Purpose: In real life there are both straight-paths and curved-paths. To evaluate walking ability of both kinds, a figure-8 walking test (F8WT) was developed. The aim of this study was to validate the measure in hemiplegic patients with walking difficulties and to identify correlations of curved walking ability with straight walking ability, motor function, and walking performance ability. Methods: Twenty subjects participated in this study. Curved walking was measured by a F8WT. Straight walking ability was measured by a 10-meter walking test (10MWT). Dynamic balancea bility was measured by timed up and go (TUG) tests. Walking performance ability was measured using a modified motor assessment scale (MMAS). Motor function was measured by the Fugl-Meyer assessment (FMA) scale. Data were analyzed using Pearson correlation analysis. Linear regression analyses were performed to explore other functional tests in mobility ability by F8WT time, 10MWT (dependent variable). Results: There was a significant positive correlation of F8WT time with 10MWT and TUG. There was a significant negative correlation of F8WT time with MMAS and FMA-coordination. There was a significant positive correlation of 10MWT with TUG. There was a significant negative correlation of 10MWT with MMAS and FMA-coordination. The F8WT time for curved walking ability was attributed to 10MWT for straight walking ability as 94% level of contribution. Conclusion: The results suggest that the F8WT is a good instrument for measuring walking ability because there is a robust correlation of F8WT time with 10MWT, TUG, MMAS, and FMA-coordination in hemiplegic patients who, after stroke, have a mobility deficiency.
Purpose: The purpose of this study was to investigate the effects of using proprioceptive neuromuscular facilitation (PNF) exercise in the progressive sitting position on the dynamic balance ability of a patient with a cerebellar injury. Methods: The subject had ataxia due to cerebellar injury. The subject participated in a PNF bilateral scapular pattern exercise with stabilizing reversal technique during a progressive sitting position session as well as baseline for 20 minutes a day for 4 weeks. In the first session, PNF exercises were performed at a height of 40 cm for 10 minutes, and in the second session they were performed at 50 cm for 10 minutes from a lower center of gravity (COG) to a higher COG sitting position. We used the Berg Balance Scale (BBS), Five-Times-Sit-to-Stand Test (FTSST), and the Timed Up and Go Test (TUGT) to measure the subject's dynamic balance ability every two days through the entire session. Results: After participating in the program, the subject's dynamic balance ability improved compared to the first baseline, as measured by BBS (2 points increased), FTSST (5.3 sec decreased), and TUGT (2 sec decreased). The increase was also maintained in the second baseline session. Conclusion: PNF exercise using bilateral scapula patterns with a stabilizing reversal technique helps to enhance the dynamic balance ability of a cerebellar injury patient.
Purpose : The purpose of this study was to investigate the effects of proprioceptive exercise (PE) using a trampoline and a balance board on a balance ability after stroke. Method : Sixteen chronic stroke patients participated. Participants were randomly assigned to the PE group or control group (8 experimental, 8 control). All of participants were in-patients at local rehabilitation centre and had been receiving a traditional rehabilitation program, five days a week. The PE group have additionally undergone for four weeks, three days a week, the PE using a trampoline and a balance board under supervision by a physical therapist but control group was not received any additional program except the traditional rehabilitation program. The position sense test used to assess a proprioceptive sense at a knee joint. The Berg Balance Scale (BBS) and the Timed Up & Go (TUG) test to measure the balance ability were carried out before and after the training. Result : After the training the error of position sense at knee joint of PE group significantly decreased compared to the control group. The PE group demonstrated a significant improvement in the scores of the BBS and TUG. Conclusion : The present study suggests that the PE program using a trampoline and balance board may become a useful tool for enhancing a balance ability in chronic stroke patients through the ennced proprioceptive position senses.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.17
no.2
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pp.19-24
/
2011
Background: The elderly are likely to fall due to physical and mental atrophies, and experiencing falls may result in fear of falls and lack of self-confidence, which also leads to hesitation to physical activities and changes in walk and balance, the major variables in independent daily life. Methods: In three senior citizen centers located in D city, 22 elderly women aged 65 or older were chosen, and they filled in the questionnaire which included their agreement to voluntarily participate in the survey and medical histories. As to whether they had falls experience, the medical history items in the questionnaire asked them if they had falling down or falls once a year, twice for the three years. The objects were divided to NFE (non-falls experience) and FE (falls experience). Results: 1. As to walking abilities, significant difference was found between NFE and FE regarding walk width, stepping with two feet, and stride length while there was no significant different in terms of cadence. 2. As to balancing abilities, was significant difference between NFE and FE in terms of the physical body center area. As to the sit-to-stand, tandom gait test, no significant difference was found, and neither in the timed up and go test. Conclusions: The elderly with falls experience has inferior walking and balancing abilities to those without falls experience, and thus they are more exposed to the risks of falls.
Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.
Journal of the Korean Society of Physical Medicine
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v.9
no.2
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pp.223-231
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2014
PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.
Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.
Journal of the Korean Society of Physical Medicine
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v.13
no.4
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pp.95-103
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2018
PURPOSE: The present study was conducted to investigate the effects of functional electrical stimulation gait training with rhythmic auditory stimulation on balance and gait ability in stroke patients. METHODS: In this blinded randomized controlled study, 26 stroke patients were assigned to either experimental group (n=13) consisting of 30 min of gait training 5 days per week for 4 weeks while performing functional electrical stimulation gait training with rhythmic auditory simulation, or a control group (n=13) performing the same gait training program, also consisting of 30 minutes 5 days a week and lasting for 4 weeks, but without functional electrical stimulation and rhythmic auditory stimulation. At baseline and after the 4 week intervention, balance was measured using the timed up and go test (TUG). Gait velocity was measured using the 10-meter walk test (10 MWT) and gait ability was assessed using the functional gait assessment (FGA). RESULTS: After the intervention, the experimental group showed statistically significant differences in gait velocity and ability (10 MWT, FGA) (p<.05). Between-group differences were statistically significant in gait velocity and ability (10 MWT, FGA) (p<.05). CONCLUSION: The findings suggest that functional electrical stimulation gait training with a rhythmic auditory stimulation gait training program may help improve gait ability in stroke patients.
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.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.27
no.2
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pp.55-67
/
2021
Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.
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