• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.169-173
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• 2015

Purpose: This study aimed to improve the asymmetrical weight-bearing ratio, by applying different repetitive sit-to-stand training methods to the paretic-side foot of hemiplegic patients, as well as to provide the necessary information for applying balance training with hemiplegic patients. Methods: The subjects were divided into two groups: a spontaneous foot group and an asymmetrical foot group. They all performed repetitive sit-to-stand training five times a week for a total of six weeks. The sit-to-standing movement was studied using standardized clinical tests. The Biodex Balance System, Time up and go test (TUG), 5 times sit-to-stand test (5XSST), and functional reach test (FRT) were used to measure the static and dynamic standing balance of the patients. Results: In the balance system measurement, the results for the overall index, ant-post index, med-lat index, fall risk index, 5XSST, and FRT after the training differed significantly between the comparison groups (p<0.05). In the evaluation of dynamic balance, the differences in TUG did not differ significantly between the comparison groups after the training (p>0.05). Conclusion: The study found that the asymmetrical group showed significant increases in static and dynamic balance in comparison to the spontaneous group after repetitive sit-to-stand training. Based on this result, it is clear that training in an asymmetrical position with the paretic foot back can increase the left-right stability limit and the anterior-posterior stability limit, thus improving balance control.

• PNF and Movement
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• 제14권2호
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• pp.83-91
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• 2016

Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects' balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at ${\alpha}=0.05$. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects' gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients' gait and balance abilities.

• 대한물리의학회지
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• 제15권1호
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• pp.105-112
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• 2020

PURPOSE: This study examined the effects of Interactive Metronome training on the plantar pressure and fall efficacy in chronic stroke patients. METHODS: Twenty-two hemiplegic patients were allocated randomly to an experimental group and control group. The experimental group received conventional physical therapy and emphasized weight-bearing interactive metronome training, whereas the control group received conventional physical therapy. The training was performed three times per week, 40 minutes per each session, for a total of seven weeks. The plantar pressure was assessed using the contact area and contact pressure, whereas the fall efficacy was assessed using the FES (Fall Efficacy Scale), ABC (Activities-specific Balance Confidence scale) and FOFQ (Fear of Falling Questionnaire). RESULTS: After training, a significant increase was observed in the paretic side of the contact area and the paretic and non-paretic side of contact pressure in both groups (p<.05). The between-group differences in the changes before and after training were statistically significant in the paretic side of the contact pressure (p<.05). After training, both the FES of the between-group and ABC of the experimental group were increased significantly (p<.05), but the between-group differences in the changes before and after training were not statistically significant in the FES, ABC, and FOFQ (p>.05). CONCLUSION: Interactive Metronome training is considered an effective treatment for improving the contact pressure of the paretic side in chronic stroke patients.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.52-60
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• 2006

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

• 대한통합의학회지
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• 제7권3호
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• pp.1-9
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• 2019

Purpose : To find out how action observation training for chronic stroke patients affects their balance and body control abilities in the posture seated in the rehabilitation of stroke. Methods : This study was conducted on 30 subjects who were diagnosed with stroke. The group conducted motion observation training through video clips, while the control group only conducted physical training, and the general physical therapy was performed equally by both counties. The static balance was measured using Biorescue and the dynamic balance was measured using Modified Functional Reach Test (MFRT), Postural Assessment Scale for Stroke, and Trunk Impairment Scale. Results : Static balance showed statistically significant difference in foot pressure (p<.05) as a result of comparison between pre and post exercise training. Dynamic balance was statistically significant (p>.05) as a result of comparing pre and post differences using modified functional reach test. The trunk control ability was statistically significant (p>.001). Comparison between the results of before and after motion observation training showed a statistically significant difference. Conclusion: This study confirmed that exercise training in sitting position was effective for static, dynamic balance ability and trunk control ability of hemiplegic patients due to stroke. These results suggest that the use of motion monitoring in stroke patients may have a positive impact on the diversity and function of rehabilitation.

• 대한물리의학회지
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• 제6권2호
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• pp.109-118
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• 2011

Purpose: The purpose of this study was to investigate the effect of core stabilization exercise on foot pressure in the hemiplegic patients. Methods: A total of 28 subjects(n=28) who were diagnosed with hemiplegic caused by a stroke were randomly divided into bridge exercise(BX, n=14) and crunch exercise(CX, n=13) groups and each group executed the exercises 20 minutes a day, 4 times per week over an 8 week period. Foot pressure was measured on the fore, mid, and hind foot for peak pressure, and distance of center of pressure(COP). Results: The peak pressure on the mid foot for BX and CX were significantly different according to the exercise period(p<.05). Peak pressure on the hind foot of BX was significantly different according to exercise period(p<.05), however there was not in CX. The effects of each exercises period were significantly different according to pre-after 8weeks(p<.05). According to exercise period(p<.05), COP distances of BX and CX were significantly different. Conclusion: The results show that both BX and CX verified an improvement in gait ability. Especially, since we confirmed BX was attributed more to gait ability than CX. This is considered to be effective on those hemiplegic patients who need core-stabilization and gait stability.

• 대한물리의학회지
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• 제12권3호
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• pp.99-104
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• 2017

PURPOSE: Gait disturbances in patients with hemiplegic stroke involve asymmetry of stance time. Step box training is used to supplement the limitations of stair walking training and increasing the torque value of the paralyzed lower leg's strength. This study aimed to investigate whether step-up training on unstable support could change walking ability in patients with chronic stroke. METHODS: Thirty stroke patients were randomly assigned to the step-up training group (experimental group), that performed training on an unstable surface, and the control group, that performed training on a stable surface. Walking speed, step length, and cadence were measured before and after training. Paired t-tests were used to compare pre- and post-intervention data, while the independent samples t-test was used to determine intergroup differences. Values of p < .05 were considered statistically significant. RESULTS: There was a significant difference in walking ability before versus after the intervention in both groups, although the experimental group showed greater differences than the control group (walking velocity by 8.1%; step length of the non-paralyzed side by 6.9%, respectively; p<.05). CONCLUSION: Step-up training might be more effective on an unstable surface than on a stable surface for increasing walking speed and step length of the non-paralyzed side.

• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.1-6
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• 2017

Purpose: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. Methods: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the traditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, $SpO_2$ was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p<0.01). The between-group difference was statistically significant only for FVC and FEV1 in the EG (p<0.01). The changes in $SpO_2$ and MBI within the group showed significant differences only in the EG and CG (p<0.01). Between-group differences were statistically significant only for $SpO_2$ and MBI in the EG (p<0.05). Conclusion: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study.

• 대한물리의학회지
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• 제15권4호
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• pp.47-54
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• 2020

PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.

• 대한물리의학회지
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• 제17권2호
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• pp.53-62
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• 2022

PURPOSE: This study was conducted to investigate the effect of a real-time pressure feedback provided during gait training on the weight weight distribution of the inner part of mid-foot in paralyzed side and gait function in stroke patients. METHODS: A total of 24 patients with hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental and control group. All participants (n = 24) performed 15 min of comprehensive rehabilitation therapy 5 times a week for a period of 4 weeks. Additionally, the experimental group and control group underwent gait training with a real time feedback and general gait training, respectively, for 15 min five times a week for 4 weeks. Weight distribution and gait function were measured before and after the 4-week training. RESULTS: Significant increases in the weight distribution (WD), stance time (ST) and step length (SL) of the paralyzed side, and a significant decrease in the 10 m walking test (10 MWT) observed after training in the two groups (p < .05). The experimental group showed larger changes in the all variables than the control group (WD, +10.5 kg vs. +8.8 kg, p < .05; ST, 12.8 s vs. 4.9 s, p < .05; SL, 4.9 cm vs. 1.7 cm, p < .05; 10 MWT, -3.5 s vs. -1.0 s, p < .05, respectively). CONCLUSION: Gait training with a real-time feedback might be effective in improving the normalization of weight bearing of the paralyzed lower extremity and gait function of stroke patients, and be considered to be a more effective gait training for improving the abilities than the general gait training.