycling exercise, participants 1 and 2 also improved in the step test by 32.5% and 53.1%, in the TUG, 27.4% and 18%, and in the 6MWT test, 28.8% and 3%. In statistical analysis between the two interventions, sensorimotor training showed a significant increased values in the step test for participant 1 and the 6MWT for participant 2 as compared with those of cycling exercise. Conclusion: Sensorimotor training and cycling exercise are helpful for improving dynamic balance and gait capacity. Furthermore, sensorimotor training may be more helpful than cycling exercise.

• PNF and Movement
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• v.16 no.3
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• pp.405-414
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• 2018

Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.