Previous studies have investigated stepping over obstacles in treadmill walking training (TWT-OS) and treadmill walking training (TWT) alone for walking capacity not considering real physical activity. As such, we investigated the effects of TWT-OS on physical activity and changes in different levels of physical activity based on community ambulation in stroke patients. Thirty subjects were randomly assigned to either the experimental group or the control group, with 15 and 15 subjects, respectively. However, one subject from the control group was excluded because of inadequate treatment sessions. All subjects underwent routine physical therapy in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-stepping while walking on the treadmill for 30 min/day, five times/week, for four weeks. Subjects were given a three-axis accelerometer to wear at the hip on a belt for one-week pre- and post-training physical activity. Step counts for seven days, average daily step counts, and the average of minutes spent in sedentary, light, and above moderate activity were chosen as outcome measures of physical activity. No significant differences between the groups were found in terms of step counts for seven days, average daily activity, or daily activity spent at sedentary levels after four-week interventions. However, the average daily activity spent at light levels (-42.60 min vs. -6.71 min) was significantly lower in the experimental group than in the controls. Conversely, average daily activity spent at above moderate levels was higher (19.86 min vs. 11.07 min) (p<.05) after adjusting for each baseline value. Significant pre- and post-training differences were found in all variables of the experimental group (p<.05). Thus, TWT-OS could improve physical levels above moderate activity as a community-oriented task more than simple repetitive waking on a treadmill, and it could provide an opportunity for patients ambulatory after stroke to participate in the community again.
Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.
Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.
The purpose of this study was to examine the effects of the pelvic tilting exercise, pelvic tilting exercises with floor walking training, pelvic tilting exercises with treadmill walking training on quantitative gait function in patients with hemiplegia. Thirty patients with hemiplegia due to cerebrovascular disease participated in this study. Subjects were randomly assigned to one of pelvic tilting exercise group, pelvic tilting exercise with floor walking training group and pelvic tilting exercises with treadmill walking training group. The effects of each therapeutic method were evaluated by measurements of gait velocity, cadence, stride length, step length, base of support and foot angle using ink-foot prints. Data were analyzed statistically using paired t-test and one-way ANOVA. The results of this research are as followings : 1. After treatment, it turned out that pelvic tilting exercises with treadmill walking training has the most effect on gait velocity, cadence, stride length, step length and foot angle, which has significant difference in statistics (p<0.05). 2. Quantification of the gait velocity, cadence, both stride length and step length demonstrated a significant increase (p<0.05) after treatment in all groups when compared with values measured before treatment. The base of support and foot angle in affected side decreased significantly (p<0.05) after treatment in all groups when compared with values measured before treatment. 3. The lumbosacral angle noted a significant increase (p<0.05) after treatment in all groups, however, an ANOVA analysis did not reveal any differences between groups.
Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.
Purpose: The purpose of this study is to examine the effect of various bridge exercises on walking ability. Method: The subjects were 30 stroke patients. They were divided into a bridge exercise group on a stable support surface (Group I), a bridge exercise group on an unstable support surface (Group II), and a bridge exercise group combined with whole body vibrations (Group III). 10 subjects were randomly assigned into each group. The subjects of this study had 30 minutes of nervous system physical therapy including gait training and strength training. In addition, each group underwent a 30 minutes session five times a week for eight weeks. Before intervention, LUKOtronic was used to measure step width and step length, time was measured with a 10 m walking test, and time and number of steps were measured with the figure 8 walking test. After the intervention, remeasured and analysis was performed for each group. Results: As a result of comparing and analyzing the change of walking ability between groups, there was a statistically significant difference. As a result of the post hoc analysis according to the change of walking ability among groups, the change of walking ability was larger in Group III than in Group I and Group II. Conclusion: Based on these results, it is confirmed that the bridge exercise combined with whole body vibration was more effective for walking ability. Based on these findings, this study proposes an effective program for elite athletes as well as stroke patients.
PURPOSE: The purpose of this study was to evaluate the effects of simultaneous application of gaze stabilization exercise and cognitive training on the balance and gait ability in subacute stroke patients. METHODS: Thirty-five patients diagnosed with stroke within 3-6 months were randomly assigned, and the experimental group (n = 18) to which both gaze stabilization exercise and cognitive training were applied and the control group (n = 17) to which only gaze stabilization exercise was applied were targeted. It was performed for 30 minutes at a time, three times a week, for a total of 4 weeks. Berg Balance Scale, Timed Up and Go test, 10Meter Walking Test, and Walking symmetry were evaluated. RESULTS: In the comparison of changes between Berg Balance Scale, Time Up and Go test, 10 Meter Walking Test, and Gait symmetry, both experimental and control groups showed significant differences before and after the intervention, and in the evaluation of Gait symmetry, significant differences between groups. CONCLUSION: As a result of this study, when gaze stabilization exercise and cognitive training were allied simultaneously, it was possible to improve the balance and gait ability of subacute stroke patients, and had a more significant effect on gait ability. In considered that training that simultaneously applies gaze stabilization exercise and cognitive training can be presented as a balance and gait rehabilitation for stroke patients on the future.
Objective: Through comparative analysis of muscle activity for whole-body vibration, walking and running movements, it is to verify the training effect of whole-body vibration exercise in terms of amount of exercise and muscle activity characteristics. Method: Flat ground walking and slope walking (10 degrees) at a speed of 5 km/h, flat ground running and slope running (10 degrees) at a speed of 11 km/h for running were performed on treadmill, and squats were maintained at 12 Hz, 20 Hz, and 29 Hz conditions on Whole body vibration exercise equipment (Galileo). Muscle activity was analyzed through EMG analysis device for one minute for each condition. Results: The Anterior Tibialis and Erector Spinae show greater exercise effect in whole-body vibration than walking and running. The Rectus Femoris, Biceps Femoris, and Gluteus Maximus have the best effect of exercise in flat running. Whole-body vibration exercise showed greater muscle activation effect as the frequency increased, and exercise effect similar to walking during the same exercise time. Conclusion: The amount of exercise through Whole-body vibration exercise was similar to that of walking exercise, and the Anterior Tibialis and Erector Spinae shows better exercise effect than walking and running.
Walking training is one of the most important rehabilitation processes with paralysis patient. Walking training by using an orthosis can help advancing a patient's independent level. However, existing orthoses have some serious demerit of mechanical problem that the knee joint is locked in the state where it is completely extended, which increases energy consumption and fatigue. For this reason, it is suggested, for more practical orthosis, that the knee joint should be placed and it should have capability of suspending patient's weight. In this paper, 1-DOF walking orthosis which compensates the demerit of the existing orthosis and secures patient's mobility has been proposed. New orthosis has been designed under the following two premises. First, the knee joint of the orthosis was designed fold in order for the orthosis to move in a walking pattern similar to that of a normal person. Second, the knee joint was designed to extend during the swing phase and lock safely during the stance phase.
PURPOSE: The purpose of this study was to determine the efficacy of dual-task action observation training (AOT) and single-task AOT related with daily living task on walking ability and ADL performance in chronic stroke patients. METHODS: Twenty-seven chronic stroke subjects were included in the study. They were randomly assigned to three task categorieds as follows: whole dual-task AOT or partial dual-task AOT or single-task AOT rehabilitation. Whole dual-task AOT observed the movement at once and partial dual-task AOT observed the movement divided into 4 parts related functional gait and activities of daily living task for 2 minutes 30 seconds. Single-task AOT observed the movement related functional gait for 2 minutes 30 seconds. Both groups had physical training session for 12 minutes 30 seconds. The study was conducted for four weeks, with three training sessions a week, for twelve weeks. All subjects were evaluated for their walking ability and activities of daily living through devices, 10m walking test (10MWT), dynamic gait index (DGI), and Korea-Modified Barthel Index (K-MBI). RESULTS: A significant improvement of walking ability and ADL performance happened among dual-task AOT subjects, compared with a single-task AOT subjects, during the 4-weeks course treatment. The results of the study showed statistically significant differences in 10MWT (p<0.05) and DGI (p<0.05), and K-MBI (p<0.05). CONCLUSION: Our results indicated that dual-task AOT has a positive additional impact on recovery of walking ability and ADL performance in chronic stroke patients.
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