• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.75-82
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• 2017

PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.1
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• pp.65-72
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• 2016

In this study, a fully active transfemoral prothesis with a knee joint is designed considering stair walking conditions. Since the torque at the knee joint required for stair walking condition is relative high compared with the one in normal walking condition, the proposed design has high torque generating mechanism. Moreover, the transfemoral prothesis is designed in compact size to reduce its weight, which is related to comfortable fit and fatigue of patients. Flat type BLDC motor is used for simple and compact structure and various components are used to generate required torque with target working angle and speed. The weight reduction of structure is carried out using optimization method after the initial design process is complete. The optimization is conducted under the load conditions of stair walking. The optimized design is validated via finite element analysis and experiments. As a result, the weight is reduced using topology and shape optimization but maintaining the safety of structure. Also the space efficiency is improved due to its compact size.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.1
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• pp.84-93
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• 2001

The effects of brisk walking & muscle strengthening exercise on pain, fatigue, physical function & disease activity were examined in 28 patients with rheumatoid arthritis. Research design was a quasi-experimental study of non-equivalent control group pretest-posttest design. 14 for the experimental group and 14 for the control group were selected from the out patients on rheumatoid arthritis clinic of Dong-A University Hospital. The experimental group underwent 16 weeks of brisk walking and muscle strengthening exercise using Thera-Band. Pain, fatigue, physical function & disease activity was measured before and after 16 weeks of exercise. At baseline test, Fatigue & physical function score between groups were significantly different. So differences with in experimental group(baseline versus follow up) were compared with differences within the control group by Mann-Whitney test. There were significant differences between groups in the difference score on pain (U=6.50 p<.001) and fatigue (U=26.5 p<.01). For the experimental group, the score on the pain & fatigue was significantly decreased but no changed for the control group. Also there was a significant differences between groups in the difference score of the physical function (U=22.5 p<.001). For the experimental group, the score of the physical function has been significantly in creased. However, for the control group, it has been no changed. But there were no significant differences between groups in the ESR (erythrocyte sedimentation rate) and the CRP (C-reactive protein)level. In summary, brisk walking & muscle strengthening exercise led to significant improvements in pain, fatigue, and physical function without exacerbating disease activity in patients with rheumatoid arthritis.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.2
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• pp.193-204
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

• PNF and Movement
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• v.16 no.3
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• pp.307-315
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• 2018

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from $2482.13mm^2$ to $626mm^2$), and walking speed improved by 18.70% (from 0.75 m/s to 0.64 m/s). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.43-52
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• 2024

Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.368-373
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• 2024

Objective: This study investigates the influence of femoral and knee torsion angles on toe in-out orientation in adults. Design: Cross-sectional study design. Methods: We measured the passive internal and external rotation range of motion (ROM) of the hip and knee joints in 21 participants using a goniometer. Toe in-out orientation was assessed with the GaitRite gait analysis system during slow and fast walking trials over a 6-meter walkway. Pearson correlation analysis was used to examine the relationship between joint ROM and gait angle at both walking speeds. Intra- and inter-rater reliability were assessed, and simple linear regression was conducted to explore these relationships. Results: Intra-rater reliability demonstrated high reliability (0.84<ICC<0.94), while inter-rater reliability (0.44<ICC<0.83) exhibited moderate to high reliability. Significant correlations were found between the hip joint's range of motion and the gait angle at slow walking speed. Similar results were observed at fast walking speed for the hip joint. Multiple regression analysis revealed that the neutral angle of the hip joint (β=0.660, p<0.001) and the neutral angle of the knee joint (β=0.284, p=0.034) significantly contributed to the toe-out angle. Conclusions: Our findings indicate a significant correlation between the range of motion of the hip joint and toe in-out orientation. A decrease in the hip joint internal rotation angle was associated with a decrease in toe in-out, while an increase in the mid-angle was associated with an increase in toe in-out.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.59-69
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• 2011

Purpose : The purposes of this study were to find correlations among Fugl-Meyer Assessment Scale, walking velocity, walking asymmetry and balance ability. Methods : The study sample consisted of 50 stroke patients referred to the Department of Rehabilitation Medicine in the Sanggye Paik, Ilsan Paik, Seoul Paik, and Dobong Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and walking velocity, walking asymmetry. The data were analyzed using independent t-test, ANOVA, and multiple regression. Results : The results revealed that upper extremity coordination, balance and pain items of Fugl-Meyer Assessment scale were significantly correlated with walking velocity and upper extremity and upper extremity motor and balance items of Fugl-Meyer Assessment scale were significantly correlated with walking asymmetry. Fugl-Meyer Assessment scale was not significantly correlated with Static Balance Index, Dynamic Balance Index and Weight Distribution Asymmetry Index. Their power of explanation regarding comfortable walking velocity and comfortable walking asymmetry were 60.3%, 42.5% respectively. Conclusion : These results showed that Fugl-Meyer Assessment scale is significantly correlated with walking velocity, asymmetry and not significantly correlated with balance ability. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict walking ability of patients with stroke. Futher study about walking velocity and asymmetry by change of Fugl-Meyer Assessment scale is needed using a longitudinal study design.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.111-113
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• 2004

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

• Physical Therapy Korea
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• v.9 no.1
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• pp.63-68
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• 2002

Foot ulceration results in substantial morbidity in patients with peripheral neuropathy. The purpose of this study was to find the relationship of plantar foot pressures during walking to plantar ulceration in patients with Hansen's disease. The subjects were recuruited from two Welfare Clinic for Hansen's disease in Wonju and Uiwang city. Ten subjects (5 females, 5 males) with plantar ulceration and a mean age of 63 years were evaluated in this study. The mean duration of Hansen's disease in these subjects was 30 years. Plantar pressures were measured during self-selected comfortable walking speed by using MatScan system. Three subjects had plantar ulceration under the first metatarsal head. Five subjects had plantar ulceration under the second and third metatarsal head. Two subjects had plantar ulcers under the fifth metatarsal head. Eight of 10 subjects had plantar ulceration at highest pressure point that measured during walking. This result suggests that the abnormal high plantar pressure could be related factor to plantar ulceration in patients with Hansen's disease. Also the foot pressure measurement may be useful to evaluate the risk of plantar ulceration in patients with Hansen's disease.