• 대한통합의학회지
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• 제8권1호
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• pp.57-66
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• 2020

Purpose : This study aimed to identify whether resistance exercise using elastic bands for six weeks can improve muscle strength, muscle tone, balance, and gait in patients with stroke. Methods : In total, 35 patients with stroke were randomly divided into three groups: resistance exercise using elastic band training combined with less affected side training group, more affected side training group, and both sides training group. Muscle strength, muscle tone, balance, and gait were assessed using a hand-held dynamometer, the modified Ashworth scale, the Berg Balance scale (BBS), and wireless 3-axis accelerometer, before and after training. Results : All three groups showed a significant increase in muscle strength of the lower extremity after training, and there was a significant difference among the groups. There was no change in muscle tone in all three groups. BBS scores increased significantly in all three groups after training, but these scores were not significantly different. The gait speed increased significantly in all three groups after the training, but the difference was not significant. The cadence increased significantly in Group 2 after training; however, there was no significant difference between Groups 1 and 3. There were no significant differences between the groups before and after the training. Step length increased significantly in Groups 2 and 3 after the training, but it was not significantly different in Group 1. After training, Groups 2 and 3 were significantly greater than Group 1 in the change in step length. Conclusion : The results show that resistance exercise using elastic bands can improve strength, balance, and gait in patients with chronic stroke. Especially, more affected side training was more effective in improving muscle strength than less affected side training. More affected side and both sides training are thought to be more effective than less affected side training to improve step length.

• 대한통합의학회지
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• 제7권4호
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• pp.231-240
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• 2019

Purpose : This study aimed to determine whether resistance exercise using elastic bands for 6 weeks could improve the muscle strength, muscle tone, balance and gait among stroke patients. Methods : A total of 11 stroke patients who had agreed to participate in the study were randomly divided into 3 groups receiving elastic band resistance training on their less affected side (experimental group 1, n=4), affected side (experimental group 2, n=3), and both the sides (experimental group 3, n=4). Muscle strength, muscle tone, balance and gait were assessed using a hand-held dynamometer, the modified ashworth scale (MAS), the berg balance scale (BBS), and G-walk respectively, before and after training. Wilcoxon signed-rank test was used to analyze intergroup changes after the intervention, whereas the Kruskal Wallis H test, and Mann-Whitney U test were used to analyze intergroup changes in all variables. Results : Strength in all the muscle, except for the flexor and extensor muscles in the affected knees, was increased in all the groups, however, no significant difference was observed. No change in the muscle tone (MAS) was found in any group. All the groups showed increased BBS scores walking speed, and walking symmetry following training, although, the differences were not significant. Changes in the affected step length of experimental group 1 were significantly greater than those of experimental group 3, whereas changes in the affected step length in experimental group 3 were significantly greater than those of experimental group 2. Conclusion : Our results suggest that resistance exercise using elastic bands are a potential intervention for improving lower extremity muscle strength, balance, and gait among stoke patients.

• 대한통합의학회지
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• 제1권4호
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• pp.15-24
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• 2013

Purpose : The purpose of this pilot study was to examine the effects of task-oriented training program on balance, activities of daily living(ADL) performance, and self-efficacy in stroke patients. Method : Two subjects with stroke in experimental group participated in the task-oriented training program, while two subjects with stroke in control group received traditional rehabilitation therapy for 4 weeks, 30 minutes per session, four times per week. The task-oriented training program consisted of four tasks with 4 difficulty levels. In two groups, balance was examined with using the Berg Balance Scale(BBS), ADL performance was examined with using the Modified Barthel Index(MBI), and Self Efficacy was evaluated with using the Self-Efficacy scale(SES) before and after 4-week training. Result : After 4 weeks training, all scores of measurement variables increased in both the experimental group and the control group, but the average rates of change differed between the two groups. After the training program, the scores of BBS, MBI, and SES in experimental group increased to 11.4%, 9.9%, 15.4%, respectively than pre-training. Conclusion : According to the results of this study, task-oriented training program might be proposed as a intervention to improve balance ability, ADL performance, and self-efficacy in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제7권2호
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• pp.88-93
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• 2018

Objective: Elevated cholesterol levels contribute to changes of the arterial endothelial permeability. Hyperlipidemia promotes atherosclerosis and is associated with an increased risk of stroke incidence. The purpose of this study was to investigate the effects of having a history of hyperlipidemia prior to a stroke incidence on postural balance, anticipatory dynamic postural control, gait endurance and gait performance in individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Fifty-two adults who were diagnosed with stroke 6 months ago or more were enrolled in this study. They were divided into two different groups according to hyperlipidemia history before stroke. All participants were assessed with the Activities-specific into Balance Confidence (ABC) scale, Berg Balance scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go test (TUG), and the 6-minute walk test (6MWT). An independent t-test was used to analyze the difference between the hyperlipidemia group and non-hyperlipidemia group. Results: After analysis, the BBS, TUG, and 6MWT scores were significantly different between the hyperlipidemia and non-hyperlipidemia group, but not the ABC and DGI scores. Conclusions: The results of this study show that having a history of hyperlipidemia before stroke affects static and dynamic postural balance performance, anticipatory dynamic postural balance, and gait endurance in individuals with chronic hemiparetic stroke. Based on the results of this study, we also suggest treatment for hyperlipidemia should be implemented throughout the therapeutic interventions, such as pharmacological or exercise programs, in order to restore the physical function of stroke survivors.

• The Journal of Korean Physical Therapy
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• 제33권4호
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• pp.202-209
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• 2021

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects' knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group. Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion: This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.

• The Journal of Korean Physical Therapy
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• 제34권2호
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• pp.57-62
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• 2022

Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.

• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.35-44
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• 2022

Background: This study aimed to compare the effects of the Mulligan mobilization with movement and McKenzie exercise after applying conservative physical therapy to patients with knee pain. Methods: Patients were randomly allocatied into two groups: the Mulligan mobilization with movement (10 subjects) and the McKenzie technique (10 subjects). Each group was givenr conservative physical therapy and manual therapy sessions, three times week, for four weeks. The pain intensity was measured using the visual analogue scale (VAS). The cervical range of motion (ROM) was measured with a goniometer. Balance was measured using the modified Berg balance scale (BBS). Results: After four weeks of therapy, VAS (p<.05) decreased significantly, and ROM and balance increased siginficantly in both groups(p<.05). There was a significant improvement in knee extension (p<.05) in the McKenzie group compared to the Mulligan group. No intergroup differences were found with respect to the knee flex, VAS, and BBS (p>.05). Conclusion: The McKenzie exercises are more effective than Mulligan mobilization with movement for improving knee extension. Both interventions have the same effects on pain relief, in increasing knee flexion ROM and improving balance in patients with knee pain.

• 대한통합의학회지
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• 제10권1호
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• pp.49-60
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• 2022

Purpose : The purpose of this study was to identify whether gym-ball exercise in standing position was an effective intervention for improving muscle strength, balance, gait, and fall efficacy in stroke patients. Methods : Twenty-four stroke patients were randomized into three groups: experimental group 1 (n=8), experimental group 2 (n=8), and control group (n=8). Experimental groups 1, 2 and the control group performed the gym-ball exercise in standing position, same exercise without a gym-ball, and general physical therapy for 4 weeks, five times a week in 30-minute sessions. Muscle strength, balance, gait, and fall efficacy were assessed using a handheld dynamometer, the Berg Balance Scale (BBS), the wearable BTS G-WALK® sensor, and the Korean version of the Falls Efficacy Scale (K-FES), before and after training, respectively. Comparisons within and between groups were analyzed using the Wilcoxon signed rank test, Kruskal Wallis H test, and Mann-Whitney U test. Bonferroni correction was performed when significant differences between groups were identified (p<.017, .05/3). Results : Regarding muscle strength, BBS score, cadence and FES-K were significantly improved after intervention in all three groups. The weight bearing rate, gait speed and step length in experimental group 1 and 2 were significantly improved after the intervention. The stride length in experimental group 1 were significantly improved after the intervention. Experimental group 1 had significantly improved BBS score and stride length after intervention than experimental group 2 and control group. Experimental group 1 and 2 improved muscle strength, weight bearing rate, and FES-K score more than the control group. Experimental group 1 showed significant improvement in cadence, gait speed, and step length after the intervention than control group. Conclusion : This study showed that exercise with gym-ball in standing position can be an effective intervention to improve balance and gait in stroke patients than the same exercise without gym-ball.

• Physical Therapy Rehabilitation Science
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• 제12권2호
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• pp.123-129
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• 2023

Objective: Kinesio tape has been applied to the ankle to improve balance and gait. Stroke patients show abnormal gait patterns due to foot drop. This study aimed to determine the effects of ankle balance taping which to support the ankle joint on balance and gait in patients with chronic stroke. Design: A randomized controlled trial. Methods: Twenty-four chronic stroke patients were selected and randomized into experimental group (n=12) and control group (n=12). The experimental group applied kinesio taping three times a week for three weeks, and the control group applied placebo taping for the same amount of time. To evaluate the effectiveness of the treatment, the subjects' walking ability, static balance, and dynamic balance were assessed before and after the experiment. Gait speed and spatiotemporal gait ability were measured to examine walking ability, postural sway velocity and velocity moment for static balance, and Timed-Up and Go test and Berg Balance Scale were conducted to check dynamic balance. Results: The experimental group showed a significant increase in walking ability, static balance, and dynamic balance in the within-group pre-post difference (p<0.05). In the between-group comparison, the experimental group had a significant difference in walking ability than the control group (p<0.05). Conclusions: Ankle balance taping can help improve gait, and this study can be used as a basis for future studies of ankle balance taping.

• 대한물리치료과학회지
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• 제15권1호
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• pp.67-74
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• 2008

A decrease in the ability to maintain static and dynamic balance after stroke could be related to the inability to select reliable sensory information in producing relative motor action needed to maintain postural stability. The purpose of this study was to compare the effects of two different types of surface conditions on the balancing ability of subjects with stroke. Eighteen hemiparetic subjects were assigned to an experimental and control group participating in a six－week rehabilitative therapeutic exercise program focusing on balance and mobility. Exercises were performed 3 to 5 times per week in a stable surface condition by the control group, and in an unstable surface condition by the experimental group. Pre－ and post test assessments involved the measurement of the static balance and dynamic balance, respectively by 7－item Berg Balance Scale－3P and by Pro－3 Balance System. Results showed that under the unstable surface condition, static balance in the experimental group showed more improvement than that of the control group.(Statistically, not very significant.) All the aspects of dynamic balance and mediolateral sway(balance) improved significantly than those of the control group. However, there were no significant differences between two groups. Overall, it can be concluded that under the unstable surface condition, the rehabilitative therapeutic exercise programs are effective in improving the dynamic balance of stroke subjects. The results suggest that the adaptation of the unstable surface in the rehabilitative therapeutic exercises could be effective for the patients with hemiplegia in balance. Further studies are needed to confirm the effectiveness of the unstable surface on improving balance and postural stability of hemiplegics.