Effect of Horseback Riding Simulation Machine Training on Trunk Balance and Gait of Chronic Stroke Patients

[Purpose] The purpose of this study was to assess the effect of horseback riding simulation machine training on trunk balance and gait of patients with chronic stroke. [Subjects and Methods] The subjects were 20 patients hospitalized for treatment after being diagnosed with stroke. Horseback riding simulation training was provided for 30 minutes, 5 times a week, for 6 weeks. Trunk balance was assessed using the Trunk Impairment Scale (TIS) and a balance measuring device (Biorescue, RM ingenierie, France), and gait ability was measured using the Functional Gait Assessment (FGA) and a gait analyzer (GAITRite, CIR system Inc., USA). [Results] There were significant changes in movement area, distance and velocity of body sway as measured by the TIS and the balance measuring device, and in gait velocity, cadence, stride length and double limb support as measured by the FGA and gait analyzer. [Conclusion] Horseback riding simulation training improved the trunk balance and gait of chronic stroke patients. This present study provides preliminary objective data for future research, and useful clinical information for physical therapists using horseback riding simulation machines as a treatment modality for patients with chronic stroke.Key words: Horseback riding simulation machine training, Trunk balance, Gait     

The Effect of Underwater Gait Training on Balance Ability of Stroke Patients

[Purpose] The purpose of this study was to investigate the effects of underwater treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a control group (n =11). [Methods] Both groups received general rehabilitation for 30 min per session, 5 times per week, over a 4-week period. The underwater treadmill group received additional underwater gait training for 30 min per session, 5 times per week, over the same 4-week period. Static and dynamic balances were evaluated before and after the intervention. [Results] The means of static and dynamic balance ability increased significantly in both groups, but there was no significant difference between the two groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill gait training was not more effective at improving the balance ability of stroke patients than land-based training.Key words: Stroke, Gait, Stability     

Effects of Dual Task Training with Visual Restriction and an Unstable Base on the Balance and Attention of Stroke Patients

[Purpose] The purpose of this study was to examine the effects of the visual restriction and unstable base dual-task training (VUDT), the visual restriction dual-task training (VDT), and the unstable base dual-task training (UDT) on the balance and attention of chronic stroke patients. [Subjects and Methods] The subjects were 38 chronic stroke patients, who were divided into two groups of 13 patients each and one group of 12 patients. They were given dual-task training for 30 minutes per session, three times a week, for eight weeks. Their balance was measured using the center of pressure (COP) migration distances, functional reach test (FRT), and Berg balance scale (BBS), and attention was measured with the Trail Making Tests and the Stroop test. [Results] In comparisons within each group, all the three groups showed significant differences before and after the training (p<0.05), and in the comparisons among the three groups, the VUDT group showed more significant differences compared with the other two groups in all tests (p<0.05). [Conclusion] Dual-task training applied with visual restriction and an unstable base in which the subjects attempted to maintain their balance was effective in improving the balance and attention of stroke patients, and the VUDT was more effective than VDT or UDT.Key words: Balance, Dual task, Stroke     

An Ankle Proprioceptive Control Program Improves Balance,Gait Ability of Chronic Stroke Patients

[Purpose] Balance and gait ability determine to a large degree the level of independence of daily living which is an important goal of rehabilitation. This study was conducted in order to examine the effectiveness of an ankle proprioceptive control program on ankle muscle strength, balance, and gait of chronic stroke patients. [Methods] Thirteen chronic stroke patients more than six months post-stroke were recruited. All subjects received ankle proprioceptive control training for 30 minutes per session, two days per week, over a period of six weeks. Outcome measures were ankle strength (BTE-Primus), the Timed Up and Go test (TUG), and spatiotemporal parameters measured by a GAITRite instrument. [Results] Significant improvements in ankle dorsiflexor strength, TUG, gait speed and cadence, step length, and stride length were observed on the paretic side. [Conclusion] The results of this study provide evidence in support of incorporation of an ankle proprioceptive control program for effective improvement of both balance and gait ability of chronic stroke patients. The findings of this study suggest the feasibility and suitability of an ankle proprioceptive control program for chronic stroke patients.Key words: Stroke, Proprioception, Ankle     

The Effect of Motor Dual-task Balance Training on Balance and Gait of Elderly Women

[Purpose] This study investigated the effect of a motor dual-task balance program on balance and gait of elderly women to suggest a more effective balance exercise method. [Subjects] Twenty elderly Korean women who could walk independently were recruited from the community dwelling. [Methods] The motor dual-task balance training (experimental) group stood on an Aero-step, and performed gym ball bouncing, catching, and throwing, while the simple task balance training (control) group merely stood on the Aero-step. Participants performed 45 minutes of training, 2 times a week for 6 weeks. Balance (fall index) was measured using a TETRAX. Gait variables were recorded on a GAITRite walkway at self-determined walking speed. [Results] The fall index of the experimental group was significantly lower than that of the control group. Step length, stride length, velocity, and cadence of the experimental group improved significantly more than those of control group. [Conclusions] We found that motor dual-task balance training improved balance and walking ability more than simple balance training. Further studies should investigate motor dual-task training with kinematic and kinetic data, and muscle activation based on motor strategies.Key words: Balance, Elderly, Motor dual-task     

The Effects of Visual Feedback Training on Sitting Balance Ability and Visual Perception of Patients with Chronic Stroke

[Purpose] The purpose of this study was to investigate the effects of visual feedback training (VFT) in the sitting position on sitting balance ability and visual perception of chronic stroke patients. [Subjects] Twenty-two hospitalized subjects who had experienced a stroke more than six months earlier were included in this study. [Methods] Subjects in both the experimental group (n=12) and the control group (n=10) participated in a conventional rehabilitation program involving a 60-minute session five days per week for a period of four weeks. Subjects in the experimental group additionally practiced VFT 30-minute sessions, five days per week, for a period of four weeks. [Results] After the intervention, the experimental group showed significantly improved static sitting balance ability (left∙right, anterior∙posterior moment, and velocity moment), and dynamic sitting balance ability (anterior∙lateral moment). In visual perception tests, motor free visual perception test (MVPT) scores showed a significant increase of approximately 17% in the experimental group after the intervention. [Conclusion] The results of this study demonstrate the effectiveness of VFT in enhancing body function, as evidenced by improved sitting balance and visual perception of chronic stroke patients.Key words: Visual feedback, Sitting balance, Stroke     

Pro-kin视觉反馈平衡训练对脑卒中患者平衡与步态的影响

目的：探讨Pro-kin视觉反馈平衡训练对脑卒中患者平衡与步态的影响。方法：纳入脑卒中偏瘫患者50例,随机分为对照组和观察组,每组25例。对照组给予常规康复治疗,观察组在此基础上,采用Pro-kin平衡训练仪进行视觉反馈平衡训练。治疗前后,采用Berg平衡量表、计时起立行走测试、Pro-kin平衡仪、数字化跑台监控仪进行平衡与步态评估。结果：治疗2周后,2组BBS评分均较治疗前有明显提高（均P<0.01）,且观察组高于对照组（P<0.05）;2组TUGT评分、睁眼及闭眼状态下运动长度和运动椭圆面积数值均较治疗前有明显下降（均P<0.01）,且观察组均低于对照组（均P<0.05）。治疗后,2组平均步长及步频均较治疗前明显增加（P<0.01）,步长变异性均较治疗前明显减小（P<0.01）,且观察组平均步长优于对照组（P<0.05）,步频及步长变异性2组间比较差异无统计学意义。结论：Pro-kin视觉反馈平衡训练可以改善脑卒中患者的平衡与步态功能。     

The Effect of Treadmill-based Incremental Leg Weight Loading Training on the Balance of Stroke Patients

[Purpose] The purpose of this study was to examine the effect of treadmill-based gait training using incremental weight loading on the ankle of the affected side on hemiplegic stroke patients’ balance. [Subjects] In this study, 30 hemiplegic stroke patients were randomly divided into an incremental weight load group (IWLG, n=15) and a no-load group (NLG, n=15). [Methods] The IWLG performed gait training on treadmills for four weeks wearing a sandbag weighing 3% of the body weight on the affected side ankle, followed by wearing a sandbag weighing 5% of the body weight from the 5th week. The NLG performed similar training without sandbags. [Results] Both the IWLG and the NLG showed significant improvements in balance ability. The IWLG showed a larger decrease in the area and length of movement of the center of pressure in static standing positions after the experiment although the difference was not significant. [Conclusion] We recommend, utilizing the treadmill-based gait training using incremental weight loading on the affected side ankle as a clinical intervention for improving hemiplegic stroke patients’ balance ability.Key words: Stroke, Incremental weight load, Treadmill     

The Effect of Obstacle Training in Water on Static Balance of Chronic Stroke Patients

[Purpose] This study evaluated the effects of water and land-based obstacle training on static balance of chronic stroke patients. [Subjects] The subjects were randomly allocated to an aqua group (n=15) and a land group (n=15). [Methods] Both groups trained for 40 minutes, 3 times a week for 12 weeks. Static balance was assessed by measuring the mean velocities of mediolateral (ML) and anteroposterior (AP), and sway area with the eyes closed. [Results] Following the intervention, both groups showed significant changes in ML velocity, AP velocity, and sway area. The static balance of the aqua group was significantly better than the land group. [Conclusion] The results of this study suggest the feasibility and suitability of obstacle training in water for stroke patients.Key words: Stroke, Aqua, Obstacle training     

The Effects of Stair Walking Training on the Balance Ability of Chronic Stroke Patients

[Purpose] The purpose of this study was to evaluate the effects of stair walking training on balance ability of chronic stroke patients. [Subjects and Methods] Forty stroke patients were allocated equally and randomly to an experimental group and a control group. The experimental group undertook 30 minutes of training therapy and 30 minutes of walking exercise on stairs with flat surfaces. The control group undertook 30 minutes went of training therapy and 30 minutes of walking exercise on a flat surface. All the participants had five training sessions each week for four weeks. A Biorescue system was used to measure the weight-bearing footprint, anterior length in the limit of stability, posterior length in the limit of stability, surface area ellipse of Romberg, and length of Romberg before and after the training. [Results] With regard to changes in the weight-bearing footprint, the anterior length in the limit of stability, and the posterior length in the limit of stability, there were significant differences on both the paretic and nonparetic sides, and there were also significant differences in the surface area ellipse of Romberg and length of Romberg after the intervention. [Conclusion] The experiment results showed that walking exercise on stairs is effective in enhancing balance performance. The same exercise can be applied to patients with other types of neurological disorders to improve their balance.Key words: Strokes, Balance, Stair gait     

骨盆强化训练对偏瘫患者步态的影响

目的探讨骨盆强化训练对偏瘫患者步态的影响。方法60 例脑卒中偏瘫患者分为对照组(n=30)和观察组(n=30),两组均接受常规康复训练,观察组增加骨盆强化训练,治疗前和治疗8 周后采用Biodex Gait Trainer 2 步态分析系统对患者的平均步长、肢体负重时间比、3 min 步行距离进行评定。结果治疗后,两组平均步长、肢体负重时间比、3 min 步行距离均较前显著改善(P<0.001),观察组显著优于对照组(P<0.001)。结论采用骨盆强化训练可改善偏瘫患者步态。     

The Effects of Horseback Riding Simulator Exercise on Postural Balance of Chronic Stroke Patients

[Purpose] The aim of this study was to examine the effects of horseback riding simulator exercise on postural balance of chronic stroke patients. [Subjects] A total of 67 stroke patients were assigned either to a horseback riding simulator exercise group (HEG, n=34) or a mat exercise group (MEG, n=33). [Methods] The subjects exercised three times per week for 8 weeks. Static balance ability was determined by eyes open balance (EOB) and eyes closed balance (ECB), which was measured using a Kinesthetic Ability Trainer Balance system. Dynamic balance was evaluated using the Berg balance scale (BBS). [Results] EOB and ECB significantly decreased and BBS had significantly increased after the intervention in the HEG and the MEG, and ECB decreased and BBS increased significantly more in the HEG than in the MEG. [Conclusion] Horseback riding simulator exercise is more effective than mat exercise for improving the ECB and BBS of stroke patients.Key words: Horseback riding simulator exercise, Postural balance, Stroke     

The Effect of the Neurac Sling Exercise on Postural Balance Adjustment and Muscular Response Patterns in Chronic Low Back Pain Patients

[Purpose] This study aimed to examine the effects of the Neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain (CLBP) patients. [Subjects and Methods] Sixteen CLBP patients participated in this study. They were randomly and equally assigned to group I, whose members received ordinary physical therapy (40 minutes per time, four times per week), and group II, whose members performed a lumbar stabilization exercise using the Neurac sling after ordinary physical therapy (40 minutes per time, four times per week). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate exercise effects. BioRescue and electromyography were utilized for the measurement of changes in postural balance adjustment and muscular response patterns, respectively. [Results] Both groups saw their VAS and ODI decrease significantly. There were significant decreases in both groups in posturography as well, but group II recorded a greater decrease. There were significant increases in the flexion–relaxation ratio in both groups, and there were significant increases in the extension–flexion ratio in the left L1–2 of group I and in all elements of group II. [Conclusion] Lumbar stabilization exercise using the Neurac sling is effective in decreasing pain, improving damaged postural balance adjustment, and normalizing muscle response patterns of CLBP patients.Key words: Chronic low back pain (CLBP), Neurac sling exercise, Postural balance adjustment     

平衡评估训练系统对脑卒中后平衡功能的康复效果

目的 探讨脑卒中后平衡功能障碍患者应用Huber 360神经肌肉控制训练与评估系统(Huber 360)的效果.方法 2020年1月至11月,首次发病的脑卒中患者16例随机分为对照组(n=8)和试验组(n=8).两组均接受常规运动功能训练3周,试验组同时采用Huber 360进行训练.训练前后,采用Berg平衡量表、H...     

认知-运动控制双重任务训练应用于老年脑卒中后认知障碍的临床价值

目的 探讨认知-运动控制双重任务训练应用于老年脑卒中后认知障碍(PSCI)的临床价值.方法 选取郑州大学第一附属医院2018年9月至2019年9月收治的老年PSCI患者131例,按随机数字表法分为2组:对照组65例给予重复经颅磁刺激和基本认知训练,观察组66例在对照组治疗基础上增加认知-运动控制双重任务训练,比较2组干...     

Effects of Robot-assisted Gait Training Combined with Functional Electrical Stimulation on Recovery of Locomotor Mobility in Chronic Stroke Patients: A Randomized Controlled Trial

[Purpose] The purpose of the present study was to investigate the effects of robot-assisted gait training combined with functional electrical stimulation on locomotor recovery in patients with chronic stroke. [Subjects] The 20 subjects were randomly assigned into either an experimental group (n = 10) that received a combination of robot-assisted gait training and functional electrical stimulation on the ankle dorsiflexor of the affected side or a control group (n = 10) that received robot-assisted gait training only. [Methods] Both groups received the respective therapies for 30 min/day, 3 days/week for 5 weeks. The outcome was measured using the Modified Motor Assessment Scale (MMAS), Timed Up-and-Go Test (TUG), Berg Balance Scale (BBS), and gait parameters through gait analysis (Vicon 370 motion analysis system, Oxford Metrics Ltd., Oxford, UK). All the variables were measured before and after training. [Results] Step length and maximal knee extension were significantly greater than those before training in the experimental group only. Maximal Knee flexion showed a significant difference between the experimental and control groups. The MMAS, BBS, and TUG scores improved significantly after training compared with before training in both groups. [Conclusion] We suggest that the combination of robot-assisted gait training and functional electrical stimulation encourages patients to actively participate in training because it facilitates locomotor recovery without the risk of adverse effects.Key words: Robot-assisted gait training, Functional electrical stimulation, Chronic stroke     

The Effect of Mirror Therapy Integrating Functional Electrical Stimulation on the Gait of Stroke Patients

[Purpose] The aim of the present study was to examine whether mirror therapy in conjunction with FES in stroke patients can improve gait ability. [Subjects] This study was conducted with 30 subjects who were diagnosed with hemiparesis due to stroke. [Methods] Experimental group I contained 10 subjects who received mirror therapy in conjunction with functional electrical stimulation, experimental group II contained 10 subjects who received mirror therapy, and the control group contained 10 subjects who received a sham therapy. A gait analysis was performed using a three-dimensional motion capture system, which was a real-time tracking device that delivers data in an infrared mode via reflective markers using six cameras. [Results] The results showed a significant difference in gait velocity between groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and the control group and between experimental group II and the control group, respectively. There were also significant differences in step length and stride length between the groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and control group. [Conclusion] The present study showed that mirror therapy in conjunction with FES is more effective for improving gait ability than mirror therapy alone.Key words: Mirror therapy, Functional electrical stimulation, Gait analysis     

Effects of Hippotherapy on Recovery of Gait and Balance Ability in Patients with Stroke

[Purpose] The aim of this study was to examine the the effects of hippotherapy on gait and balance ability in patients with stroke. [Subjects and Methods] Thirty stroke patients were randomly divided into a hippotherapy group and a treadmill group and they conducted exercise for eight weeks. [Results] Berg Balance Scale score, gait velocity, and step length asymmetry ratio were significantly improved in the group receiving hippotherapy training. However, in the group receiving treadmill training, only step length asymmetry ratio was significantly improved. In the comparison between the hippotherapy group and treadmill group, there was no significant difference in Berg Balance Scale score, but a significant difference was found in gait velocity and step length asymmetry ratio. [Conclusion] The results of this study indicated that hippotherapy is a helpful treatment for stroke patients.Key words: Stroke, Balance, Hippotherapy     

Drinking Behavior Training for Stroke Patients Using Action Observation and Practice of Upper Limb Function

[Purpose] This study examined the effects of action observation and action practice on stroke patients’ upper limb function. [Subjects and Methods] The subjects were 33 chronic stroke patients who were randomly assigned to four groups. The action observation group (5 males, 3 females) watched a video of the task, the action practice group (5 males, 4 females) performed the action, the combined action observation-action practice group (5 males, 4 females) watched the video of the task and practiced the action, and the control group (4 males, 3 females) did not perform either action observation or action practice. The video used in the action observational physical training comprised a scene of an adult male picking up a cup, bringing it to his mouth in order to touch his mouth, and then returning the cup to its initial position. [Results] Improvements in drinking behavior functions were observed immediately after the experiment and one week later. After the intervention, the number of drinking motions had increased the most in the combination group. One week after the experiment, there were increases in the action observation, action training, and combination groups. [Conclusion] A combination of action observation and action training is the most effective treatment method, and action training is a desirable second to combined therapy.Key words: Action observation, Drinking behavior training, Upper limb function     

Effect of Training with Whole Body Vibration on the Sitting Balance of Stroke Patients

[Purpose] The purpose of this study was to determine the effects of task-oriented training with whole body vibration (WBV) on the sitting balance of stroke patients. [Subjects] The subjects were 30 stroke patients who were randomly divided into experimental (n₁=15) and control (n₂=15) groups. [Methods] Subjects in both groups received general training five times per week. Subjects in the experimental group practiced an additional task-oriented training program with WBV, which was performed for 15 minutes, five times per week, for four weeks. The center of pressure (COP) path length and average velocity were used to assess subjects static sitting balance, and the Modified Functional Reach Test (MFRT) was used to assess their dynamic sitting balance. The paired t-test was performed to test the significance of differences between before and after the intervention. The independent t-test was conducted to test the significance of differences between the groups. [Results] Following the intervention, the experimental group showed a significant change in MFRT. [Conclusion] The results of this study suggest that task-oriented training with WBV is feasible and efficacious for stroke patients.Key words: Balance, Stroke, Whole body vibration