• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.169-185
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• 2020

Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.101-108
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• 2020

PURPOSE: The purpose of this study was to investigate the effect of treadmill walking training using the metronome on the gait pattern. METHODS: A total of 33 healthy persons were studied consisting of 17 female and 16 male in the 20-30 age group. A gait analysis program was installed on a treadmill with a built - in gait analysis sensor and laptop. After 9 minutes of treadmill walking, gait analysis was performed for 1 minute. The mean values of the differences in the step length, angle of COP, separation line standard deviation and step force of the lower legs affecting walking symmetry were calculated for treadmill walking and treadmill walking using the metronome. The Shapiro-Wilk test was used to test the normality of the collected data and a paired t-test was performed to analyze the difference in walking before and after using the metronome. RESULTS: As a result of the analysis, the mean of difference between the measured values of the bilateral lower extremity for step length, angle of COP, separation line standard deviation and step force were statistically significant before and after treadmill walking using the metronome. CONCLUSION: Therefore, the treadmill walking training using the metronome is effective in decreasing the difference in the foot width, gait angle, gait distribution, and foot pressure. Because of this, the treadmill walking training using the metronome has a significant effect on walking symmetry among the elements for correct walking, which is a means for enabling efficient and continuous walking.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.39-48
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• 2020

PURPOSE: This study examined the effects of integrating transcutaneous electrical nerve stimulation into treadmill gait training by applying functional electrical stimulation on the spasticity, balance, and gait ability of chronic stroke patients METHODS: Twenty participants were assigned randomly to two groups: the treadmill gait training group with applied functional electrical stimulation (FES) with integrated transcutaneous electricalstimulation (TENS) (experimental group, EG, n = 10) and the treadmill gait training group with FES (control group, CG, n = 10). Both groups received treadmill gait training with FES for 30 minutes a time, four times a week, during five weeks. The experimental group received additional TENS on their L3, L5, and S2 dermatome for 30 minutes before the interventions. The spasticity, balance, and gait ability were evaluated before and after the training to compare the intergroup and intragroup changes. RESULTS: Both groups showed significant improvements in the static, dynamic balance, and gait ability (p < .05), but did not show any significant changes in the muscle tone. The EG showed significant improvements in the static balance ability and gait cycle compared to the CG (p < .05). CONCLUSION: Treadmill gait training combined with FES with integrated TENS is an effective method for improving the static balance and gait cycle. On the other hand, the effects of treadmill gait training with FES on spasticity need to be studied further.

• Journal of Korean Physical Therapy Science
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• v.25 no.1
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• pp.31-43
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• 2018

Purpose: The purpose of this study is to investigate and to verification of changes that the effect of treadmill and body weight support treadmill training on balance and gait ability for sub-acute stroke patients during 4 week. Method: 16 subjects who was diagnosed stroke were divided into 2 groups(8-treadmill training group, 8-body weight support treadmill group) by randomized control trial. Both training programs were consisted with 40 minuted, 5 times a week for 4 weeks and after training programs. Analysis: We analysed effects and changes on balance and gait ability. Analyses were performed using PASW ver. 18.0 and results were reported as mean ${\pm}$ standard deviation (S.D.). To investigate within group comparisons and to verification on effects of exercise, we did paired t test and repeated measured ANOVA test. Significance was set at p<.05. Result: Both training programs showed positive changes in Limit of Stability but significant results which is area of hemiside, area of intact side, area of posterior, total area were reported in body weight support treadmill training group. Changes of Berg Balance Scale was significantly increase and it had significant correlation between groups. Changes of 6 Minutes Walking Test was significant increase in both groups but there was no significant changes on Foot print and Romberg test. Conclusion: After considering all factors, both training programs showed effect on improvement of balance and gait ability in sub-acute stroke patients, but body weight support treadmill training group had better improvement in dynamic balance than treadmill training group. For the increase of balance and gait ability in sub-acute stroke patients, we need to continues study on difference of treadmill and body weight support treadmill and then we will give stroke patients a better satisfaction if we develop and provide a rehabilitation program for improvement of balance and gait ability.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.90-101
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• 2013

■ Objectives The goal of this study was to observe the gait patterns from a patient with Parkinson disease under three different walking speeds. ■ Methods The patient walked on a treadmill and we measured gait parameters using a treadmill gait analysis system for 2 minutes. The Parkinson patients walked under three different conditions, first, at the preferred walking speed, second, at slower speed than the preferred walking speed, and, third, at faster speed than the preferred walking speed. ■ Results In terms of temporal gait parameters, as speed of treadmill increased, stance phase and total double support decreased, and swing phase increased. In terms of spatial parameters, as speed of treadmill increased, step and stride length increased. In terms of kinetic parameters, max pressure increased as speed of treadmill increased. ■ Conclusion According to different walking speeds, some gait parameters of spatiotemporal and kinetic was changed.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.131-142
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• 2024

PURPOSE: This study was a systematic review and meta-analysis of the literature comparing the differences between task-oriented treadmill training and general treadmill training for stroke patients. METHODS: Literature published in the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), and PubMed was reviewed. A total of 1,163 studies were initially retrieved, of which eight articles were included in the final review. A quality assessment of the included studies was conducted using the Risk of Bias (RoB) 2.0 tool, and Duval and Tweedie's trim and fill method was used to evaluate publication bias. Data analysis was performed using R studio 4.2.1. RESULTS: According to the quality assessment using RoB 2.0, three articles were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size of task-oriented tradmill training was .35. Regarding gait function, the values were .76, .25, and .40, respectively, for gait endurance, gait speed, and gait pattern. According to Duval and Tweedie's trim and fill method, no publication bias was observed. CONCLUSION: Study findings indicate that task-oriented treadmill training is the most effective intervention for improving gait endurance in patients with stroke. Therefore, applying this intervention to patients with stroke in the community is recommended.

• Physical Therapy Korea
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• v.19 no.3
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• pp.81-90
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• 2012

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.763-769
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• 2016

Objective: To confirm the immediate gait improvement in a post-stroke gait disturbance patient equipped with a weighted vest. Methods: We selected a patient who was able to walk without another’s help or with tools. The selected patient had an unstable gait because she had only started an independent gait within the past week, so we thought that a weighted vest could be very helpful for her. We first collected gait parameters using a treadmill gait analysis system while the patient walked on the treadmill without the weighted vest. After a 10-minute break, gait parameters were collected again while the patient walked on the treadmill while wearing the weighted vest. The gait parameters we collected included step length (cm), stance phase (%), swing phase (%), SW/ST, and gait line length (mm). For objective evaluation of gait improvement, we calculated the ratio of gait parameters of the right and left limbs. Results: The gait of the post-stroke patient was more symmetrical when wearing the weighted vest than without the weighted vest. Without the weighted vest, her step length ratio was 0.78, stance phase ratio was 0.88, swing phase ratio was 1.50, SW/ST ratio was 1.70, and gait line length ratio was 0.91. With the weighted vest, her step length ratio was 0.88, stance phase ratio was 0.90, swing phase ratio was 1.38, SW/ST ratio was 1.54, and gait line length ratio was 0.98. No side effects were observed due to the weighted vest.

• Korean Journal of Applied Biomechanics
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• v.17 no.4
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• pp.1-8
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• 2007

The purpose of this study was to investigate the difference in the stride-to-stride variability between two treadmill conditions; traditional treadmill and special treadmill whose speed can be adjusted automatically by subject's walking speed. Eight male subjects (25.1 years, 172.7 cm, 66.6 kg) were participated in treadmill walking experiment. First, preferred walking speed (PWS) of each subject was determined. Second, each subject performed walking experiment with fixed PWS condition and with free PWS condition for 10 minutes. 3D motion capture system (Motion analysis Corp., USA) with 6 cameras was used to collect motion data with sampling frequency of 120Hz. Temporal and spatial variables for stride-to-stride variability were calculated. Coefficient of variance (CV) which quantifies the amount of variability and Detrended Fluctuation Analysis (DFA) which explains the structure (self-similarity) of the variability were used for analysis. Results showed that the amount of variability during free PWS condition was greater than that of fixed PWS condition. DFA results showed that there was a statistical difference between two treadmill conditions for the variables of step length, stance time, and double support time. From these results, it is possible that traditional treadmill study might give incorrect conclusion about gait variability study. Further study is necessary to clarify these matters by considering the number of subjects, experimental time, and gait variables for the study of stride-to-stride variability.