Objective: This study was performed to examine differences in the association between straight and curved walking abilities of inpatients in the subacute phase and walking independence level. Design: Cross-sectional study. Methods: Subjects were divided into an independent group and a supervised group (n=10 each) by walking independence level within the ward decided by physical therapists. Inclusion criteria comprised the ability to ambulate independently within the ward, regardless of the use of walking aids. Straight walking abilities (walking velocity, stride length, and cadence) were evaluated using the 5-meter walk test. Curved walking abilities were evaluated using the Figure-of-8 Walk Test (F8W) and the 3-meter zigzag walk test (3ZW). Differences in associations between straight and curved walking abilities of inpatients were examined by calculating correlation coefficients between straight and curved walking abilities. Results: Age, walking velocity, stride length, F8W and 3ZW varied markedly between independent and supervised groups. In the independent group, F8W and 3ZW correlated significantly with walking velocity and cadence (p<0.05). In the supervised group, F8W correlated significantly with walking velocity and stride length (p<0.05), but 3ZW did not correlate significantly with straight walking abilities. Conclusions: The association between straight and curved walking abilities varied between inpatients who could ambulate independently and inpatients requiring supervision for ambulating. These differences may depend on skill on straight and curved walking abilities. There is a possibility that curved walking exercise is necessary for supervised group.
Objective: Dual-task walking deficits impact functional daily life, which often requires walking while performing simultaneous tasks such as talking, thinking or carrying an object. This study is to find out the latest trend of dual-task training's influence on ambulatory abilities of a stroke patient. Design: Systematic review of randomized controlled trials. Methods: This literature review was conducted in Pubmed and Sciencedirect with the follwing key words:stroke, cerebro-vascular accident, hemiplegia, gait, rehabilitation, exercise. 7 studies were chosen in findings by search tool. 3 studies were case study, 3 studies were cross sectional observational study and 1 study was randomized controlled trial. Results: It was found that stroke patients have difficulties in doing 2 motor tasks simultaneously and when they do 2 tasks, one is done in a naturally preferred activity areas. Moreover, when simply applying dual-tasks, the walking speed decreased. Meanwhile, when applying them through training, the speed increased. This showed the improvement of effective task-implementation abilities after dual-task training using task-integration models. Conclusions: In the beginning of the 2000s, dual-tasks were implemented by simply combining walking and cognition or exercise task, and the results of this study suggest that subjects with stroke have difficulty performing dual task. However, the latest trend is to let patients do the dual-task training by combining it with virtual reality. Therefore, dual task training could be performed in a safe in the environment such as virtual reality or augment reality.
Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.
Journal of the Korean Society of Physical Medicine
/
v.13
no.1
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pp.89-98
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2018
PURPOSE: While underwater, patients with hemiplegia experience unwanted limb flotation on their paretic side due to low muscle mass and high body fat. However, only a limited number of studies support the effectiveness of this practice. Therefore, the purpose of this study was to determine how the balance and walking abilities of patients with hemiplegia due to stroke were affected by wearing an aquatic cuff on their ankles during underwater treadmill walking. METHODS: Twenty stroke patients were divided into an experimental group comprised of 20 patients who would wear an aquatic cuff and a control group comprised of 10 patients without an aquatic cuff. Both groups underwent a six-week intervention for 30 minutes a day three times a week. To evaluate the groups' balance and walking abilities before and after the intervention, the 10 m walking test, timed up go test, Berg Balance Scale, functional reaching test, and the GAITRite system were used. RESULTS: The results of the 10 m walking test, timed up go test, differences between the left and right gait cycles, and functional reaching test showed statistically significant differences in the rates of change between the two groups (p<.05). CONCLUSION: The study results suggest that underwater treadmill training in stroke patients can be more effective when they wear an aquatic cuff on their ankles compared to wearing no aquatic cuff.
Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.
Objective: This study aimed to investigate the effects of a walking program developed by applying the flow learning method in order to improve children's attitude toward nature and their empathy ability among other five-year-olds. Methods: A total of 49 five-year-olds attending classes at two kindergartens located in B city participated in this study. There were 24 children in the comparative group and 25 children in the experimental group. Before and after the program, all participants individually took a child's nature-friendly attitude test and rated their empathy ability with a teacher. Using the SPSS 25.0 version program, data were analyzed by conducting means, standard deviation, t-test, and ANCOVA(Analysis of Covariance). Results: Children who participated in the walking program using flow learning showed significantly higher nature-friendly attitudes than those of the comparative group. And empathy abilities in the experimental group were higher than in the comparative group in all areas. Conclusion/Implications: The results of this study suggest that a walking program applying flow learning is effective in improving young children's nature-friendly attitude and their empathy abilities.
Purpose: The current study seeks to examine the effect of coordinative pattern exercises of the upper and lower extremities using harnesses and walking rails on the walking and balance abilities of chronic stroke patients, and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 16 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=8), on which coordinative pattern exercises of the upper and lower extremities were conducted, and a comparison group (n=8) that received typical exercise therapy. The experimental group underwent 30 minutes of typical exercise therapy and 30 minutes of coordinative pattern exercises of the upper and lower extremities, while the comparison group underwent typical exercise therapy for 30 minutes twice a day, five days per week for a six-week period. To evaluate walking ability, 10-m walking tests (10MWT) and 6-m walking tests (6MWT) were conducted. To assess balance ability, timed up and go tests (TUG) were performed. Results: After the intervention, significant (p<0.05) differences were seen in the 10MWT, 6MWT, and TUG in both the experimental and comparison groups. As for the 10MWT, the experimental group showed more significant improvement than the comparison group (p<0.05). In terms of the 6MWT, no significant differences were found between the groups, while the experimental group showed more significant differences than the comparison group in the TUG (p<0.05). Conclusion: The results from the current research indicate that training programs that apply coordinative pattern exercises of the upper and lower extremities with harnesses are extremely effective for improving the walking and balance abilities of chronic stroke patients.
Purpose: The objective of this study was to identify functional problems, including walking ability, of patients with strokes using the International Classification of Functioning, Disability, and Health (ICF) and to present a method that could solve functional problems, thereby determining the applicability of the ICF to increase the quality of evaluation and intervention in clinical fields in the future. Methods: Information on stroke patients who were admitted and treated in a hospital was collected. The authors conducted evaluations, interventions, and measurements of the results of the ICF tool in order to improve gait abilities of patients. The subjects were trained using proprioceptive neuromuscular facilitation (PNF) one hour a day and five times a week for four weeks. The result measurement variables were a six-minute gait test, 10 m velocity test, gait instability test, and measurements using the ICF sheet. Results: In the six-minute gait test, gait distance increased by 48 m, from 102 m to 150 m. The gait velocity test result showed an improvement from 0.36m/s to 0.44m/s. The subjects performed a gait instabilitytestwithacupfilledwith50mmwater. In the gait instability test, the amount of water was 38 mm before the intervention; however, it was 50 mm after the intervention. The gait velocity with a cup filled with water improved from 0.25m/s to 0.31m/s. Conclusion: An evaluation and intervention were designed with the ICF tool for stroke patients. Gait abilities improved when the PNF technique was used. The IFC method can be used for evaluation and intervention, and it could help improve gait abilities of stroke patients.
Kim, Kyung-hwan;Park, Sung-hoon;Kim, Hyung-min;Pak, Noh-wook;Kim, Da-yeon
PNF and Movement
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v.15
no.1
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pp.77-84
/
2017
Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.
Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects' balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at ${\alpha}=0.05$. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects' gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients' gait and balance abilities.
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