• 한국전문물리치료학회지
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• 제23권3호
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• pp.1-10
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• 2016

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

• 대한물리치료과학회지
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• 제7권1호
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• pp.367-375
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• 2000

The purpose of this study is to announce the present condition, walking training, and adaptable training of a limb amputated patient. The study is a successful report of the limb amputated patient through the medical treatment of the physical therapy. A cause of the limb amputated patient, a truck driver, was that the patient was hit by a train when the driver alight from the truck. Then, the driver was surgical operated on left AK (Above Knee) amputation and left AE (Above Elbow) amputation by orthopedics at the Young Dong Severance Hospital on Dec.7, 1996. Two weeks after the operation (Dec., 22, 1996), the patient was trained at the Yonsei Medical Center Physical Therapy Hospital for the walking and temper adjust training. It was possible to do a flat surface walking and a slope surface walking without helping due to the patients optimistic personal character and motivation. However, the patient struggled to a dull surface walking and his weak endurance. the patient has several problems when the patient wears artificial legs and hands, fears on fall down, and mentally worries on noise when he walks. It is necessary to approach for this problems by many fields of the helpers, such as Rehabilitation medical doctor, physical therapist, occupational therpist, artificial limbs makers, psychologists, and etc. Therefore, in order for recovering from the amputated parts function after the surgical operation, more approved reports have to be for the amputated patients due to increasing traffic accidents, industrial disaster, cancer, diabetes, obstacles of the peripheral nervous system, and etc.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• The Journal of Korean Physical Therapy
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• 제25권1호
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• pp.23-28
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• 2013

Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.

• PNF and Movement
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• 제11권1호
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• pp.17-25
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• 2013

Purpose : To identify importance of coordinative locomotor training, we reviewed the coordinative locomotor training using sprinter & skater with respect to motor control theory. Methods : We reviewed literatures related with sprinter & skater and coordination.. Results : The coordinative locomotor training is useful tool to improve interlimb coordination. A problem of interlimb coordination ability is to minimize the degree of freedoms during walking and to solve with context-condition variability and how to make a interlimb coordinative structures. A way of solving method is coordinative locomotor training using sprinter & skater in PNF. The coordinative locomotor training set to fit the gait steps can be applied with gait tasks and can be extended by applying the irradiation of the PNF. Conclusion : The coordinative locomotor training using sprinter & skater in PNF is a useful way method to improve interlimb coordination during walking.

• 디지털융복합연구
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• 제13권1호
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• pp.367-373
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• 2015

본 연구의 목적은 뇌졸중 환자를 대상으로 후방보행 훈련이 균형능력(기능적 보행 검사, 일어나 걸어가기 검사) 및 보행(10 미터 보행검사)에 미치는 영향을 알아보고자 하였다. 이를 위해 18명의 뇌졸중 환자를 대상으로 실험군과 대조군에 각각 9명씩 무작위로 배정하였다. 두 그룹 모두 일반적인 신경학적 재활 물리치료를 1회 45분씩 주당 5회 4주 동안 실시하였으며, 실험군에는 후방보행 훈련을 4주 동안 1회당 20분씩 주당 3회를 추가하여 실시하였다. 후방보행 훈련 후 균형능력을 평가한 결과 기능적 보행평가는 $17.67{\pm}1.00$점에서 $19.22{\pm}1.10$점으로 상승하였고(p<.05), 일어나 걸어가기 검사에서는 $26.45{\pm}1.37$초에서 $23.28{\pm}1.35$초로 감소하여 유의하게 향상되었다(p<.05). 후방보행 훈련 후 10 미터 보행검사에서도 $21.74{\pm}1.35$초에서 $18.33{\pm}1.10$초 감소하여 유의하게 향상되었다(p<.05). 따라서 뇌졸중 환자에게 후방보행 훈련을 적용하면 균형능력(기능적 보행평가, 일어나 걸어가기 검사) 및 보행(10 미터 보행 검사)에 향상을 가져옴으로 유용한 운동치료의 프로그램으로 제안할 수 있을 것이다.

• 대한물리의학회지
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• 제13권1호
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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.

• 한국운동역학회지
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• 제30권3호
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• pp.247-253
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• 2020

Objective: This study aimed to examine the effects of real-time visual feedback gait training on gait stability in older adults. Method: Twelve older adults participated in this study, being divided into 2 groups including a) visual feedback (VF) and b) non-visual feedback (NVF) groups. For 4 weeks, VF performed a treadmill walking training with real-time visual feedback about their postural information while NVF performed a normal treadmill walking training. For evaluations of gait stability, kinematic data of 15-minute treadmill walking were collected from depth-based motion capture system (30 Hz, exbody, Korea). Given that step lengths in both right and left sides were determined based on kinematic data, three variables including step difference, coefficient of variation, approximate entropy were calculated to evaluate gait symmetry, variability and complexity, respectively. Results: For research findings, VF exhibited significant improvements in gait stability after 4-week training in comparison to NVF, particularly in gait symmetry and complexity measures. However, greater improvement in gait variability was observed in NVF than VF. Conclusion: Given that visual feedback walking gives potential effectiveness on gait stability in older adults, gait training with visual feedback may be a robust therapeutic intervention in people with gait disturbances like instability or falls.

• 한국전문물리치료학회지
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• 제21권1호
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• pp.20-28
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• 2014

The purpose of this study was to investigate the effects of visual cue deprivation during sideways treadmill training in individuals with stroke. Twenty-eight stroke patients were divided into two groups, and each group participated in a sideways treadmill training session for 20 minutes, three times per week for 4 weeks. The eyes close group (15 subjects) performed this treadmill training with visual cue deprivation, while the eyes open group (13 subjects) performed it without visual cue deprivation. Gait function was measured in both groups before and after the training sessions with the Biodex Gait Trainer 2, which determined walking speed, distance, step length, and time on each foot. Balance was measured before and after each training period in both groups using the Five-Times Sit-to-Stand Test (FTSST), the Timed Up and Go test (TUG), and the seven-item Berg Balance Scale-3P (7-item BBS-3P). The eyes close group showed significantly improved gait function, walking speed, distance, step length, and time on each foot after training (p<.05). The eyes close group showed improved balance ability, FTSST, TUG, and 7-item BBS-3P test after training (p<.05). The findings indicated that sideways treadmill training with visual cue deprivation positively affects gait ability of stroke patients. Therefore, sideways treadmill training with visual cue deprivation may be useful for the recovery of gait ability of stroke patients.

• 대한물리의학회지
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• 제11권4호
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• pp.71-78
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• 2016

PURPOSE: The purpose of this study was to investigate which treadmill walking training mode is more effective strategy for improving pulmonary function of persons with chronic stroke. METHODS: Twenty-one chronic stroke patients were allocated and randomly to an experimental group (treadmill training with randomized speed control, n=11) and a control group (treadmill training without speed change, n=10). All participants received 30 minutes of neurodevelopmental treatment. In addition, the two groups performed treadmill training for 20 minutes each time with or without speed change. Speed change was applied 40%, 50%, 60%, 70% of Heart Rate Reserve. All the exercise programs lasted six weeks, with five times per week. Pulmonary function was assessed before and after exercise program by using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV). RESULTS: In the both groups, FEV1 was significantly increased after training (p<.05). Compared to the control group, the experimental group showed 11.9% larger amount of change (p<.05). In the experimental group, FVC and MVV were significantly increased after training (9.9%, 7.6%, respectively) (p<.05). But in the control group, there was no significant difference in the FVC and MVV after training. CONCLUSION: Treadmill training with randomized speed control will be a better positive rehabilitation program than treadmill training without speed change to improve pulmonary function in persons with chronic stroke.