• 대한통합의학회지
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• 제11권2호
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• pp.221-230
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• 2023

Purpose : This study was performed to evaluate the effects of virtual reality combined robot assist gait training (VRG) on improvement of balance and respiratory function in chronic stroke patients. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 35 chronic stroke patients. They were randomly allocated 2 groups; VRG group (n=18) and conservative treatment group (CG; n=17). The VRG group received 30 minutes robot assisted gait training combined virtual reality training, robot assisted gait training was conducted in parallel using a virtual reality device (2 sessions of 15 minutes in a 3D-recorded walking environment and 15 minutes in a downtown walking environment). In the conservative treatment group, neurodevelopmental therapy and exercise therapy were performed according to the function of stroke patients. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome balance and respiratory function were measured by a balance measurement system (BioRescue, Marseille, France), Berg balance scale, functional reach test for balance, Spirometry (Cosmed Micro Quark, Cosmed, Italy) for respiratory function Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximum expiratory volume (PEF) were measured according to the protocol. The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in balance and respiratory function during intervention period. VRG revealed significant differences in balance and respiratory function as compared to the CG groups (p<.05). Our results showed that VRG was more effective on balance and respiratory function in patients with chronic stroke. Conclusion : Our findings indicate that VRG can improve balance and respiratory function, highlight the benefits of VRG. This study will be able to be used as an intervention data for recovering balance and respiratory function in chronic stroke patients.

• 대한물리의학회지
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• 제12권4호
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• pp.73-82
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• 2017

PURPOSE: Proprioceptive Neuromuscular Facilitation (PNF) has been shown to improve body function and activity/participation in people with functional dysfunctions. This study evaluates if active exercise using theraband in PNF pattern may induce similar benefits as exercise using manual PNF pattern performed by physiotherapists on promoting mobility, balance and fear of fall in community-dwelling elderly. METHODS: Twenty-three community-dwelling elderly with independent activities of daily living were recruited and randomly allocated into either PNF group - exercise in PNF pattern by trained physiotherapists or Theraband-PNF (T-PNF) group - exercise using theraband in PNF pattern, for an hour, twice weekly for 4 weeks. Functional outcomes such as Timed Up and Go test, Elderly Mobility Scale, Berg balance scale, functional reach and subjective measures including fear of fall (FOF) scale, bodily pain in visual analogue scale were measured pre and post-program. RESULTS: Twenty-one participants completed the program. PNF group demonstrated significant within-group improvements in all subjective measures and objective measures. Similar within-group improvements were demonstrated in all outcome measures except FOFS in T-PNF group. However, no between-group differences were found in any of the outcome measures. CONCLUSION: Comparable improvements in functional outcomes in community dwelling elderly were demonstrated in both groups. As manual PNF exercise traditionally need clinicians' contact and feedback on patient which limit the training to be carried out extensively in community setting. The current findings suggest that exercise using theraband in PNF pattern is feasible to be adopted as self-practice exercise for community-dwelling elderly to induce beneficial effects on functional outcomes.

• 대한물리의학회지
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• 제11권4호
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• pp.105-114
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• 2016

PURPOSE: This study is to investigate the therapeutic effect of Tetrax on balance dysfunction caused by ataxia in cerebellar stroke. METHODS: A total of thirty subjects with cerebellar stroke were recruited. The participants was divided into two groups, the experimental (n=15) and the control group (n=15). Tetrax training and conventional physical therapy (CPT) were performed in experimental group, whereas the patients in the control group were treated with CPT twice a day. Each session of the Tetrax and CPT was carried out for 30 minutes, 5 times per week for 4 weeks. Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) was the primary outcome measure, and the secondary outcomes covered Berg balance scale (BBS), falling index (FI), Timed up and go (TUG), and modified Barthel index of Korean version (K-MBI). All outcome measures were evaluated before and after 4 weeks. RESULTS: K-SARA was decreased significantly after 4 weeks intervention in both the experimental (p<.05) and the control group (p<.05). Furthermore, the experimental group produced significantly better outcomes in K-SARA, BBS, FI, and TUG compared with the control group (p=.012, p=.027, p=.008, and p=.048). There were significant correlations between K-SARA and BBS, FI, TUG, and K-MBI (p<.001, p<.001, p=.004, and p<.001). CONCLUSION: The restoration of ataxia was related with the improvement of the balance, falling risk, mobility, and activity of daily living. Tetrax training was effectively aided recovery of ataxia after cerebellar stroke.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.193-197
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• 2022

Purpose: The purpose of this pilot study was to assess the feasibility of a proposed study "To investigate the effects of applying a vibration stimulation to the paretic and non-paretic sides on balance and gait in stroke patients" before proceeding with the main study. Methods: A total of 30 patients who had suffered a stroke and who met the selection criteria participated in this study. However, only 14 patients completed the study. The study subjects were randomly assigned to vibration stimulation on either both sides (B group) or the paralyzed side (P group). The interventions were applied for six weeks. The patients were assessed using the Berg balance scale (BBS), Timed up and go (TUG), 10-meter walk (10 MW), and 6-minute walk (6 MW) tests. Results: There was a significant difference before and after the application of vibration stimulation in the BBS, TUG, 10MW, and 6 MW tests in the B group (p<0.05). Similarly, there was also a significant difference observed in the 10 MW and 6 MW tests in the P group (p<0.05). The difference between the two groups was not significant in the BBS, TUG, 10 MW, and 6 MW tests (p>0.05). Conclusion: This pilot study suggests that it would be feasible to conduct a large-scale randomized controlled trial (RCT) to examine the effects of applying a vibration stimulation to the paretic and non-paretic sides, on the balance and gait in stroke patients.

• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.212-217
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• 2022

Purpose: This study sought to investigate the effects of visual cue deprivation balance training by applying head control feedback to the balance function and the fall index in older people. Methods: The study was conducted on 26 older people at the S Hospital in Gyeongsansi. The patients were randomly divided into the experimental groupI (EGI, n=9), the experimental groupII (EGII, n=9), and the control group (CG, n=8). The three groups were trained for 30 minutes three times a week for four weeks. To assess the patients' static balance function, their limits of stability (LOS) was measured using the BioRescue system, (RM Ingenierie, France), composed of a pressure platform that can measure force in diverse ways, a computer, and a monitor. The dynamic balance function was measured using the Berg Balance Scale (BBS). Also, the fall index was measured to evaluate the risk of falling. A paired t-test was performed to compare pre- and post-training performance within the groups. One-way ANOVA was performed for comparing the three groups. A post hoc least significant difference (LSD) test was also performed. Results: The results of the LOS showed a significant difference after training in the EGI and EGII groups (p<0.05). As a result of the difference between the three groups, there was a significant difference after training (p<0.05). The results of the BBS showed a significant difference after training in the EGI group (p<0.05). As a result of the difference between the three groups, there was a significant difference after training (p<0.05). Conclusion: Visual cue deprivation balance training applying head control feedback is effective in improving the dynamic balance function in older people. It is also necessary to constantly maintain the head orientation by feedback and to properly control the head movement.

• 대한물리의학회지
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• 제6권1호
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• pp.9-17
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• 2011

Purpose : The purpose of this study was to compare the effects of performing feedback vs repeative tasks on lower extremity motor function and falls efficacy in chronic hemiplegic patients. Methods : 40 hemiplegic patients took part in this study. The average age of the feedback-task group was 68.45 years and 68.20 in the repeative-task group. All subjects participated in the study for 8 weeks, doing exercises 3 per day per week. All participants were assessed by using the Berg balance scale (BBS), the lower-extremity subscale of the Fugel-Meyer assessment of sensorimotor impairment (FMLE), and the falls efficacy scale (FES). The data were analyzed using a paired t-test. Results : After 8 weeks of exercise training, the results of this study were: the BBS and FMLE of hemiplegic patients showed a feedback-task and repeative-task groups (p<0.05). The FES of hemiplegic patients also showed a significant difference between the quantitative-task and qualitative-task groups (p<0.05). Conclusion : We present findings suggesting that chronic hemiplegic patients could improve their standing balance ability better through a feedback-task exercise program, as opposed to a repeative-task exercise program.

• 대한물리의학회지
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• 제5권3호
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• pp.435-443
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• 2010

Purpose : The goal of this study was to identify the effects of treadmill walking training (TW) and ergometer bicycle training (EB) on gait and balance in stroke patients. Methods : The subjects consisted of 42 stroke patients. They were randomly divided to two groups: TW(n=20) and EB(n=22). Each group trained along with the conventional physical therapy, three times a week for six weeks. The ability of gait was assessed by the 10m walk test and Timed Up and Go test(TUG). The ability of balance was assessed by Berg Balance Scale(BBS) and Balance Performance Monitor(BPM). Results : There was no significant difference between the 10m walking test and TUG groups, but there was a statistical difference between before and after the training for all groups. The result of BBS that assessed balance showed a significant reduction between before and after the training for all groups, but there was no difference between the two groups. While the two groups showed no difference in the BPM assessment, only the EB showed a significant improvement of before and after the training in each group. Conclusion : The outcomes suggest that stroke patients can improve their gait and balance performance through the TW and EB trainings. Although dynamic mean balance showed significance from EB, no significant difference was found between two groups. Even though it cannot be determined through this study which training group is more effective among the above mentioned two, it could be suggested that each training is effective to gait ability and the ability of balance of stroke patients.

• Physical Therapy Rehabilitation Science
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• 제8권4호
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• pp.187-193
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• 2019

Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.92-101
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• 2023

Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.