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The Reliability of Balance, Gait, and Muscle Strength Test for the Elderly with Dementia: A Systematic Review

  • Lee, Han-Suk;Park, Sun-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.49-58
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    • 2017
  • PURPOSE: To summarize the evaluation tools of balance [Berg Balance Scale (BBS), timed up and Go (TUG), forward reaching test (FRT)], gait [6 m walking Test (6MWT)], and strength [Chair Stand Test (CST)] for patients with dementia. METHODS: The following databases were searched: Pub MED, Cochrane, Sciences Direct, and Web of Sciences. The inclusion criteria were as follows: 1) repeated measurement design, 2) subjects with dementia, 3) use of testing tools such as the BBS, TUG, FRT, 6MWT, and CST, 4) report the reliability. One reviewer performed the quality assessment of diagnostic accuracy study and two evaluators performed data extraction independently. RESULTS: Six articles and one letter were included. The interrater reliability of 6MWT, TUG, and CST, were acceptable (ICC>.90). However, FRT had unacceptable reliability. In test-retest reliability, only BBS has acceptable reliability (ICC>.90). Others had various reliabilities. The risk of interrater reliability bias was low in all studies. However, the risk of bias of intrarater reliability was low in five studies and moderate in two studies. CONCLUSION: The interrater reliability of the 6MWT, TUG, and CST were acceptable. However, in test-retest reliability, only BBS has acceptable reliability. Therefore, we suggest the use of BBS to test the balance of dementia patients. In addition, the study of tool reliability according to the subtype of dementia is needed in the future.

Concurrent Validity of the Functional Gait Assessment, Berg Balance Scale, and Timed Up and Go Test in Patients With Stroke (뇌졸중 환자에 대한 기능적 보행평가, 버그 균형척도, 일어나 걸어가기 검사의 동시 타당도)

  • Won, Jong-Im;Kim, Ki-Song
    • Physical Therapy Korea
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    • v.18 no.2
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    • pp.43-51
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    • 2011
  • Balance is a complex motor skill that depends on interactions between multiple sensorimotor processes and environmental and functional contexts. Many rehabilitation specialists believe that balance assessment under multitask conditions may be a more sensitive indicator of balance problems and falls than balance assessment in a single-task context. Functional Gait Assessment has many tasks that allow for testing under multitask conditions. The purpose of this study was to determine the concurrent validity between the Functional Gait Assessment (FGA), Berg Balance Scale (BBS), and Timed "Up & Go" Test (TUG) in patients with stroke. One hundred and five participants with at least 3 months post stroke and able to walk at least 6 m with or without a mono cane, participated in this study. Concurrent validity between the FGA, BBS, and TUG was assessed using Spearman rank order correlation. The FGA correlated with the BBS (r=.80, p<.01) and TUG (r=-.77, p<.01). The good and moderate correlation between the FGA, BBS, and TUG establishes the concurrent validity of the FGA in patients with stroke. These measures provide clinicians with valuable information about patients' functional balance capabilities.

Concurrent Validity between Figure-of-8 Walking Test and Functional Tests Included Tasks for Dynamic Balance and Walking in Patient with Stroke (뇌졸중 환자에서 8자 모양 경로 보행 검사의 동시 타당도 연구)

  • Kim, Joong-Hwi;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.24 no.5
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    • pp.325-333
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    • 2012
  • Purpose: The purpose of this study was to determine the concurrent validity between Figure-of-8 Walking Test (F8W), Berg Balance Scale (BBS), Four Squared Step Test (FSST), and Timed UP and GO Test (TUG) in patients with stroke. Methods: Forty two participants (26 men, 16 women, $55.0{\pm}11.72$) with at least three months post stroke who were able to walk at least 10 m without walking aid participated in this study. Assessment of concurrent validity between the F8W (time and steps) and BBS was performed using Spearman rank order correlation and between the F8W (time and steps), FSST and TUG assessed using Pearson correlation. Results: The time of the F8W showed correlation with BBS (r=-0.46, p<0.01), FSST (r=0.64, p<0.01), and TUG (r=0.81, p<0.01), and steps of the F8W showed correlation with BBS (r=-0.43, p<0.01), FSST (r=0.47, p<0.01), and TUG (r=0.51, p<0.01). Conclusion: The F8W is a valid measure of balance and walking skill among patients with stroke and may provide complementary information with regard to dynamic balance and functional walking for the real life of stroke patients.

Effect of Balance Ability in the Eldery Women of Motion-based Game Exercise Program and Stretching Exercise Program (체감형 게임 운동 프로그램과 스트레칭 운동 프로그램이 여성노인의 균형능력에 미치는 효과)

  • You, Young-Youl;Lee, Byoung-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.667-674
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    • 2010
  • Purpose : The purpose of this study was to investigate the effect of motion-based game exercise program and stretching exercise program on static and dynamic standing balance in elderly women. Methods : Subjects participated in the exercise program was 40 eldery women took part in this study. The average age of the elderly was 70.60 years. All subjects could walk without an assistive device. All subjects were participated in this study during 4 weeks(3 days per week, 30min/day). All participants were assessed on berg balance scale(BBS), functional reach test(FRT), timed up&go test(TUG). Results : The data were analyzed using paired t-test. After 4 weeks exercise training, the result of this study were as follows: The BBS of the elderly was significant difference between test-retest(p<0.05). The TUG of the elderly were significant difference between test-retest(p<0.05). The Motion-Based game from FRT of the was more significant difference than stretching exercise program(p<0.05). we also found significant differences for both groups FRT scores, and changes in mean BBS, TUG scores, but BBS, TUG were not significant. Conclusion : We findings suggest that elderly women person could improve their standing balance through Motion-Based game exercise program, and stretching exercise program.

Relationship Between Gait Symmetry and Functional Balance, Walking Performance in Subjects with Stroke (뇌졸중 환자의 보행 대칭성과 기능적 균형 및 보행과의 상관관계 연구)

  • Kim, Joong-Hwi
    • The Journal of Korean Physical Therapy
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    • v.26 no.1
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    • pp.1-8
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    • 2014
  • Purpose: The aim of the present study was to understand the relationship between gait symmetry and functional balance, walking performance in stroke patients and to makes recommendation regarding the most suitable measure for standardization of expression of spatiotemporal gait symmetry. Methods: 45 subjects with stroke (31 men, 14 women, $57.3{\pm}10.3$ years old) participated in this study. Gait symmetry was calculated by equations of symmetry ratio (SR) and symmetry criterion (SC) for stance time, swing time, single leg support time (SLST), step length, and stride length. Spatiotemporal parameters were measured respectively by walkway system ($GAITRite^{TM}$ system). Limit of stability (LOS) by using forceplate (Balance Performance Monitor) during voluntary weight displacement and Berg Balance Scale (BBS) were measured as functional balance and Timed Up and Go test (TUG) and Functional Ambulation Category (FAC) were assessed as functional walking. Results: SR in stance time and swing time was correlation with BBS, TUG and FAC (p<0.05). SR in SLST only with BBS (p<0.01), SR in step length only with FAC (p<0.05). SC in stance time was correlation with BBS and TUG (p<0.05). SC in swing time and SLST with BBS, TUG and FAC (p<0.01), SC in step length with TUG and FAC (p<0.01), SC in stride length with BBS and FAC (p<0.01). Conclusion: Gait symmetry in spatiotemporal gait parameters provides meaningful information about functional balance and walking performance in stroke subjects. Our analysis may support the recommendations of the symmetry criterion as equation for standardization of gait symmetry.

The Effect of Pilates Mat Exercise and Instability Support Surface Exercise on Balance for the Elderly Person Aged 65 or More (필라테스 매트 운동과 불안정 지지면 운동이 65세 이상 노인의 균형에 미치는 영향)

  • Lee, Chaewoo;Kim, Hyeonsu;Bae, Wonsik
    • Journal of The Korean Society of Integrative Medicine
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    • v.2 no.3
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    • pp.75-82
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    • 2014
  • Purpose : The purpose of this study was to investigate the effect of pilates mat exercise (PME) and instability support surface exercise (ISSE) for TUG (Time up & go) and static balance in the elderly person aged 65 or more. Method : 30 subjects in Y-equestrian were randomly divided two group, pilates mat exercise (PME) group and instability support surface exercise (ISSE) group. Each group carried out 40 minutes exercise two times a week for 12 weeks. TUG (Time up & go) and Biorescue were measured for static balance. Result : The results were as follows, the TUG between pilates mat exercise (PME) group and instability support surface exercise (ISSE) group in post-test, were significantly different in measures (p<.05). And there were significant in two group after exercise (p<.05). The static balance between pilates mat exercise (PME) group and instability support surface exercise (ISSE) group in post-test, were significantly different in measures (p<.05). And there were significant in two group after exercise (p<.05). Conclusion : These finding revealed that pilates mat exercise was effective on TUG and static balance in the elderly person aged 65 or more so that these exercise can be new alterative exercise for obesity management in the elderly person.

A Study on the Safety-Towing System for Barge Using Portable GPS (휴대용 GPS를 이용한 부선의 안전예항시스템 구축에 관한 연구)

  • Lee, Sang-Min;Ahn, Byung-Kil
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.14 no.4
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    • pp.303-307
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    • 2008
  • The tug boat is restricted in her maneuvering ability due to the towed barge, and tug-barge has been strongly affected by the external forces, i.e. the wind, wave, currents, and so on. Therefore, it is difficult to get the safety of tug-barge operation. It is necessary for the captain of tug boat, VTS and operation department to develope the system which can keep observing the course, speed and position of the towed barge in actual sea and prevent the marine accidents in advance. In this study, we proposed the basic method to develope the safety towing system for barge using portable GPS which was easily movable and relatively inexpensive. Then we conducted the test on the real barge. As a result, we could obtain diverse navigation data to make a safety towing work. It was noted that these data could be used for carious purposes.

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A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke (뇌졸중 환자의 낙상 예측을 위한 평가도구 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.21 no.2
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

The effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in persons with stroke: a pilot study

  • Park, Jae Ho;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.3
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    • pp.125-131
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    • 2016
  • Objective: The purpose of this study was to investigate the effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in stroke patients. Design: Randomized controlled pilot trial. Methods: Fifteen subjects were randomly divided into three groups where five subjects were in the visual feedback robotic device assist gait training (VRGT) group, five subjects in the auditory stimulation robotic device assist gait training (ARGT) group, and five subjects in the control group. Subjects received visual feedback and auditory stimulation while undergoing robotic gait training for 45 minutes, three times a week for 2 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 2 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test (10MWT) pre- and post-intervention. Results: All subjects showed that BBS, TUG test, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved post-treatment (p<0.05). The VRGT and the ARGT showed significant improvements in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). The VRGT group showed a significant improvement in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). In addition, it has been confirmed that VRGT had significantly improved in BBS, TUG test, and 10MWT scores compared with the auditory stimulation and control group (p<0.05). Conclusions: The results of this study showed improved balance and gait abilities after VRGT and ARGT groups compared with general physical therapy and was found to be effective in enhancing the functional activity of persons affected with stroke.

The grading of cognitive state comparisons with different distances across three conditions in stroke survivors

  • Kim, Yumi;Park, Yuhyung
    • Physical Therapy Rehabilitation Science
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    • v.3 no.2
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    • pp.134-141
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    • 2014
  • Objective: The purpose of this study was to compare with different distance across three conditions in stroke survivors with the grading of cognitive state. Design: Cross-sectional study. Methods: Twelve stroke patients who agreed to active participation were included. Participants were allotted to normal cognitive (CN) group (n=7) and cognitive impairment (CI) group (n=5) and then walked on a self-paced walkway at three conditions on the Time Up and Go (TUG) test and the 6 minute walk test (6MWT): 1) walking with your comfortable speed, 2) walking while carrying a tray with glasses, 3) walking with a verbal cognitive task. The TUG test was repeated three successful times on each condition. For the 6MWT, participants were tested one time. Results: The CI group walked slower than the CN group at the three conditions on the TUG test. However, there was no significant difference between two groups to each condition. A significant effect of dual tasking was found only in error of verbal cognitive task condition for the TUG test (p<0.05). On the 6MWT, the participants in the CI group walked short distance rather than the CN group (p<0.05). There were significant differences between two groups not only at all conditions but also at error of verbal cognitive task condition as well (p<0.05). Conclusions: To consider the results of different distances such as the TUG test and the 6MWT, we think that exercises in long distance would be more effective to patients with CI. Those would be improved patient's endurance in cognitive problem.