• Korean Journal of Applied Biomechanics
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• v.30 no.4
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• pp.301-309
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• 2020

Objective: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke during walking. Method: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory stimulus used white noise, and all participants listened for 40 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated while all participants walked before and after listening to white noise. The variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle. Results: There is a significant increase in the antero-posterior (A-P) CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). Conclusion: Our findings confirmed the positive effect of using white noise as auditory stimulus through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

• PNF and Movement
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• v.19 no.2
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• pp.287-301
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• 2021

Purpose: Gait training for stroke patients focuses on adjusting to new environments to facilitate outdoor walking. Therefore, the purpose of this study was to identify the effects of various ground obstacle walking combined with treadmill walking on the gait parameters and functional gait ability of chronic stroke patients. Methods: Twenty-four chronic stroke patients were divided into two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group received a combined gait training using various ground obstacle walking and treadmill walking (VGOW) five times/week for four weeks. The control group received traditional treadmill training (TW) five times/week for four weeks. Patients were evaluated using the figure-8 walk test (F8WT) and the Functional Gait Assessment (FGA) before and after each intervention. Results: The ANCOVA results showed that both treatments significantly influenced F8WT steps, F8WT time, and FGA score. The paired t-test results showed a significant improvement in F8WT steps, F8WT time, and FGA score in the experimental group compared to those in the control group. Conclusion: Combined gait training using various ground obstacle walking and treadmill walking can improve gait ability in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.1-11
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• 2023

PURPOSE: This study examined the immediate effects of applying ankle eversion taping using kinesiology tape in chronic stroke patients-design: a randomized cross-over trial. METHODS: Seventeen stroke patients underwent three interventions in random order. The subjects were initially assigned randomly to an ankle eversion taping, placebo taping, or no taping for each intervention. Ankle eversion taping was used for mechanical correction and was involved in ankle dorsiflexion and eversion. The tape was stretched by 30-40%. Placebo tapping was applied in the same form as eversion tapping but was not stretched. The balance ability was assessed using the Y-balance test. The gait ability was assessed by maximum foot pressure and time of stance phase, and gait speed was assessed using a 10 m walk test (10MWT). All measurements were performed immediately after the intervention. RESULTS: The results showed that the dynamic balance and stance phase time in chronic stroke patients was improved after ankle eversion taping. The ankle eversion taping conditions increased significantly (p < .05) compared to the placebo and no taping conditions. CONCLUSION: The application of ankle eversion taping that uses kinesiology tape instantly increased the gait ability of chronic stroke patients. On the other hand, more research will be needed to identify the long-term effects of ankle eversion taping.

• Physical Therapy Korea
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• v.13 no.1
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• pp.32-37
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• 2006

The purpose of this study was to investigate the effects of clinical characteristics of chronic stroke patients on physiological cost index (PCI) during walking. Fourteen stroke patients participated in this study. To investigate the clinical characteristics, Fugl-Meyer score (FMS), gait velocity (GV), muscle strength of the knee extensor, modified Ashworth scale (MAS) of ankle plantar flexor, devices, and gait patterns during walking were measured and analyzed. The results were as follows: Firstly, use of devices and high MAS of the ankle plantar flexor significantly increased PCI. Secondly, PCI was significantly correlated with the FMS and MAS of the ankle plantar flexor. In conclusion, inhibition of spasticity of the ankle plantar flexor is considered to reduce PCI during walking for chronic stroke patients.

• 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 Korea
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• v.18 no.3
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• pp.8-15
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• 2011

Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.1
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• pp.87-94
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• 2012

Purpose : The purpose of this study was to examine the feasibility and efficiency of balance training program through an interactive video game regimen in people with chronic stroke. Methods : Thirty patients with chronic hemiparetic stroke were recruited. Participants were randomly assigned to either a control group (n=15) or an experimental group (n=15). The control group received the general physical therapy including of strengthening and balance exercise five times a week whereas the experimental group received a program of balance exercise with video game play based on virtual reality as well as the same typical physical therapy. The experimental group received 6 sessions for four weeks. Each session was given 5 minutes. An interactive computer game exercise regimen lasted 30 minutes without rest periods. Outcome measures for weight transfer to paretic side, non-paretic side and sit-squat-speed, sit-squat-length, sit-to-standspeed and sit-to-stand-area for the control group (n=15) and experimental group (n=15) before and after treatment were obtained by using the biorescure. Results: Outcomes demonstrated significant improvement in the experimental group compared with the control group in weight transfer to paretic side, non-paretic side and sit-squat-speed, sit-squat-length, sit-to-stand-speed. No significant training effect was showed in sit-to-stand-area between pretraining and post-training. Conclusion : An interactive computer game exercise based on task oriented approach for balance in chronic stroke were feasible. In other words, This regimen resulted in a greater improvement in dynamic balance for people with chronic stroke.

• Physical Therapy Korea
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• v.24 no.1
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• pp.30-40
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• 2017

Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.

• PNF and Movement
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• v.17 no.1
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• pp.119-127
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• 2019

Purpose: The purpose of this study is to show the effect of elastic band on balance and functional ability in chronic stroke patients living in community. Methods: The subjects who participated in the study were 9 patients with chronic stroke. One of them gave up during the study, finally 8 patients performed. The intervention was conducted once a week for 10 weeks. In this study functional reach test (FRT), timed up and go test (TUG), Tinetti performance oriented mobility assessment (Tinetti-POMA) were measured for balance. The coordination training of arms and legs using the elastic band was performed in three positions as supine, side lying, sitting. One arm performed flexion-adduction- external rotation with elbow flexion pattern and the opposite side(diagonal) leg was performed flexion-adduction-external rotation with knee flexion pattern, the other arm's pattern was extension-abduction-internal rotation with elbow extension and the opposite side (diagonal) leg was in extension-abduction-internal rotation with knee extension pattern. The training was performed in each position for 15 minutes in per position. The participants had a five minute break after each training. Results: The results are as follows. FRT and Tinetti-POMA showed significant increase statistically in each position. The TUG showed significant decrease statistically in each position. Conclusion: Even though the coordination training with elastic band had performed once a week, it showed positive effects on balance in chronic stroke patients. Therefore, if we can suggest the appropriate frequencies of coordination training of arms and legs using the elastic band, it can be a method to improve daily life and life quality to patients with chronic stroke.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1894-1903
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• 2015

The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke. Six chronic stroke patients participated for a duration of 31 weeks. Treatment outcomes were assessed via Chedoke-McMaster Stroke Assessment, the Berg Balance Scale, the Assessment of Motor and Process Skill (AMPS), and the Stroke Impact Scale pre- and post-intervention. The participants exhibited significant improvements in impairment, static and dynamic balance, and mood and emotion after group TOCT. The results of AMPS indicated an improvement in the motor area in 3 of the subjects. In the process area, 4 of the subjects exhibited improvement. The results of this study suggest that TOCT is beneficial to physical functions for chronic hemiparetic stroke patients in community-dwelling.