Earticle

The purpose of this study was to identify the effect of a mechanical horseback riding on trunk control and balance function in patients with post-stroke hemiparesis. Six subjects with post-stroke hemiparesis volunteered to participate in this study. All subjects underwent the mechanical horseback riding training for averaging 30 minutes daily for 4 weeks (total of 20 sessions). Assessment tools were made with trunk control test (TCT), postural assessment scale for stroke (PASS), Berg balance scale (BBS), and timed up and go test (TUG) before and after the 4-week training period. TCT, PASS, BBS and TUG showed significant improvement after the mechanical horseback riding training (p<0.05). This study demonstrates that a mechanical horseback riding training may be favorable for enhancing trunk control and balance ability of patients with post-stroke hemiparesis. This study provides valuable information for future studies in this field. Further studies with wider range of participants and longer experiment span are required to strengthen the results of present study.

This study was performed to investigate the effects of virtual reality exercise with video game on gross motor performance and balance in a child with spastic cerebral palsy. The subject of study was cerebral palsy with spastic diplegia presenting 4th level in gross motor function classification system. The subject received virtual reality video game exercise using Wii Fit system, which was performed for 35 minutes in each session, 2 sessions per week over a 5-week period (a total of 10 sessions). Assessment tools were made with the pediatric balance scale, the gross motor function measure, and balance evaluation in Wii Fit system in each session. After the training, gross motor performance and balance ability were improved. The exercise using virtual reality video game may be a beneficial tool to improve gross motor performance and balance in the spastic cerebral palsy at clinics and home-based setting.

The Masai Barefoot Technique (MBT) shoes are commonly used in clinical studies, however, research effort to identify the benefits of the MBT shoes has been in little attention. Furthermore, evidences for the favorable use of the MBT shoes have been limited for foot pressure and electromyographic activities. The purpose of this study was to examine whether there was the differences of plantar pressure, contact time, and stride length between MBT shoes and normal shoes. Convenient sample of 20 subjects (men: 10 and women: 10) was recruited for this study. And data for the plantar pressure, contact time, and stride length of subjects were collected by using treadmill gait analysis system. During measurement, the application of the MBT shoes or ordinary shoes was determined by randomly selection. There were significant differences in plantar pressure, contact time and stride length between the MBT shoes and ordinary shoes (p<0.05). These findings suggest that the MBT shoes may be beneficially used for foot management in clinical setting.

This study aimed to compare the effect of the on the treadmill walking training combined with obstacles-crossing (TWT-OC) and overground walking training (OWT) on the balance ability of patients with chronic stroke. 11 subjects volunteered to participate in this study; they were randomly assigned to either the TWT-OC group (5 subjects) or OWT group (6 subjects). Subjects from the TWT-OC group underwent a treadmill walking training comined with obstacles-crossing for 30 minutes daily, three days a week for four weeks, whereas subjects from the OWT group received overground walking training. The Berg balance scale (BBS), timed up and go test (TUG), and activities-specific balance confidence-Korean version (ABC-K) were measured before and after the 4-week training. The OCTWT group showed significantly better functional mobility of balance measured by BBS and ABC-K scores (p<.05) when compared with those of the OWT group. Further, within-group comparison showed significant improvement in all variables (p<.05). These findings suggest that the OCTWT and OWT may be helpful for improving the balance ability of patients with chronic stroke, and the TWT-OC has probably more favorable outcomes for chronic strokes, however, further trials with wider range of subjects are warranted for generalization and clinical relevance.

The purpose of this study is to determine whether the efficacy of considering handedness constraint-induced movement therapy (CIMT) affects the performance level of the activities of daily living (ADL) and hand function in a chronic traumatic brain injury patient. The design of this study was a case report. The subject was 18 years old and a right-sided hemiparesis. CIMT is the method of the intervention that limit the movement of unaffected upper limb. This experiment was performed by using a elbow splint in this subject which was applied more than 14-hr a day for 8 weeks. Assessments were performed three conditions: baseline is no intervention, First intervention performed for 4 weeks, and second intervention performed. First intervention was performed by participating common life task with the right hand. Intensive hand activity program was provided to subject during second intervention. The ability of the ADL performance was measured by Canadian occupational performance measure (COPM) and functional independence measure (FIM). For the measurement of hand function was Jebsen-Taylor hand function test and grip dynamometer. After the 8 weeks CIMT, the result of subject's performance level of ADL and hand function were enhanced. The FIM score increased by 102 points from 88 points after 8 weeks. During intervention first intervention, writing and simulated feeding sub-items measuring time were decreased by 29.05 sec, 20.05 sec from 35.01 sec, 38.03 sec in Jebsen hand function test, however, during second intervention , turning over cards, picking up large light object, picking up large weighted object sub-items measuring time were decreased by 13.01 sec, 7.07 sec, 11.01 sec from 18.04 sec, 10.05 sec, 15 sec. Grip strength increased on right hand nearly doubled from 11kg. These findings suggest that considering handedness while CIMT performed could influence the affected hand function and performance level of ADL. It provides a helpful information for further studied in this field.

The aim of the this study was to identify the evidence-based research and practice for relieving the symptoms of cerebellar disease using a qualitative meta-analysis. Studies were selected with a search of computerized databases of the literature (KERIS, 2001-2011) in the use of key words such as ‘cerebellum’, ‘motor learning’, ‘equilibrium’, ‘sensory-motor coordination’, ‘reaching’, and ‘motor planing’. 638 articles were selected by the application of the search strategy to the KERIS databases. Final selection of articles included 16 studies with an exception of animal studies and microbiological studies, and these articles were categorized by the research design and statistical methods. Of these articles, case study was 56. 2%, and main topics were sensory-motor and coordination. We conclude that all article show studies's design and theme limited. There would be needed to improve the quality in research level and the consistency in describing the symptoms of cerebellum disease and treatment's approach.

The recovery of walking function may be one of main issues in stroke rehabilitation, and in such reason, most clinicians make every effort to improve walking function in their own ways with great care. Given that community reintegration and social participation is the highest therapeutic goal in stroke rehabilitation, community ambulation should be recognized as a fundamental element for comprehensive therapeutic approaches to return the patients to premorbid life. This study aimed to demonstrate a variety of factors to establish therapeutic strategies for optimizing the performance of movement skills in the requirement of community ambulation and to place emphasis on clinical reasoning of community ambulation and important attitude in therapists’ decision making by reviewing literatures. The findings of recent studies support the effectiveness of walking training in real world for improving the ambulation skill of patients with post-stroke hemiparesis. Although it may not be actually easy to incorporate additional therapeutic efforts to increase activity level in community into the rehabilitation process of stroke patients who need long-term management service, community ambulation should be included as integral part of stroke rehabilitation, considering that community activities influence greatly on their physical function and quality of life. It requires clinicians’ recognition of community ambulation skill for the patients and a full consideration of skill performance in community environment to create beneficial treatment plan in stroke rehabilitation. Thus, study effort should be focused on exploring more favorable training methods to achieve successful community ambulation, ultimate goal in stroke rehabilitation. It will provide the critical basis to develop the feasibility of patient-centered approaches in stroke rehabilitation.