• Korean Journal of Applied Biomechanics
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• v.17 no.4
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• pp.1-8
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• 2007

The purpose of this study was to investigate the difference in the stride-to-stride variability between two treadmill conditions; traditional treadmill and special treadmill whose speed can be adjusted automatically by subject's walking speed. Eight male subjects (25.1 years, 172.7 cm, 66.6 kg) were participated in treadmill walking experiment. First, preferred walking speed (PWS) of each subject was determined. Second, each subject performed walking experiment with fixed PWS condition and with free PWS condition for 10 minutes. 3D motion capture system (Motion analysis Corp., USA) with 6 cameras was used to collect motion data with sampling frequency of 120Hz. Temporal and spatial variables for stride-to-stride variability were calculated. Coefficient of variance (CV) which quantifies the amount of variability and Detrended Fluctuation Analysis (DFA) which explains the structure (self-similarity) of the variability were used for analysis. Results showed that the amount of variability during free PWS condition was greater than that of fixed PWS condition. DFA results showed that there was a statistical difference between two treadmill conditions for the variables of step length, stance time, and double support time. From these results, it is possible that traditional treadmill study might give incorrect conclusion about gait variability study. Further study is necessary to clarify these matters by considering the number of subjects, experimental time, and gait variables for the study of stride-to-stride variability.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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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.

• PNF and Movement
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• v.15 no.3
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• pp.333-341
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• 2017

Purpose: This study was to explore the effects of trunk exercise using PNF combined with treadmill training on balance and walking ability in patients with Parkinson's disease. Methods: This study included 16 patients with Parkinson's disease. Participants were randomly assigned to 2 groups: an experimental group (n=8) and a control group (n=8). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (trunk exercise using PNF) and control group (conventional training) participated in a 30-minute exercise program. Both groups performed the training 5 times per week for 4 weeks. Disease severity (determined using the unified Parkinson's disease rating scale motor subscale, UPDRS-3), balance (determined using the Berg balance scale, BBS), walking speed (determined using the 10-meter walking test, 10MWT), and walking endurance (determined using the 6-minute walking test, 6MWT) were measured at baseline and after 4 weeks. Results: Pre- to post-intervention improvement was noted on all outcome measures for both groups (p<0.05). Post-intervention, there was a significant improvement in the experimental group as compared to the control group for the following measured outcomes (p<0.05): UPDRS-3 (p=0.03; 95% CI, -5.52 to -0.24), BBS (p=0.04; 95% CI, 0.59 to 6.45), 10MWT (p=0.01; 95% CI, -2.19 to -0.42), and 6MWT (p=0.04; 95% CI, 1.81 to 96.72) Conclusion: The results of this study revealed that trunk exercise using PNF plus treadmill training improves balance and walking ability as compared to conventional training plus treadmill training in patients with Parkinson's disease.

• Physical Therapy Korea
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• v.23 no.3
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• pp.1-10
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• 2016

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.384-397
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• 2003

The purpose of this study was to investigate the effect of Treadmill Training on WISCI level, walking velocity, walking endurance, motor score and gait cycle of spinal cord injury patient with incomplete. Four subjects with spinal cord injury participated in this study. They took walking excercise 5 times per week for 8 weeks. One time excercise spent 30minutes. The theraputic effect was evaluated by WISCI level, walk 10 meters test, walk for 12 minutes test, motor score and gait cycle. Four subjects were examined before, after 8 week, walking training. Collected data were statistically analyzed by SPSS PC for Wilcoxon signed rank test. The results of this study are as follows; 1) In WISCI level, walking velocity, walking endurance and motor score, post - treatment score were higher compared to pre-treatment score with statistical significance(p<0.05). 2) In Rt SLS, DLSII and Lt SLS, post-treatment percentage were higher compared to pre-treatment percentage with statistical significance(p<0.05). but DLSI were not statistical significance(p>0.05). The findings suggest that spinal cord injury patients with incomplete can improve their WISCI level, walking velocity, walking endurance, motor score and gait cycle through Treadmill gait training.

• Physical Therapy Korea
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• v.22 no.4
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• pp.71-78
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• 2015

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.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.145-151
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• 2022

Purpose : Stroke patients exhibit abnormal walking patterns such as slow walking speed and asymmetrical walking values. The recovery of symmetrical walking in the stance phase using a treadmill means improvements in walking speed and asymmetrical walking. The purpose of this research was to investigate the effect of unilateral step treadmill training (USTT) on gait speed and the recovery of symmetrical walking in chronic stroke patients. Methods : Fifteen patients (11 men and 4 women) with chronic stroke participated in this study. The 10-meter walk test (10MWT) and GAITRite system were used to determine the intervention-related changes in gait speed and symmetrical walking values such as non-paretic step length (NSL), non-paretic step time (NST), paretic single-support time (PSST), step length asymmetry (SLA), and step time asymmetry (STA) after USTT. All participants completed USTT and underwent measurements at 3 different times: at pretest, posttest, and the follow-up test. Repeated-measures analysis of variance was used to compare walking speed and asymmetrical walking values. The statistical significance level was set at p<.05. Results : Walking speed by 10MWT (p<.05) showed significant improvements after USTT as follows: at pretest and posttest (p<.05), posttest and follow-up test (p<.05), and pretest and follow-up test (p<.05). Recovery of symmetrical walking patterns such as NSL (p<.05), NST (p<.05), and SLA (p<.05) were observed after USTT. However, no significant improvements were found in PSST (p>.05) and STA (p>.05) in symmetrical gait. Conclusion : This study suggests that USTT may have a positive effect on walking speed and symmetrical walking patterns in chronic stroke patients. Thus, this study contributes to the existing knowledge about the usefulness of USTT for the effective management of patients with chronic stroke. Further studies are needed to generalize these findings.

• Korean Journal of Applied Biomechanics
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• v.27 no.1
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• pp.35-43
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• 2017

Objective: The purpose of this study was to determine how gaze angle affects muscle activity and kinematic variables during treadmill walking and to offer scientific information for effective and safe treadmill training environment. Method: Ten male subjects who have no musculoskeletal disorder were recruited. Eight pairs of surface electrodes were attached to the right side of the body to monitor the upper trapezius (UT), rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), bicep femoris (BF), tibialis anterior (TA), medialis gastrocnemius (MG), and lateral gastrocnemius (LG). Two digital camcorders were used to obtain 3-D kinematics of the lower extremity. Each subject walked on a treadmill with a TV monitor at three different heights (eye level; EL, 20% above eye level; AE, 20% below eye level; BE) at speed of 5.0 km/h. For each trial being analyzed, five critical instants and four phases were identified from the video recording. For each dependent variable, one-way ANOVA with repeated measures was used to determine whether there were significant differences among three different conditions (p<.05). When a significant difference was found, post hoc analyses were performed using the contrast procedure. Results: This study found that average and peak IEMG values for EL were generally smaller than the corresponding values for AE and BE but the differences were not statically significant. There were also no significant changes in kinematic variables among three different gaze angles. Conclusion: Based on the results of this study, gaze angle does not affect muscle activity and kinematic variables during treadmill walking. However, it is interesting to note that walking with BE may increase the muscle activity of the trapezius and the lower extremity. Moreover, it may hinder proper dorsiflexion during landing phase. Thus, it seems to reasonable to suggest that inappropriate gaze angle should be avoided in treadmill walking. It is obvious that increased walking speed may cause a significant changes in biomechanical parameters used in this study. It is recommended that future studies be conducted which are similar to the present investigation but using different walking speed.

• PNF and Movement
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• v.17 no.2
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• pp.189-197
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• 2019

Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson's disease (PD). Methods: Twenty-four participants with Stage 1 to 3 ($2.13{\pm}0.64$) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson's disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081-6.519), BBS (p = 0.042; 95% CI, 1.375-4.541), TUG (p = 0.034; 95% CI, -3.315--0.143), 10MWT (p = 0.011; 95% CI, -2.032--0.289), and 6MWT (p = 0.002; 95% CI, 24.39-91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.120-125
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• 2010

The purpose of this study was to compare the effects of treadmill walking in underwater and overground which affects gait and physical function of people who have had a stroke. Twenty people after a stroke who have become hemiplegic over 6 months were participated. Participants were divided into two groups: underwater treadmill group(UTG) and overground treadmill group(OTG). The intervention was done 4 times per weeks for 6 weeks and 1 session lasted for 30 minutes. Gait and physical function elements were measured at baseline, at the middle(3 weeks) and at the end of the intervention(6 weeks). For the elements of gait, walking velocity, affected stance phase, affected weight bearing were assessed. For the elements of physical function, Short Form 8(SF-8) health survey was used. The result of this study showed that both groups improved similarly in walking velocity. However participants in UTG improved more than those in OTG in affected stance phase(p<.05), affected weight bearing(p<.05) and emotional aspect(p<.001). Based on the results of this study, it can be suggested that treadmill walking both in underwater and on the ground can be effective in improving hemiplegic gait and physical function of people who have had a stroke. The result also suggest that the underwater treadmill exercise can be more effective than overground treadmill in restoration of gait in people after stroke.