• Title/Summary/Keyword: walking rehabilitation

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Effects of Medical Exercise Therapy on Walking Ability and Ankle Muscles Activation after Chronic Stroke (Medical Exercise Therapy가 만성 뇌졸중 환자의 보행능력 및 족관절 근활성도에 미치는 영향)

  • Cho, Yuong-Hwan;Park, Jong-Hang;Kim, Kyung-Yoon;Nam, Ki-Won
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.3
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    • pp.311-321
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    • 2011
  • Purpose : The purpose of this study was to determine effect of Medical Exercise therapy on walking ability and ankle muscles activation after stroke. Method : Participants were randomly divided into either MET training group(n=12) and control group(n=12). All of participants had been receving a traditional rehabilitation program, 5 days a week. MET training group have additionally undergone for six weeks, 3 days a week, the MET program. But control group was not received any additional program except the traditional rehabilitation program. The 10 mWT, F8WT and 2 MWT to measure walking ability were carried out twice before and after training. Muscular activity of the ankle was estimated by analyzing the RMS of action potential for EMG in terms of tibialis anterior muscle(TA), soleus(SO), gastrocnemius medial head(GM), gastrocnemius lateral head(GL). Rresults : At the walking ability, MET training group demonstrated a significant improvememt in the score of the 10 mWT(p<0.001), 2 MWT(p<0.05), but F8WT was not significant improvement(p>0.05). At the ankle muscle activation, MET training group demonstrated a significant improvememt in the RMS of the TA(p<0.01) and SO(p<0.05) but GM(p>0.05) and GL(p>0.05) were not significant improvement. Conclusion : From these results of this study, MET training for 6 weeks has an effect on improvement of walking ability and ankle muscles activation after stroke.

The Effects of PNF Upper- and Lower-Limb Coordinated Exercise on the Balancing and Walking-Abilities in Stroke Patients (고유수용성신경근촉진법을 적용한 상하지 협응 운동이 뇌졸중 환자의 균형 및 보행능력에 미치는 효과)

  • Cho, Hyuk-Shin;Cha, Hyun-Gyu;Shin, Hyo-Seop
    • PNF and Movement
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    • v.15 no.1
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    • pp.27-33
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    • 2017
  • Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.

Essential Functions Required by Patients and Physical Therapists in the Rehabilitation Process of Stroke Patients: A Survey Study (뇌졸중 환자의 재활 과정에서 환자와 물리치료사가 요구하는 기능에 대한 조사연구)

  • Jung-Byung Chae;Ju-Hyeon Jung
    • PNF and Movement
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    • v.22 no.2
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    • pp.289-303
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    • 2024
  • Purpose: In this study, 100 stroke patients and 205 physical therapists were surveyed to determine the essential functions needed in the rehabilitation process of stroke patients. Methods: This study involved 100 stroke patients and 205 physical therapists. Sixteen functions suggested in the previous study as necessary in the rehabilitation process of stroke patients were selected, and a revised questionnaire was prepared and distributed to several institutions. A frequency analysis of the collected data was conducted to aggregate the functions required in rehabilitation, and a scoring process was used to determine their ranking among the 16 functions. Results: The functions required in the rehabilitation process, as selected by stroke patients, were ranked as follows: walking, toileting, eating, using products and technology for communication, and washing oneself. The functions required in the rehabilitation process, as selected by physical therapists, were ranked as follows: muscle power functions, maintaining body position, muscle tone functions, attention functions, and walking. Conclusion: The results of the study confirm the importance of an agreed goal between the stroke patient and the therapist regarding the functions required for the rehabilitation. This understanding plays a significant role in achieving the patient's expectations and the therapist's predicted performance, thereby providing reassurance and confidence in the impact of the research.

Korean Medical Rehabilitation for Total Knee Replacement (슬관절 전치환술 후 한방재활치료의 효과 보고)

  • Kim, Chang-Gon;Lee, Jin-Hyun;Jo, Dong-Chan;Moon, Su-Jeong;Park, Tae-Yong;Ko, Youn-Suk;Song, Young-Sun;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.1
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    • pp.111-118
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    • 2014
  • The objective of this study is to report the effectiveness of Korean medical rehabilitation for total knee replacement. Three female patients who had total knee replacement were treated by Korean medical rehabilitation with protocol. We evaluated the consequences by checking numeric rating scale (NRS), Lysholm knee score, physical examination of knee joint and walking state. After Korean medical rehabilitation, we find out that the pain and function were improved. NRS, Lysholm knee score, physical examination of knee joint, walking state of patients were also improved. Korean medical rehabilitation can be effectively used for total knee replacement patients. There is a limit that this study hasn't sufficient number of cases. Further studies are needed to set up a Korean medical rehabilitation protocol.

Auto-Walking Training After Incomplete Spinal Cord Injury (불완전 척수손상 후의 자동보행훈련)

  • Jeong, Jae-Hoon
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.81-90
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    • 2003
  • This study was conducted to assess the effects of the gait training method in incomplete spinal cord injured persons using an auto-walking machine. Persons with incomplete spinal cord injury level C or D on the American Spinal Injury Association impairment scale participated for eight weeks in an auto-walking training program. The gait training program was carried out for 15 minutes, three times per day for 8 weeks with an auto-walking machine. The foot rests of the auto-walking machine can be moved forward, downward, backward and upward to make the gait pattern with fixed on crank. The patient's body weight is supported by a harness during waking training. We evaluated the gait speed, physiologic cost index, motor score of lower extremities and the WISCI (walking index for spinal cord injury) level before the training and after the forth and eighth week of walking training. 1. The mean gait speed was significantly increased from .22 m/s at pre-training to .28 m/s after 4 weeks of training and .31 m/s after 8 weeks of training (p=.004). 2. The mean physiologic cost index was decreased from 4.6 beats/min at pre-training to 3.0 beats/min after 4 weeks and 2.0 beats/min after 8 weeks of training, but it was not statistically significant (p=.140). 3. The mean motor score of lower extrernities was significantly increased from 29.8 to 35.8 after 8 weeks of training (p=.043). 4. The mean WISCI level was significantly increased from level 10 to level 19 after 8 weeks of training (p=.007). The results of this study suggest that the gait training program using the auto-walking machine increased the gait speed, muscle strength and galt pattern (WISCI level) in persons with incomplete spinal cord injury. A large, controlled study of this technique is warranted.

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Comparison of characteristics during backward walking according to various stride frequencies in underwater and ground environments

  • Kim, Heejoong;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.7 no.2
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    • pp.83-87
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    • 2018
  • Objective: The purpose of this study was to investigate the relationship between heart rate (HR), self-awareness of exercise intensity (rating of perceived exertion, RPE), and 5-meter walk test (5MWT) of persons affected by stroke during backward walking according to the preferred stride frequency (PSF), PSF+3 and PSF+6 conditions. Design: Cross-sectional study. Methods: A total of 11 persons with stroke (9 males, 2 females) participated voluntarily. All patients underwent backward walking under the PSF, PSF+3, and PSF+6 conditions in underwater and ground environments, and each condition was performed for 5 minutes. The HR, RPE, and walking speeds were measured during walking, and the measured values from underwater and ground environments were compared. Results: The HR and RPE in the ground environment were significantly increased (p<0.05), and although the 5MWT showed an increase in speed, it was not significant. The HR and RPE in the underwater environment were also significantly increased (p<0.05), however, although the 5MWT results was increased, it was not significant. The HR and RPE were significantly increased in the PSF+6 condition (p<0.05). Conclusions: The results of this study showed that backward gait training underwater can provide an appropriate exercise intensity for stroke survivors and suggests that exercises performed in an underwater environment is more effective compared to the ground environment.

Gait Pattern of Hemiplegic Patients with Swimming Aqua-noodles

  • Kim, Suk-Bum;O'Sullivan, David
    • Korean Journal of Applied Biomechanics
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    • v.29 no.1
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    • pp.15-21
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    • 2019
  • Objective: The purpose of this study was to investigate the effects of aqua-noodles on the practice of underwater walking in patients with hemiplegia. Method: After an oral explanation and signing an IRB approved consent form 10 participants ($66.8{\pm}10.75yr$, $165.3{\pm}8.79cm$, $73.6{\pm}46kg$) agreed to participate in this study. Each of the participants was required to walk with the aqua noodles and without the aqua-noodles in a swimming pool. Each participant was asked to walk a distance of 5 m a total of 10 times, 5 with and 5 without the aqua-noodles. The depth of the swimming pool was at 1.3 m, approximately chest height. The following variables were calculated for analysis; height of the knee (m), knee joint ROM ($^{\circ}$), ankle joint ROM ($^{\circ}$), knee joint maximum angular velocity ($^{\circ}/sec$), and ankle joint maximum angular velocity ($^{\circ}/sec$). Results: First, there was a significant increase in time (s) for the maximum knee height to reach as well as the maximum knee height (m) increased when the participant used the aqua-noodles. Second, there was a statistically significant decrease in stride length when the aqua-noodles were used. Conclusion: This study helps to verify that the effect of underwater walking exercise can provide a suitable walking exercise environment. The results of this study provide systematic scientific information about how walking in water can be used for the rehabilitation of patients and the elderly.

Effects of Flexible and Semirigid Lumbosacral Orthosis on Lower-Limb Joint Angles during Gait in Patients with Chronic Low Back Pain: A Cross-Sectional Study

  • Im, Sang-Cheol;Kim, Kyoung
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.4
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    • pp.1-11
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    • 2021
  • PURPOSE: Lumbosacral orthosis (LSO) is often used to help manage low back pain because it is economical and effective. This study examined the effects of flexible and semirigid LSOs on the lower-limb joint angles in walking in patients with chronic low back pain. METHODS: The effects of the lumbosacral orthosis during gait on the sagittal, frontal, horizontal planes and the change in lower limb angle were examined in fourteen chronic low back pain patients who walked without wearing a LSO, wearing a flexible LSO, and wearing a semirigid LSO in random order for three-dimensional motion analysis. RESULTS: The flexion of the hip and knee joints decreased more significantly during walking with an LSO than without one. The genu valgum angles were reduced in the stance phase more during walking with an LSO than without one. The external rotation of the knee joints in the stance phase increased more during walking with an LSO than without one. CONCLUSION: The angles of the lower-limb joints of patients with chronic low back pain are affected by walking with an LSO, and the effects increased as the LSO stiffened.

Effects of Resistance Exercise with Pressure Biofeedback Unit on the Gait Ability and Knee Joint Function in Subject with Total Knee Replacement Patients

  • Jin Park
    • The Journal of Korean Physical Therapy
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    • v.36 no.1
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    • pp.27-32
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    • 2024
  • Purpose: This study was conducted to verify the effect of applying a pressure biofeedback unit on walking ability and knee joint function while performing knee joint extensor strengthening exercises using resistance exercise equipment in total knee replacement (TKR) patients. Methods: This study was conducted on twelve patients receiving rehabilitation treatment after being admitted to a rehabilitation hospital post-TKR. Of these, six were allocated to a feedback group with a pressure biofeedback unit, and the other 6 were allocated to a control group without a pressure biofeedback unit. The subjects performed an exercise program for 45 minutes per session, five times a week, for two weeks. Walking ability and knee joint function were evaluated and analyzed before and after exercise. Results: The feedback group showed significantly better improvements in walking speed, gait cycle, step length on the non-operation side, time on the foot on the operation side, K-WOMAC stiffness, and K-WOMAC function than the control group (p<0.05). Conclusion: When strengthening the knee joint extensor muscles using resistance exercise equipment in TKR patients, the provision of a pressure biofeedback unit was found to improve walking ability and knee joint function by inducing concentric-eccentric contraction of the knee joint extensor muscles. Therefore, the study shows that exercise based on the provision of a pressure biofeedback unit should be considered when strengthening knee joint extensor muscles to improve the walking ability and knee joint function of TKR patients in clinical practice.

Development of a 2-DOF Ankle Mechanism for Gait Rehabilitation Robots (보행 재활 로봇을 위한 2자유도 족관절 기구 개발)

  • Heo, Geun Sub;Kang, Oh Hyun;Lee, Sang Ryong;Lee, Choon-Young
    • Journal of Institute of Control, Robotics and Systems
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    • v.21 no.6
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    • pp.503-509
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    • 2015
  • In this paper, we designed and tested an ankle joint mechanism for a gait rehabilitation robot. Gait rehabilitation programs are designed to improve the natural leg motion of patients who have lost their walking capabilities by accident or disease. Strengthening the muscles of the lower-limbs and stimulation of the nervous system corresponding to walking helps patients to walk again using gait assistive devices. It is an obvious requirement that the rehabilitation system's motion should be similar to and as natural as the normal gait. However, the system being used for gait rehabilitation does not pay much attention to ankle joints, which play an important role in correct walking as the motion of the ankle should reflect the movement of the center of gravity (COG) of the body. Consequently, we have designed an ankle mechanism that ensures the safety of the patient as well as efficient gait training. Also, even patients with low leg muscle strength are able to operate the ankle joint due to the direct-drive mechanism without a reducer. This safety feature prevents any possible adverse load on the human ankle. The additional degree of freedom for the roll motion achieves a gait pattern which is similar to the normal gait and with a greater degree of comfort.