• The Journal of Korean Physical Therapy
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• 제17권3호
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• pp.339-350
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• 2005

This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.

• The Journal of Korean Physical Therapy
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• 제16권2호
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• pp.44-53
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• 2004

Treadmill training is a new promising therapy in gait rehabilitation of patients with hemiplegia. The purpose of this study was to identify the effect of treadmill training on walking speed and gait endurance in patients with chronic hemiplegia. The subject of this includes twenty patients, who had suffered from chronic hemiplegia and were in the K rehabilitation center; each ten patients were randomly assigned to experimental or control group. Among twenty patients, one group of ten for experiment was treated with progressive speed increase treadmill ambulation traing besides conventional physical therapy(SITAT) while the rest ten for the controlled group was treated with conventional physical therapy(CPT) only, for 8 weeks alike. Before and after the foregoing 8 weeks training, walking velocity and gait endurance were measured to both groups. The data were analyzed by paired t-test. The results of this study are as follows; The SITAT and CPT showed the significant difference in walking velocity and gait endurance. As compared the rehabilitation of dependent varibles between the SITAT and CPT, SITAT showed the significant difference in walking velocity and gait endurance. The outcome suggest that patient with chronic hemiplegia can improve their walking velocity and gait endurance throught treadmill training.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.257-262
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• 2021

Objective: Patients with stroke generally diminished ankle range of motion, which decreases balance and walking ability. This study aimed to determine the effect of ankle self-mobilization with movement (s-MWM) on ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in patients with chronic stroke. Design: Randomized controlled trial design Methods: Twenty-four post-stroke patients participated in this study. The participants were randomized into the control (n = 12) and self-MWM groups (n = 12). Both groups attended standard rehabilitation therapy for 30 minutes per session. In addition, self-MWM group was performed 3 times per week for 8 weeks. All participants have measured ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in before and after the intervention. Results: After 8 weeks of training, self-MWM group showed greater improvement in ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index than in the control group (p<0.05). Further, self-MWM group had significantly improvement in all dependent variables compared to the pre-test (p<0.05). Conclusions: Our investigation demonstrates that self-MWM is beneficial for improving functional ability. Also, self-MWM was superior to control with respect to improving ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index.

• 대한물리의학회지
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• 제15권4호
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• pp.67-74
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• 2020

PURPOSE: The progression of the center of pressure (COP) velocity of the stance phase may have important roles for predicting gait speed in older adults with cognitive decline. This study was conducted to identify the correlation between gait speed and the velocity of COP progression during the stance phase in older adults with cognitive decline. METHODS: Forty adults aged 65 years or older (twenty participants without cognitive decline, 20 participants with cognitive decline) were recruited. The COP progression velocity was measured using an F-scan pressure-sensitive insole system. The stance phase was divided into four sub-stages. (loading response, mid-stance, terminal stance, and pre-swing). Gait speed, double support phase, and cadence were also measured. Correlations and multiple regression analyses were performed. RESULTS: Gait speed was associated with the COP progression velocity in midstance (r = .719, p < .05), cadence (r = .719, p < .05) and the COP progression velocity in loading response velocity (r = .515, p < .05) in older adults with cognitive decline. However, no correlation was found in older adults without cognitive decline. In multiple regression analysis using gait speed as a dependent variable, the COP progression velocity in midstance and cadence were significant predictors of gait speed, with the COP progression velocity being the most significant predictor. CONCLUSION: The COP progression velocity is an important factor for predicting gait speed in older adults with cognitive decline, suggesting that the cognitive function influences gait speed and the velocity of COP progression.

• 대한통합의학회지
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• 제8권2호
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• pp.169-185
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• 2020

Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

• 대한통합의학회지
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• 제4권4호
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• pp.33-39
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• 2016

Purpose : The aim of this study was to investigate the effects of plastic ankle foot orthosis on adult post-stroke hemiplegic patients walking ability and balance. Method : The searched for the case controlled clinical trials about the effects of plastic ankle foot orthosis(pAFO) for walking ability and balance using quantitative gait analysis in adult post-stroke patients. Ten trials were selected from Riss4U databases published until June 2016 in Korea. The selected trials contained a control group with pre-test and post-test design, measured walking ability and balance as a dependent variable. Result : The selected ten trials involved a total of 180 patients. The walking speed, cadence, the portion of double limb supporting, stride length on affected side were improved by plastic ankle foot orthosis. Conclusion : The plastic ankle foot orthosis has some evidence to improve the walking ability and balance in post-stroke hemiplegic patients.

• 융합정보논문지
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• 제9권10호
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• pp.220-226
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• 2019

본 연구는 발바닥 굽힘근에 저주파 치료인 경피신경전기자극과 중주파 치료인 간섭전류가 뇌졸중 환자의 보행 및 발목 관절가동범위에 즉각적인 영향을 미치는지 알고자 한다. 30명의 연구대상자는 경피신경전기자극군과 간섭전류군으로 동일하게 나누어 마비측 장딴지근에 각각 통전하였다. 60분 통전 직후 스마트폰을 이용한 보행 평가와 발등 굽힘 관절가동범위를 측정하였다. 연구결과 두 전기치료 방법 모두 보행속도, 분속수, 발목 관절가동범위에 유의한 증가를 보였다. 두 전기치료 방법 모두 뇌졸중 환자의 보행 및 발목 관절가동범위를 증가시킬 수 있는 중재 방법이었지만 두 전기치료방법 간의 차이는 더 많은 대상자 모집을 통해 확인되어야 할 것이다.

• 한국응용과학기술학회지
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• 제35권1호
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• pp.205-213
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• 2018

평형능력은 보행에 영향을 미치고, 보행속도는 노인의 건강한 척도를 말해주는 기준이 된다. 이 연구의 목적은 체성감각계 지원이 여성 노인의 보행 및 평형감각에 미치는 영향을 보고자 하였다. 평소 지팡이를 사용하지 않고, 규칙적으로 운동을 하지 않으며, 이비인후과적으로 이상이 없는 노인으로 평균 연령이 75세 여성 노인 61명을 실험군 31명과 통제군 30명으로 분류하였다. 종속변인으로는 2.44m왕복걷기, 10m 일반걷기 및 빠르게 걷기, 6분 걷기를 실시하였다. 평형감각 검사로는 뉴로컴사의 EquiTest를 이용하여 분석하였다. 연구 결과 2.44m 왕복걷기와 10m 일반걷기에서는 유의한 차이가 없었으나 10m 빠르게 걷기, 6분걷기에서는 유의한 효과를 보이는 것으로 나타났다. 평형감각에서는 조건 2, 3, 4, 6에서 유의한 효과를 보이는 것으로 나타났다. 결론적으로 체성감각계 지원이 노인 여성들의 보행 및 평형유지 능력에 유의한 효과를 보이는 것으로 나타나 지팡이의 적극적 사용이 권장된다 할 수 있겠다.

• PNF and Movement
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• 제10권4호
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• pp.1-7
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• 2012

Purpose : The purpose of this study was to evaluate the relationship between physical performance, such as gait and postural control, and cognition on as assessed by clinical tools in individuals with chronic hemiparetic stroke. Methods : Twenty-six patients who had hemiparetic stroke participated in this study, and were evaluated four common clinical measurements, including the Berg balance scale (BBS), 10 meter walk test (10MWT), 6 minute walking test (6MWT), and Montreal cognitive assessment (MoCA). Multiple regression analysis was used BBS score, 10MWT, and 6MWT as the dependent variables; MoCA score, post-stroke duration, age, and affected side as independent variables. Results : In the regression equation of the BBS score, the correlation coefficient (r) was 0.875, the coefficient of determination (R2) was 0.786, and the MoCA score was the most important variable for determining the BBS score. In the regression equation for the 10MWT, ther was 0.888, the R2 was 0.999, and the MoCA score was the most important variable for determining 10MWT. Finally, the r was 0.777, the R2 was 0.998, and the MoCA score was the most important variable for determining 6MWT in the regression equation of the 6MWT. Conclusion : The results show that cognitive abilities affect gait proficiencies in individuals with chronic hemiparetic stroke. Therefore, these results suggest that cognitive tests are necessary for examining and evaluating the abilities of postural control and gait performance for chronic stroke patients in research and clinical environments.

• 한국운동역학회지
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• 제27권3호
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• pp.229-238
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• 2017

Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.