Wan Hee Lee

Effect of treadmill training based real-world video recording on balance and gait in chronic stroke patients: A randomized controlled trial

OBJECTIVE The purpose of this study was to determine the role of treadmill training based real-world video recording (TRWVR) for balance and gait ability in chronic stroke patients. DESIGN Thirty chronic stroke patients were randomly assigned to either the TRWVR group (n=15) or the control group (n=15). Both groups participated in a standard rehabilitation program; in addition, the TRWVR group participated in TRWVR for 30 min per day, three times per week, for 6 weeks, and the control group participated in treadmill walking training for 30 min per day, three times per week, for 6 weeks. Balance ability was measured using the Berg Balance Scale (BBS), Timed Up and Go test (TUG) and the postural sway by force platform system. Gait performance was measured using a pressure sensitive walkway. RESULTS Significant differences in the time factor for dynamic balance and gait (P<0.05) were observed in the TRWVR and control group, with the exception of static balance. For the group × time interaction, significant improvements in dynamic balance and gait (P<0.05). In the correlation coefficient, no significant correlation was observed between changes in postural sway and other dependent variables. CONCLUSIONS Findings of this study demonstrated that the real-world video recording has an effect on dynamic balance and gait in chronic stroke patients when added to treadmill walking.

Reliability of rehabilitative ultrasound imaging for the medial gastrocnemius muscle in poststroke patients

The purpose of this study was to evaluate the suitability of rehabilitative ultrasound imaging for quantification of medial gastrocnemius muscle in poststroke patients.

Test–retest reliability of the GAITRite walkway system for the spatio-temporal gait parameters while dual-tasking in post-stroke patients

Abstract Purpose: To examine the test–retest reliability of spatio-temporal gait parameters during performance of single- and dual-tasking in post-stroke patients. Method: This study was conducted using a single-group repeated-measures design, involving a baseline measurement session and a follow-up session two days later. Forty-three chronic stroke patients (>6 months) participated in this study. Spatio-temporal gait parameters under the single- and dual-task conditions at a self-selected comfortable gait speed were measured using the GAITRite walkway system. Intraclass correlation coefficients [ICC(2,1)] were calculated for determination of reliability between sessions. The level of agreement between the two sessions was determined using Bland–Altman 95% limits of the agreement plots. Results: In all gait parameters, a significant difference was observed between the single- and dual-task conditions (p < 0.05). For the single condition, ICC (95% CI) was very good for all measures, ranging from 0.98 to 0.99 (0.97–0.99). In addition, for the dual-task condition, ICC (95% CI) was good to very good for all measures, ranging from 0.69 to 0.90 (0.49–0.99). Conclusions: The results of current study demonstrated that the test–retest reliability of the GAITRite system for measurement of spatio-temporal gait parameters under single- and dual-task conditions was good to very good. Therefore, we suggest that measurement of spatio-temporal gait parameters under a dual-task condition using the GAITRite system would be useful for clinical assessment in post-stroke patients. Implications for Rehabilitation Improvement of walking ability provides opportunities for stroke patients to participate in the community. Our finding, additional cognitive tasks can interfere with the independently basic activities of daily living in stroke patients, may provide basic information for use in development of rehabilitation programs for stroke patients. Spatio-temporal gait parameters under the dual-task condition measured using the GAITRite system may be useful for clinical assessment in post-stroke patients.

Reliability of rehabilitative ultrasonographic imaging for muscle thickness measurement of the rhomboid major.

This study was to establish inter‐rater and intrarater reliability of the rehabilitative ultrasonographic imaging (RUSI) technique for muscle thickness measurement of the rhomboid major at rest and with the shoulder abducted to 90°.

Virtual Reality Training with Cognitive Load Improves Walking Function in Chronic Stroke Patients

Virtual reality training is considered as an effective intervention method of stroke patients, and the virtual reality system for therapeutic rehabilitation has emphasized the cognitive factors to improve walking function. The purpose of current study was to investigate the effect of virtual reality training with cognitive load (VRTCL) on walking function of chronic stroke. Chronic stroke patients were randomly assigned to the VRTCL group (11 patients, including 5 men; mean age, 60.0 years; post-stroke duration, 273.9 days) or control group (11 patients, including 2 men; mean age, 58.6 years; post-stroke duration, 263.9 days). All subjects participated in the standard rehabilitation program that consisted of physical and occupational therapies. In addition, VRTCL group participated in the VRTCL for 4 weeks (30 min per day and five times a week), while those in the control group participated in virtual reality treadmill training. Walking function under single (walking alone) and dual task (walking with cognitive tasks) conditions was assessed using an electrical walkway system. After the 4-week intervention, under both single and dual task conditions, significant improvement on walking function was observed in VRTCL and control groups (P < 0.05). In addition, in the dual task condition, greater improvement on walking function was observed in the VRTCL group, compared with the control group (P < 0.05). These findings demonstrated the efficacy of VRTCL on the walking function under the dual task condition. Therefore, we suggest that VRTCL may be an effective method for the achievement of independent walking in chronic stroke patients.

Intra- and inter-rater reliabilities of measurement of ultrasound imaging for muscle thickness and pennation angle of tibialis anterior muscle in stroke patients

Abstract Background: Dysfunction of skeletal muscle has been commonly reported in stroke patients. Objective: The purpose of this study was to investigate the intra- and inter-rater reliabilities of measurement of ultrasound imaging (USI) for pennation angle (PA) and muscle thickness (MT) of tibialis anterior muscle in stroke patients. Methods: Thirty-four stroke patients (19 men) participated in this study. USI was used for measurement of PA and MT of the tibialis anterior muscles at rest and during maximum voluntary contraction (MVC). Two examiners acquired images from all participants during two separate testing sessions, seven days apart. Intra-class correlation coefficients (ICCs), confidence interval (CI), standard error of measurement, minimal detectable change, and Bland–Altman plots were used for estimation of reliability. Results: In the intra-rater reliability between measures, for all variables (PA and MT of the paretic and non-paretic sides of tibialis anterior muscles at rest and during MVC), the ICCs ranged between 0.639 and 0.998 and the CI was within an acceptable range of 0.388–0.999. In inter-rater reliability between examiners for the two tests, for all variables, the ICCs ranged between 0.690 and 0.995 and the CI was within an acceptable range of 0.463–0.997. In addition, significant difference was observed between the paretic and non-paretic sides of the tibialis anterior muscle architecture (p < 0.05). Conclusion: These finding demonstrate that measurements of the tibialis anterior muscle using USI can be useful for clinical assessment in stroke patients. In addition, objective and quantitative measurements of tibialis anterior muscle using USI may provide appropriate management for the walking recovery of stroke patients.

The effects of the menstrual cycle on the static balance in healthy young women

[Purpose] The purpose of this study was to investigate the effects of the menstrual cycle on the static balance of healthy young women. [Subjects and Methods] Eighteen healthy young subjects (mean age 19.1 years; weight 57.5 kg; height 159.9 cm) participated in this study. The Good Balance system was used to measure the postural sway speed and velocity moment of subjects in the static standing posture. Subjects were measured for static balance between 1 and 3 days after menstruation and 13 days after menstruation. [Results] The velocity moment of postural sway was significantly higher at 13 days after menstruation. [Conclusion] Our results indicate that the menstrual cycle affects the static balance of healthy subjects. During the menstrual cycle, intensity for balance exercises in females should be carefully controlled for injury prevention.

The effects of horse riding simulation exercise with blindfolding on healthy subjects’ balance and gait

[Purpose] The study was conducted to determine the effect of horse riding simulation combined with blindfolding on healthy individuals’ balance and gait. [Subjects and Methods] Thirty subjects were randomly divided into an experimental group (n=15) and a control group (n=15). The subjects in the experimental group covered their eyes using a blindfold, climbed onto a horse riding simulator, and performed the horse riding simulation exercise. The control group took part in the horse riding exercises without a blindfold. All of the subjects performed the 20 minutes long exercise once a day, five times a week, over a four-week period. [Results] The experimental group showed significant improvement in static balance, dynamic balance, velocity, and cadence compared to pre-intervention measurements. In addition, the control group showed significant improvement in static balance, dynamic balance, single support, and cadence compared to pre-intervention measurements. Significant differences in post-training gains in static balance, dynamic balance, and cadence were observed between the experimental group and the control group. [Conclusion] Subjects that performed horse riding simulation exercise after blindfolding showed significant improvements in balance and cadence compared to the control group.

The effects of sitting with the right leg crossed on the trunk length and pelvic torsion of healthy individuals

[Purpose] The purpose of this study was to determine the effects on the trunk length and pelvic torsion of healthy individuals that arise from crossing the right leg while sitting. [Subjects and Methods] The subjects in this study were 30 healthy individuals consisting of 18 males and 12 females. The subjects were instructed to sit on a chair, the height of which was adjustable, so that their knee and hip joints were bent at 90°. For the study, they sat stripped to the waist, with the back and hips bare. They were then instructed to perform a one-leg-crossed sitting posture by placing the right leg on the top of the left knee. A spinal posture test was performed to measure the subjects’ trunk length and pelvic torsion by using a three-dimensional image-based spinal diagnostic system. [Results] The results of the three-dimensional spine examination showed statistically significant decreases in trunk length and pelvic torsion after the one-leg-crossed sitting posture. [Conclusion] In this study, the right leg-crossed sitting posture led to a decrease in the right trunk length with time and, in terms of pelvic torsion, increased the posterior rotation of the right pelvis when compared with the left pelvis.