• PNF and Movement
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• v.21 no.1
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• pp.11-18
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• 2023

Purpose: This study aims to compare the effects of obstacle walking training combined with cognitive tasks on balance, gait, and activities of daily living in patients with stroke. Methods: A single-subject design was used, where one stroke patient participated. Obstacle walking training combined with cognitive tasks was performed for 1 hour per day for a total of 10 times during the intervention phase. The subjects were measured five times in the baseline phase, 10 times in the intervention phase, and five times in the follow-up phase. The outcome measurements included the Berg balance scale (BBS), the 10-meter walk test (10 MWT), and the Korean modified Barthel index (K-MBI). Results: In this study, the results showed that the 10 MWT scores during the intervention period improved and that this improvement remained, even during the post-period. In addition, BBS and K-MBI values for stroke patients increased significantly after training. Conclusion: The results of this study revealed that obstacle walking training combined with cognitive task training may be helpful to improve balance, gait, and activities of daily living in stroke patients. Therefore, obstacle walking training combined with cognitive tasks is recommended for stroke patients.

• Journal of Korean Academy of Nursing
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• v.33 no.6
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• pp.743-752
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• 2003

Purpose: This study was conducted to combine the effects of pulmonary rehabilitation program (PRP) on exercise capacity/tolerance and general health status of COPD patients based on the primary research results examined the effects of PRP, Method: Seventeen studies were selected by the sampling criteria established to include the studies that reported enough statistics necessary to conduct meta-analysis. Result: According to the study results, the most effective indicators for exercise capacity/tolerance were exercise time (such as cycling time or treadmill walking time) and ground walking distance within given time (6 minutes or 12 minutes), whereas effects on such indicators as VE and VO$_2$ were not statistically significant. PRP induced significant effect on patients' general health status, frequently measured by physical, psycho-emotional, and holistic indicators, the enhancement on psycho-emotional dimension resulted from PRP was more prominent than those of the other dimensions. From the results, it was noted that the place where PRP was given and the contents of PRP exercised their influence on the outcome variables. Which body part was trained was also one of the important factors that influence on the patients' perception of dyspnea during exercise as well as on exercise capacity/tolerance. Conclusion: PRP including exercise training significantly improved the exercise capacity and general health status of COPD patients.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.2
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• pp.133-143
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• 2011

Objectives : The present study introduces the clinical application of Hamstring Chuna Manual Therapy to a patient who underwent the pain after spinal fusion. Methods : A patient who had the pain after spinal fusion was hospitalized at Bucheon Jaseng hospital of Oriental Medicine for 35 days. During the hospital treatment, the pain was relieved by Hamstring Chuna Manual Therapy. The improvement of the patient was measured by VAS(Visual Analogue Scale) score, SLR(Straight-Leg Raising) test, and walking distance. Results : The values of the patient's VAS score, SLR test, and walking distance measured before and after Hamstring Chuna Manual Therapy presented that the pain was relieved after Hamstring Chuna Manual Therapy. Conclusions : Therefore, this case demonstrates that Hamstring Chuna Manual Therapy is effective treatment method for relieving pain in the spine.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.1
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• pp.115-124
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• 2014

Objectives : The aim of this study is to report the improved case of bilateral avascular necrosis(AVN) of femur head treated with Korean medicine and Fascia Chuna Therapy Methods : The patient diagnosed with bilateral AVN is hospitalized at department of korean rehabilitation medicine, Samse hospital of korean medicine. The subject is treated by herbal medicine, acupuncture, SBV and hip joint gyoung-geon chuna. This study was measured by visual analogue scale(VAS) score, walking time without pain per 6 minutes and harris hip score(HHS). Results : The patient showed decreased VAS score, HHS and improved walking time without pain per 6 minutes after treated with korean medicine and hip joint Fascia Chuna Therapy. Conclusions : The patient showed reduced pain and positive effect on activities of daily living.

• Physical Therapy Korea
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• v.24 no.3
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• pp.1-9
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• 2017

Background: The method of measuring the walking function of patients with chronic stroke differs depending on patients walking capability and environmental conditions. Objects: This study aimed to demonstrate the influences of walking capacity and environmental conditions on the results of short- and long-distance walk tests in patients with chronic stroke. Methods: Forty patients with chronic stroke volunteered for this study, and allocated to group-1 (<.4m/s, household walking, $n_1=13$), group-2 (.4~.8m/s, limited community ambulation, $n_2=16$), and group-3 (>.8m/s, community ambulation, $n_3=11$) according to their walking capacity. The 10-meter walk test (10MWT) and 6-min walk tests, (6MWT) were used to compare the short- and long-distance walk tests results, which were randomly performed under indoor and outdoor environmental conditions. Results: The comparison of the results obtained under the indoor and outdoor conditions revealed statistically significant differences between the groups in the 6MWT and 10MWT (p<.05). Post-hoc tests' results showed significant differences between groups-1 and -2 and between groups-1 and -3 in the 10MWT, and between group-1 and -3 in the 6MWT. Furthermore, in group-2 the 10MWT and 6MWT results significantly differed between the indoor and outdoor conditions, and the values measured under the indoor and outdoor conditions significantly differed between 10MWT and 6MWT (p<.05). Group-3 showed a significant difference in 10MWT results between the indoor and outdoor conditions (p<.05). Conclusion: These findings suggest that the results of the short- and long-distance walk tests may differ depending on the walking capacity of patients with chronic stroke and the environmental condition under which the measurement is made, and these effects were greatest for the patients with the limited community ambulation capacity.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.176-181
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• 2017

Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.73-78
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• 2015

Objective: This study focused on subacute stroke patients who were asked to kick a ball while walking on a treadmill. The aim of the study was to determine the effect of a body weight-supported treadmill training (BWSTT) combined with ball-kicking on muscle strength, balance, and gait. Design: Single blind, randomized controlled trial. Methods: Twenty stroke patients who volunteered to participate in this study were randomly assigned to either the BWSTT combined with ball-kicking (BWSTT-BK; 10 participants) group or the BWSTT group (10 participants). Participants in the BWSTTBK group performed treadmill walking combined with simultaneous ball-kicking for 30 minutes daily for 5 weeks. Participants from the BWSTT group performed only treadmill walking. The muscular strength, balance, and gait ability were measured before and after the 5-week training. To assess for muscular strength, a digital muscle tester was used to measure hip flexor, knee extensor, and dorsiflexor strength. To assess for balance, the Berg Balance Scale (BBS) and Timed Up and Go Test (TUG) was used. To assess for gait, the 10 meter walk test (10MWT) and Functional Gait Assessment (FGA) was used. Results: The BWSTT-BK group showed significantly improved muscular strength, balance, and gait according to BBS, TUG, 10MWT, FGA, and digital muscle testing scores compared to the BWSTT group (p<0.05). In addition, within-group comparison showed significant improvement in all variables (p<0.05). Conclusions: These findings suggest that BWSTT-BK results in more favourable outcomes for stroke patients. Therefore, BWSTT-BK may be useful for the recovery of gait ability of stroke patients.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.134-141
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• 2014

Objective: The purpose of this study was to compare with different distance across three conditions in stroke survivors with the grading of cognitive state. Design: Cross-sectional study. Methods: Twelve stroke patients who agreed to active participation were included. Participants were allotted to normal cognitive (CN) group (n=7) and cognitive impairment (CI) group (n=5) and then walked on a self-paced walkway at three conditions on the Time Up and Go (TUG) test and the 6 minute walk test (6MWT): 1) walking with your comfortable speed, 2) walking while carrying a tray with glasses, 3) walking with a verbal cognitive task. The TUG test was repeated three successful times on each condition. For the 6MWT, participants were tested one time. Results: The CI group walked slower than the CN group at the three conditions on the TUG test. However, there was no significant difference between two groups to each condition. A significant effect of dual tasking was found only in error of verbal cognitive task condition for the TUG test (p<0.05). On the 6MWT, the participants in the CI group walked short distance rather than the CN group (p<0.05). There were significant differences between two groups not only at all conditions but also at error of verbal cognitive task condition as well (p<0.05). Conclusions: To consider the results of different distances such as the TUG test and the 6MWT, we think that exercises in long distance would be more effective to patients with CI. Those would be improved patient's endurance in cognitive problem.

• PNF and Movement
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• v.13 no.2
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• pp.73-80
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• 2015

Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.

• Physical Therapy Korea
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• v.25 no.2
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• pp.53-61
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• 2018

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.