Earticle

Purpose: This study aimed to evaluate the effect of task-oriented training on trunk stabilization, coordination of the lower extremities, and dynamic balance of patients with stroke. Methods: Ten patients with stroke were randomly divided into two groups of five patients each who met the selection criteria. The training was conducted five times a week for 60 minutes. The experimental group received task-oriented training and general physical therapy, while the control group received only general physical therapy. The Mann-Whitney U test was used to compare differences between the groups, and the Wilcoxon signed-rank test was used to compare differences between pre- and post-intervention within each group. Results: Trunk stabilization was measured using the trunk impairment scale. Only the coordination assessment on the trunk impairment scale was statistically significant after intervention in the experimental group (p = 0.046) and between the experimental and control groups (p = 0.029). The LEMOCT, figure-of-8 walk test (F8WT), timed up-and-go (TUG) test results were not statistically significantly different in the group after intervention. However, the F8WT and TUG test results showed a statistically significant difference between the experimental and control groups (p = 0.029). Conclusion: The task-oriented training showed positive effects on the trunk stabilization, coordination of the lower extremities, and dynamic balance of the patients with stroke.

Motor imagery is the mental representation of movement without any body movement. It has been reported that showing positive results to improve balance and walking in neural rehabilitation. This study aimed to prove the effects of motor imagery with functional training on fall efficacy in elderly people as well as balance and gait, and to investigate whether motor imagery training can be used as a possible intervention for fall prevention. Three subjects who were over 65 years old participated for this study. Outcome measures were Berg Balance Scale (BBS) to evaluate the subjects’ balance ability, Timed Up and Go Test (TUG) for dynamic balance ability, and Fall Efficacy(FES) to assess fear of falling in the elderly. Also GAITRite System was used to measure gait parameters. Motor imagery training was performed for 1 hour per day, three times per week for six weeks (a total of 18 sessions). The findings suggest that all variables improved after the intervention. Overall, a motor imagery training might be used to enhance balance and gait, fall efficacy in the elderly people.

The purpose of this study was to investigate the effect of task-oriented functional training on a musscle strength , balance and gait ability of chronic hemiplegia patients. Ten who were able to walk independently were evaluated in this study. Subjects exercised three, 60min times a week for 12 weeks. Functional Exercises consist of sit to stand, reaching, pick up, transfer and gait on various environments. We measured strength of lower extremity by manual muscle test, static balance by forceplate, dynamic balance through TUG and BBS. 10m walking time reflects gait ability. The paired t-test was performed to analyze differences between pre-and post-tests and α＝.05 set up with the significant level. The major findings of this study were that task-oriented functional exercises brought about increases in strengths of knee extensor(p<.001) and ankle dorsiflexor(p<.05), decrease in a averge sway path(p<.05), decrease in TUG (p<.05), increase in BBS(p<.05) and decrease in a10m walking time(p<.05). The strength of knee extensor to be significantly correlated with balance, gait ability(p<.05). Dynamic balance has positive correlation with gait ability(p<.05). We suggest that task-oriented functional training enabled stroke patient to improve the muscle strength, balance and gait ability, which is contribute to plan to rehabilitation exercise.

The purpose of this study is to investigate the effect of task-oriented voluntary trunk rotation among stroke patients with unilateral neglect; the focus was to detect any reduction of unilateral neglect or increase in balancing ability. This study used a single subject experimental design with multiple baselines. Participant 1, 2 and 3 performed 4, 8 and 12 sessions each during the baseline phase, and 16, 12 and 8 sessions at the intervention, respectively. The results were assessed by using the line bisection test, Berg Balance Scale(BBS), which were separately implemented. The Line bisection scores of participant 1, 2 and 3 were improved by 38.9%, 44% and 35.9%, trunk rotation in task-oriented voluntary trunk rotation. The BBS scores of participant 1, 2 and 3 were improved by 39.6%, 31.6% and 7.7% each, compared to the baseline. The findings suggest that task-oriented voluntary trunk rotation is adaptable to clinical applications to reduce unilateral neglect and to enhance balancing ability to the target patients. Future studies with wider range of participants and longer experiment span, are required in order to strengthen the result of the research.

This study was to identify the effects of task oriented training of trunk stability on a swiss ball in sitting position on trunk stability and balance in children with spastic diplegic cerebral palsy. 20 subjects were participated in this study and allocated into the experimental group (EG) trained with task oriented training on a swiss ball and the control group (CG) trained with it on a mat. Pediatric reaching test (PRT) and Touching-to-the-ground in Trunk control measurement scale (tTCMS) for trunk stability and Sitting, Quadruped and Kneeling in Gross motor function measure (sGMFM, qGMFM and kGMFM) and Static and Dynamic stability in TCMS (sTCMS and dTCMS) for balance were used as assessment tools conducted before and after 8-week training. In results, there were significant differences in PRT, tTCMS, sGMFM, qGMFM, kGMFM, sTCMS and dTCMS in both EG and CG (p<.05). And there were more significant differences in PRT, tTCMS, sTCMS and dTCMS of EG than those in CG (p<.05). Therefore, this study showed that task oriented training of trunk stability on a swiss ball in sitting position gave beneficial effects on trunk stability and balance in children with spastic diplegic cerebral palsy.

목적 : 본 연구는 경직형 양마비 아동에게 과제지향훈련을 시행할 때 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향을 알아보며 뇌성마비 아동을 치료하기 위한 중재방법으로 임상적으로 유용한지 제안하고자 시도되었다. 연구방법 : 연구 대상자를 단순 무작위 표본추출법으로 실험군(남자 : 9명, 여자 : 8명, 평균연령 : 8.12세)과 위약군(남자 : 9명, 여자 : 8명, 평균연령 : 7.53세) 각각 18명씩 배분한 후 두 중재군 모두에게 1회 40분, 주 2회 과제지향훈련을 12주 동안 실시하였다. 실험군은 무게저항을 제공하는 무게조끼를 착용하고, 위약군은 무게저항 없이 무게조끼만 착용 하였다. 두 중재군 모두에게 닫힌 운동사슬과 다관절의 기능적인 움직임 패턴을 촉진하는 과제지향훈련을 각각 8~10회 실시하며 과제 사이에 약 3분간 휴식 하였다. 두 중재군의 대동작 수행력, 균형 능력에 대한 사전검사는 중재 전에 측정하였고, 사후검사는 중재 6주후와 12주후 총 2회 시행하였으며 마지막으로 추적검사는 실험종료 12주후에 실시한 후 두 중재군 사이의 시간경과에 따른 변화량을 분석하였다. 결과 : 대동작 수행평가는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의한 차이가 나타났다(p<.05). 아동용 균형척도는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의 한 차이가 있었다(p<.05). 결론 : 그러므로 닫힌 운동사슬과 다관절의 기능적인 움직임을 촉진시키는 과제지향훈련 시 무게조끼 적용은 경직형 양마 비 아동의 대동작 수행력과 균형 능력을 향상시키는 유용한 중재 방법으로 고려될 수 있다.

Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg’s Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

Background: Task-oriented training on an unstable support surface is an effective intervention for improving the ankle joint stability and muscle strength in patients with ankle instability. This study examined the effects of balance training on an unstable support surface in patients with ankle sprains with ankle instability. Methods: Forty-four patients with ankle sprains participated in this study. Screening tests were performed and assigned to an experimental group, who performed task-oriented training on an unstable support surface (n=22), and a control group, who performed task-oriented training on a support surface (n=22) using a randomization program. All interventions were applied 3 times per week for 4 weeks. The numeric rating scale (NRS), cumberland ankle instability tool (CAIT), balance ability, muscle activity, and muscle thickness were compared to evaluate the effects of the intervention. Results: Both groups showed significant differences in the NRS, CAIT, balance ability, and muscle activity between before and after the intervention (p<.05). In addition, there were significant differences in balance ability, muscle activity, and muscle thickness between the experimental and control groups (p<.05). Conclusion: Task-oriented training on an unstable support surface is an effective intervention for improving the balance ability, muscle activity, and muscle thickness during contraction.

Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.

PURPOSE: The purpose of this study was to compare task-oriented balance training on stable and unstable surfaces in terms of the fall risk, balance, and gait abilities in patients with stroke. METHODS: Twenty patients with stroke were divided randomly into a stable surface group (SSG, N=10) or unstable surface group (USG, N=10). The participants in the SSG and USG performed task-oriented balance training on stable and unstable surfaces, respectively. All participants were evaluated using the Tetrax, Berg balance scale (BBS), and 10-meter walking test (10MWT) before and after the intervention. Both groups received training 30 min per day, five times per week, for six weeks. RESULTS: The within-group changes in the fall risk, BBS, and 10MWT were significantly different in both USG and SSG (p<.05). USG showed significantly more improvement in the BBS and 10MWT compared to SSG (p<.05). CONCLUSION: Task-oriented balance training on an unstable surface is more beneficial in improving the balance and gait abilities of stroke patients.

The purpose of this study was to investigate the balance of stroke patient appling Task-Oriented Functional training program. Sixteen subjects were recruited from KeiMyung university Dongsan Medical Center inpatient satisfying requirement for this study. They were divided into Task-Oriented Functional training group and Conventional therapy group. They were measured by Sensory organization test and Motor control test items using EquiTest Version 8.0 machine before and after the test. The result of this study were to follow: 1. In Sensory organization test, there were no significant differences in static eguibrium score in both groups(p<.05). 2. In Sensory organization test, there were significant differences in dynamic eguibrium score in both groups(p<.05). 3. In Motor control test, there were significant differences in both groups(p<.05). 4. In exercise group, there were no significant differences in static Sensory organization test(p<.05). 5. In exercise group, there were significant differences in dynamic Sensory organization test(p<.05). 6. In exercise group, there were significant differences in Motor control test(p<.05). 7. In control group, there were no significant differences in static Sensory organization test(p<.05). 8. In control group, there were no significant differences in dynamic Sensory organization test(p<.05). 9. In control group, there were no significant differences in Motor control test(p<.05).

PURPOSE: The purpose of this study was to compare the effects of task-oriented training and virtual reality training on upper extremity function, balance ability, depression in stroke patients. METHODS: Forty stroke patients were randomly allocated into a task oriented training group (TTG, n = 20), a virtual reality training group (VRG, n = 20). Both groups received the usual physical therapy. In addition, TTG patients underwent task training such as sweeping the table, cup stacking, carrying wood block. VRG patients underwent virtual reality training using X-box kinect. Both groups received 30 minutes of training per day, five times per week, for twelve weeks. RESULTS: After intervention, both groups showed significant improvement on upper extremity function, balance ability, and depression. VRG showed more improvement on upper extremity function, balance ability, and depression than TTG. CONCLUSION: According to the results of this study, task-oriented training and virtual reality training are feasible and suitable for stroke patients. And virtual reality training is more effective method than task oriented training.

본 연구는 과제지향적 자세조절훈련이 아급성기 뇌졸중 환자의 자세조절 및 균형과 일상 생활 수행능력에 어떠한 영향을 미치는지 알아보기 위하여 실시하였다. 연구 대상은 아급성기 뇌졸중 환자 30명을 무작위로 일반적인 물리치료를 실시한 군과 일반적인 물리치료를 병행한 과제지향적 자세조절훈련을 실시한 군으로 각각 15명씩 배정하였다. 모든 대상자들은 일반 적인 물리치료를 시행하였고, 실험군에는 추가적으로 과제지향적 자세조절 훈련을 30분 간 시행하였다. 뇌졸중 환자를 위한 자세조절 평가(Postural Assessment Scal for Stroke Patients, PASS)를 통해 자세조절 능력을 평가하였고, 버그 균형척도(Berg Balance Scale, BBS)를 통해 환자의 균형능력을 평가하였으며, 수정된 바델지수(Modified Barthel Index, MBI)를 통하여 일상생활 수행능력을 평가하였다. 연구의 결과, 모든 군에서 치료 후의 PASS, BBS, MBI의 결과값이 치료전보다 유의하게 향상되었고(p<.05), PASS, BBS, MBI에서 실험군이 대조군에 비해 유의한 차이를 보였다(p<.05). 이러한 결과는 일반적인 물리치료를 병행한 과제지향적 자세조절 훈련이 아급성기 뇌졸중 환자의 자세조절, 균형 및 일상생활 수행능력 향상에 효과를 가져다 준 것으로 사료된다.

This study aimed to compare the effects of general physical therapy and task-oriented postural control training plus general physical therapy on postural control, Balance and activities of daily living (ADL). Thirty subjects were randomly allocated to either the general physical therapy group or task-oriented postural control training plus general physical therapy group, with 15 subjects in each group. Both groups performed general physical therapy. The experimental group performed additional task-oriented postural control training 5 times per week over a 6 week period for 30 minutes per session. The outcomes were assessed by the Postural assessment scale for stroke patients (PASS), the Berg balance scale (BBS), and the modified Barthel index (MBI). Both groups were significantly differences in the amount of change of PASS, the BBS, and the MBI(p<.05). Comparison of the results for both groups after intervention demonstrated that the task-oriented postural control training plus general physical therapy group had a more significant on the the PASS, the BBS and the MBI(p<.05). This results suggested that the task-oriented postural control training plus general physical therapy may be more beneficial than general physical therapy for improving postural control, balance and ADL of patients with sub-acute stroke.

본 연구는 점진적 과제지향 저항훈련이 뇌졸중 환자의 하지근력, 균형 및 보행에 미치는 효과와 일반적 재활훈련이 뇌졸중 환자의 하지근력, 균형 및 보행에 미치는 효과의 차이를 비교하는 것을 목적으로 실시하였다. 서울에 위치한 ○병원에 입원한 뇌졸중 환자 18명을 연구 대상자로 선정하였다. 대상자는 무작위로 두 그룹으로 나누어 점진적 과제지향 저항훈련군(10명)과 일반적 재활훈련군(8명)으로 진행하였다. 재활훈련의 방법은 6주 동안 주 5회씩, 1회 30분간의 과제지향 점진적 저항 근력 훈련과 일반적 재활훈련을 적용하였다. 훈련 전과 후 1주일 동안에는 하지근력, 정적 균형, 동적 균형 및 보행 능력을 평가 비교하여 다음과 같은 결과를 얻었다. 점진적 과제지향 저항훈련을 통해 환측의 하지 근력, 동적 균형 및 보행 능력의 유의한 증가를 보였으며(p<.05), 일반적 재활훈련을 통해 고관절 외전근을 제외한 환측의 하지 근력, 동적 균형 및 보행 능력의 유의한 증가를 보였다(p<.05). 점진적 과제지향 저항훈련이 통계적으로 일반적 재활훈련보다 동적 균형과 보행 능력에서 유의하게 증가하였다(p<.05). 본 연구를 통하여 점진적 과제지향 저항훈련과 일반적 재활훈련이 뇌졸중 환자의 하지 근력, 동적 균형, 보행 능력에 효과가 있음을 구명하였다. 그리고 점진적 과제지향 저항훈련이 뇌졸중 환자의 동적 균형과 보행 능력에 일반적 재활훈련보다 효과가 있음을 구명하였다. 앞으로 뇌졸중 환자에 대한 보다 효율적인 과제와 과제 난이도의 점진적 증가 방법의 개발이 필요하다고 생각한다.

This study was to evaluate the effects of progressive task-oriented resistive training and general rehabilitative training on functional recovery of lower extremity strength, balance and gait in stroke subjects. Twenty-four subjects selected by inclusion criteria. Participants were randomly allocated to two groups: progressive task-oriented resistive training(n=12) and general rehabilitative training(n=12). Two groups trained for five session thirty minutes per week during six weeks. Results were evaluated by lower extremity strength, static balance, dynamic balance and gait function. The results of study were as follows: There were significantly increased by progressive task- oriented resistive training that the lower extremity strength, dynamic balance and gait function(p<.05). There were significantly increased by general rehabilitative training that the lower extremity strength, dynamic balance and gait function(p<.05) except hip abduction. There were significantly increased by progressive task-oriented resistive training more than general rehabilitative training that the dynamic balance and gait function(p<.05). In conclusion, the progressive task- oriented resistive training and general rehabilitative training improves lower extremity strength, dynamic balance, gait function for the stroke patients. And progressive task-oriented resistive training improves dynamic balance and gait function more than general rehabilitative training. These results suggest that progressive task-oriented resistive training is feasible and suitable for individuals with a stroke.

목적 : 본 연구는 경직형 양마비 아동에게 과제지향훈련을 시행할 때 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향을 알아보며 뇌성마비 아동을 치료하기 위한 중재방법으로 임상적으로 유용한지 제안하고자 시도되었다. 연구방법 : 연구 대상자를 단순 무작위 표본추출법으로 실험군(남자 : 9명, 여자 : 8명, 평균연령 : 8.12세)과 위약군(남자 : 9명, 여자 : 8명, 평균연령 : 7.53세) 각각 18명씩 배분한 후 두 중재군 모두에게 1회 40분, 주 2회 과제지향훈련을 12주 동안 실시하였다. 실험군은 무게저항을 제공하는 무게조끼를 착용하고, 위약군은 무게저항 없이 무게조끼만 착용하였다. 두 중재군 모두에게 닫힌 운동사슬과 다관절의 기능적인 움직임 패턴을 촉진하는 과제지향훈련을 각각 8~10회 실시하며 과제 사이에 약 3분간 휴식 하였다. 두 중재군의 대동작 수행력, 균형 능력에 대한 사전검사는 중재 전에 측정하였고, 사후검사는 중재 6주후와 12주후 총 2회 시행하였으며 마지막으로 추적검사는 실험종료 12주후에 실시한 후 두 중재군 사이의 시간경과에 따른 변화량을 분석하였다. 결과 : 대동작 수행평가는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의한 차이가 나타났다(p<.05). 아동용 균형척도는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의한 차이가 있었다(p<.05). 결론 : 그러므로 닫힌 운동사슬과 다관절의 기능적인 움직임을 촉진시키는 과제지향훈련 시 무게조끼 적용은 경직형 양마비 아동의 대동작 수행력과 균형 능력을 향상시키는 유용한 중재 방법으로 고려될 수 있다.

Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.