Background: As ways to optimize the mobilization of postural stability muscles for sitting up motions, arm reaching motions and head raising motions have important effects. Objectives: This study was conducted to investigate the effects of reaching to sit-up training on the trunk muscle activity, postural ability, and balance ability of patients with hemiplegia due to stroke. Design: Randomized controlled trial. Methods: This study was conducted with 18 stroke patients who met the selection criteria divided into two groups: a study group of 9 patents and a control group of 9 patients. The study group carried out reaching to sit-up training, which can promote trunk muscles and improve control through trunk interactions. The control group received general physical therapy intervention Results: The activity of the trunk muscle was significantly different before and after intervention in study and control group. The functional reaching test showed significant changes in both the study group and the control group. The timed up and go test showed a significant change in the study group. Conclusion: Reaching to sit-up training for 4 weeks showed increases in trunk muscle activity in stroke patients and was effective in improving balance ability.

Background: ErigoPro enables acute stroke patients to carry out stable weight-bearing training with gradual verticalization. Study on the effectiveness of robotic assisted treatment equipment for chronic patients is insufficient. Objectives: This study aims to investigate the effect of dynamic vertical posture training using ErigoPro on trunk alignment and balance in chronic stroke patients. Design: Randomized controlled trial. Methods: The subjects of this study were 30 patients were randomly assigned to a study group of 15 patients and a control group of 15 patients. The study intervention was carried out for 50 minutes per day consisting of 30 minutes of general neuro-physiotherapy and 20 minutes of ErogoPro training, 3 times a week for 8 weeks. Results: The study group showed difference in trunk inclination (P<.05), kyphotic angle (P<.05), lateral deviation of the spine (P<.05), thoracic angle (P<.01), timed up and go test (P<.01), Berg balance score (P<.01). There was a significant difference between the groups in the trunk inclination (P<.05), timed up and go test (P<.01), Berg balance score (P<.05). Conclusion: It could be seen that the treatment combined with ErigoPro training for 8 weeks was effective in restoring trunk alignment and improving balance ability in chronic stroke patients.

목적 : 본 연구는 몰입형 가상현실과 비몰입형 가상현실 두 가지 형태의 가상현실 기기를 이용한 중재가 만성 뇌졸중 환자의 상지기능 향상에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구 대상은 뇌졸중 발병 후 6개월 이상인 편마비 환자 3명이었다. 연구설계는 단일대상실험연 구(single-subject research design)인 AB 디자인과 교차 연구설계(alternating design)를 사용하였 다. 중재효과를 측정하기 위한 상지기능 평가는 Box and Block Test와 Fugl-Myer Assessment를 사 용하였고, 연구진행은 기초선 4회, 중재 기간 16회를 포함하여 총 20회기를 진행하였다. 연구결과는 시 각적 그래프와 2SD 구간을 설정하여 분석하였다. 결과 : 연구결과는 비몰입형과 몰입형 가상현실 중재법 모두 기초선과 비교하여 Box and Block Test, Fugl-Myer Assessment 점수가 확연히 증가하였다. 그러나 비몰입형 가상현실 중재와 몰입형 가상현 실 중재 간의 의미있는 차이는 발견할 수 없었다. 결론 : 본 연구는 몰입형 가상현실을 이용한 중재가 비몰입형 가상현실을 이용한 중재와 같이 만성 뇌졸중 대상자의 상지기능 향상에 긍정적인 효과를 줄 수 있다는 것을 확인하였다. 이러한 결과는 만성 뇌졸중 대상자들의 상지기능 향상을 목표로 하는 임상현장에서 가상현실 중재와 연구에 유용한 자료가 될 것이 라 사료된다.

Background: For the rehabilitation of stroke patients, it is necessary to confirm the differences in the mechanical properties of the paretic- and non-pareticside masseter muscles. Objectives: To investigate the muscle tone and stiffness of masseter muscles in patients with chronic stroke. Design: A case study. Methods: This study included 20 stroke patients. Muscle tone and stiffness of the paretic and non-paretic masseter muscles in stroke patients were measured using MyotonPRO. Measurements were performed under relaxation and masseter muscle contraction conditions. Results: There was no significant difference in the muscle tone and stiffness of the paretic and non-paretic side masseter muscles in the relaxation conditions (P>.05). In male, left hemiplegia, right hemiplegia and infatction, the nonparetic side masseter muscles showed significantly increased than musle tone and stiffness of the paretic side masseter muscles in the contraction (P<.05). In female and hemorrhage, the non-paretic side masseter muscles showed significantly increased than musle tone the paretic side masseter muscles in the contraction (P<.05). Conclusion: The muscle tone and stiffness were lower on the paretic side than on the non-paretic side during masseter muscle contraction in stroke patients; thus, muscle strengthening training was required.

Background: The purpose of this study was to investigate whether the function of stroke patients could be improved by simultaneously performing bridging and masticating exercises. And, this was tested by examining whether the effects of arousal and cognitive improvement due to mastication muscle activity could affect exercise ability. Objectives: To compare the effects, the movement of the center of pressure and the stability limit change were measured using a balance analysis platform (BT4). Design: Randomized controlled trial. Methods: In this study, 36 chronic stroke patients were randomly assigned to either single training group of the bridging exercise or combined training group that performed both the bridging exercise and the mastication exercise. The exercise was performed for thirty minutes a day, three times a week, for eight weeks. Results: In both groups, the static balance ability improved after exercise, but the dual-task training group had a better improving effect on the distance and area of the center of pressure while the eyes was open. The dynamic balance ability also improved after exercise, and the dual-task training was more effective in reducing forward, left, and right movements, but not in backward movement. Conclusion: The importance of mastication was recognized in the rehabilitation of chronic stroke patients, and it can be expected to use mastication to improve balance in stroke patients in the future.

목적 : 본 연구의 목적은 최근 10년간 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재들에 대해 알아보고 체계적으로 고찰을 실시하고자 한다. 연구방법 : 2010년 1월부터 2020년 12월까지 Research Information Sharing Service(RISS), Koreanstudies Informatin Service System(KISS), DBpia, PubMed, ScienceDirect, Scopus의 온라 인 데이터 베이스에 등록된 논문을 검색하였다. 최종적으로 18개의 Randomized Controlled Trials(RCT) 논문을 대상으로 PICO 방법을 사용하여 분석하였다. 결과 : 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재방법은 9개였고, 총 18회 사용되었다. 그중 Nintendo Wii가 4회(22.22%), 가상현실 프로그램이 4회(22.22%)로 가장 많았다. 연구 분석 결과 뇌졸중 환자의 상지기능 향상에 Nintendo Wii와 가상현실 프로그램이 효과적인 것으로 나타났다. 결론 : 뇌졸중 환자의 상지기능 향상을 위한 가상현실 중재방법의 종류와 빈도를 제시하였고 가장 많이 사용되는 Nintendo Wii와 가상현실 프로그램의 중재 방법에 대한 근거 논문들을 중재 방법, 중재 기간 및 횟수, 중재효과를 표로 만들어 제시하였다. 결과는 임상 치료사들이 치료방법 및 기간, 평가도구를 선택하는데 근거 자료로 사용할 수 있을 것이다.

Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

Background: Weakness of the abdominal and mid thoracic muscles the lead to thoracic kyphosis of stroke patients. The trunk muscles activity of stroke patients is significantly related to upper extremity. Objectives: To investigate the effect of seated exercise of thoracic and abdominal muscles on upper extremity function and trunk muscles activity in stroke patients. Design: One-group pretest-posttest design. Methods: A total of 27 stroke patients were recruited. All stroke patient were given seated abdominal exercise (posterior pelvic tilt exercises) and thoracic exercise (postural-correction exercise). All exercises were conducted for 30 minutes, three times a week for four weeks. The manual function test (MFT) and electromyography (EMG) were measured, and EMG electrodes were attached to thoracic paraspinal muscles and lower rectus abdominal muscles. EMG signal is expressed as %RVC (reference voluntary contraction). Results: Experimental group showed significant increases in abdominal muscles, paraspinal muscles activity and MFT total score, items of arm motion (forward elevation of the upper extremity, lateral elevation of the upper extremity, touch the occiput with the palm) in MFT after four weeks. Conclusion: These results suggest that, in stroke patients, seated exercise of thoracic and abdominal muscles contribute to improve trunk muscles activity and upper extremity function in stroke patients.

Background: Weakness of the trunk muscles decreases the trunk control ability of stroke patients, which is significantly related to balance and gait. Objectives: To compare the impact of diagonal pattern self-exercise on an unstable surface and a stable surface for trunk rehabilitation on trunk control, balance, and gait ability in stroke patients. Design: Nonequivalent control group design. Methods: Twenty four participants were randomized into the experimental group (diagonal pattern self-exercise while sitting on an unstable surface, n=12) and the control group (diagonal pattern self-exercise while sitting on a stable surface, n=12). All interventions were conducted for 30 minutes, three times a week for four weeks, and the trunk impairment scale (TIS), berg balance scale (BBS), functional gait assessment (FGA), and G-walk were measured. Results: All groups indicated significant increases in all variables (TIS, BBS, FGA, cadence, speed, stride length) after four weeks. The TIS, BBS, FGA, cadence, gait speed, and stride length group-by-time were significantly different between the two groups. Conclusion: We found that, in stroke patients, diagonal pattern self-exercise on an unstable surface is a more effective method for improving trunk control, balance, and gait ability than diagonal pattern self-exercise on a stable surface.

Background: The foot drop stimulator is designed to improve the walking ability of foot drop in patients after stroke, however, studies on clinical effects are still lacking. Objective: To investigate the effect of a foot drop stimulator on the walking and balancing abilities of foot drop patients after a stroke. Design: One-Group (Pretest-Posttest) Design. Methods: All subjects walked in all three conditions: foot drop stimulator (FDS) ankle foot orthosis (AFO) and barefoot. Primary outcome measures were assessed for walking and balance using a 10-m walking test (10MWT) and a timed up and go test (TUG). Secondary outcome measures consisted of a brief user interview, and the patients recorded the advantages and disadvantages of each condition. Results: FDS, AFO, and barefoot conditions showed a statistically significant difference in 10MWT and TUG (P<.001) as a result of comparing three conditions. FDS and AFO were significantly different from the barefoot condition as post-hoc results; however, there was no significant difference between the two conditions (P>.05). Conclusion: In this study, the foot drop stimulator contributed to improving the balance ability, and the walking ability was similar to the effect of the anklefoot orthosis.

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic (n1= 15) and ground (n2=15) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

목적 : 본 연구는 완곡추적 안구운동과 경부신전근 진동자극법의 결합중재가 만성 뇌졸중 환자의 편측무시와 일상생활활동 수행에 미치는 영향을 확인하는 것이다. 연구방법 : 본 연구는 발병 후 6개월 이상 지난 3명의 뇌졸중 편측무시 환자를 대상으로 하였으며, 단일대상연구 방법 중 ABAC디자인으로 연구를 진행하였다. 연구는 기초선(A1) 1주, 중재기(B) 2주, 기초선(A2) 1주, 그리고 중재기(C) 2주로 총 6주간 진행되었으며, 중재기(B)에서는 완곡추적 안구운동(Smooth Pursuit Eye Movement; SPEM)의 단일중재를, 중재기(C)에서는 경부신전근 진동자극법(Neck Muscle Vibration; NMV)과 SPEM의 결합중재를 실시하였다. 평가는 매회기 선 나누기 검사와 벨 테스트(Bells test)를 실시하였으며, 한국판 캐서린 버지고 척도(Korean-Catherine Bergego Scale; K-CBS)와 한국판 일상생활활동 중심 작업기반 신경행동 평가(Korean version of ADL-focused Occupation-based Neurobehavioral Evaluation; K-A-ONE)를 기초선(A1)의 첫 회기와 각 중재기의 마지막 회기에 시행하였다. 결과 : 연구결과 SPEM과 NMV를 단일 또는 결합하여 적용하였을 때 편측무시의 지필검사(선 나누기 검사와 벨 테스트)와 관찰적 검사(K-CBS와 K-A-ONE)에서 편측무시가 개선됨을 확인하였고, 특히 결합중재시에 더 효과가 좋았던 것으로 나타났다. 그리고 편측무시가 개선됨에 따라 일상생활활동의 수행(K-A-ONE)에서도 향상을 보였는데, 편측무시 환자의 일상생활을 저해하는 신경행동 손상은 편측무시 뿐만 아니라 공간관계나 마비와 같은 손상 등이 영향을 미치는 것으로 나타나 다양한 신경행동 손상의 중재를 포함하는 포괄적인 재활프로그램을 계획해야함을 확인하였다. 결론 : 본 연구를 통해 SPEM과 NMV의 결합중재가 만성 뇌졸중 환자의 편측무시를 감소시키고 일상생활 활동 수행을 향상시키는데 효과적인 중재라는 것을 확인하였다.

목적 : 본 연구는 인지 중재 비율을 조절한 점진적 관찰감소 동작관찰훈련과 기존의 동작관찰훈련에 대한 상지기능 변화를 비교하여 효율적인 중재 방법을 알아보고자 실시하였다. 연구방법 : 14명의 만성 뇌졸중 환자를 대상으로 7명의 실험군은 점진적 관찰감소 동작관찰훈련을, 7명의 대조군은 기존의 동작관찰훈련을 주 3회, 30분씩, 4주간 실시하였고 각 군은 기존에 실시하던 전통적 작업치료 및 물리치료 역시 시행하였다. 상지 운동기능의 사전, 사후 평가는 울프운동기능검사(Wolf Motor Function Test; WMFT), 상지기능장애 설문지(Disabilities of the Arm, Shoulder and Hand; DASH), 상자와 나무토막 검사(Box and Block Test; BBT)를 사용하였고, 각 군의 중재 전과 후의 차이는 윌콕슨 부호 순위검정(Wilcoxon signed-ranks test), 두 군 간의 중재 후 효과 비교는 맨 휘트니검정(Mann-Whitney U test)을 사용하여 분석하였다. 결과 : 점진적 관찰감소 동작관찰훈련군과 기존의 동작관찰훈련군은 모두 WMFT, DASH, BBT에서 통계적으로 유의한 변화가 있었다(p<.05). 점진적 관찰감소 동작관찰훈련군과 기존의 동작관찰훈련군의 상지기능 변화량 비교에서는 WMFT의 소요시간과 DASH의 점수에서 점진적 관찰감소 동작관찰훈련군이 더 많은 변화 가 있었으며 통계적으로 유의한 차이가 있었다(p<.05). 결론 : 본 연구 결과 중재기간에 따라 인지 중재 비율을 고려한 점진적 관찰감소 동작관찰훈련이 기존의 동작관찰훈련보다 상지기능 향상에 효과적이었다는 것을 알 수 있었다. 따라서 만성 뇌졸중 환자의 상지기능 향상을 위한 동작관찰훈련의 중재 시 인지비율을 고려한 중재 전략이 필요하다.

목적 : 본 연구는 양손 협응력 훈련도구의 활용과 평가를 적용하여 만성 뇌졸중 환자의 시지각 능력과 양손 기민성의 효과에 대해 검증하고 훈련도구로서의 역할을 제시하는데 목적을 두었다. 연구방법 : 본 연구의 선정기준에 적합한 41명을 무작위로 선정하여 실험군 21명과 대조군 20명으로 성별·연령별 동질성을 확보하여 분류한 후 실험군은 매일 양손훈련도구와 일반작업치료를 각각 15분간 실시하고, 대조군은 일반작업치료를 30분간 실시하였다. 훈련 제공기간은 주 5회 6주 동안 실시하였다. 평가는 Motor-free Visual Perception Test-3(MVPT-3)와 Complete Minnesota Dexterity Test(CMDT)를 활용하여 모든 집단에 실시하고 실험군은 양손 협응력 훈련도구의 수행능력 측정을 추가로 실시하였으며 평가는 총 3회(훈련 전, 3주후, 6주후)를 시행하였다. 결과 : 실험군에 대한 양손 협응력 훈련도구의 평가결과 수행시간에 대한 통계적 차이는 없었으나(p>.05) 수행시간은 평가 주차별로 감소하였으며, 오류수는 통계학적으로 유의한 차이를 보였다(p<.05). MVPT –3에서 실험군은 훈련기간에 따라 유의한 차이(p<.05)로 증가하였고 대조군은 유의한 차이를 보이지 않았다(p>.05). 또한, 집단간 분석에서 통계학적으로 유의한 차이(p<.05)를 보인 훈련기간은 3주후와 6주 후 훈련이었다. CMDT에서는 집단과 훈련기간에 따른 유의한 차이를 보이지 않았다(p>.05). 결론 : 양손 협응력 훈련도구의 활용 및 평가를 통해 만성 뇌졸중 환자의 시지각 기능과 상지 기능향상에 효과적인 훈련도구로서의 적용이 가능함을 보였으며 향후 병실이나 가정에서도 누구나 쉽게 활용할 수 있을 것을 기대한다.

Background: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group (n1=10), a placebo group (n2=10), and a control group (n3=10). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton®PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone

Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but tho

The aim of this study was to investigate the effects of foot position adjuster on body alignment and weight loads in chronic stroke patients. The subjects were 15 chronic stroke patients who were admitted to KHospital in Daegu, South Korea. The study compared the body alignment and weight load changes on flat ground with the foot position adjuster using Foot scan and Dartfish video analysis software. In the results of this study, posterior superior iliac spine (PSIS) alignment decreased significantly after use of the foot position adjuster and center pressure was significantly increased after use of the foot position adjuster. This study suggests that foot position adjuster influences body alignment and weight distribution.

The purpose of the study was to determine the effect of joint mobilization with respiratory muscle taping on pulmonary function and chest expansion ability in patients with chronic stroke. Thirty subjects (n=30) were randomly divided into three groups: a joint mobilization group (n=10), a respiratory muscle-taping group (n=10), and a joint mobilization with respiratory muscle-taping group (n=10). Measurements for pulmonary function and chest expansion were performed to assess its effectiveness. A spirometer was used to measure the pulmonary function, and a tape measure was used to assess the chest expansion. In the joint mobilization group, peak expiratory flow (PEF) was increased. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and upper and lower chest expansion were also increased. All of variables of respiratory muscle-taping group also were increased. FEV1 and FVC were significantly different between joint mobilization with respiratory muscle-taping and respiratory muscle-taping group. The results of the present study suggest that mobilization with respiratory muscle taping increase the pulmonary function and chest expansion.

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM (n1=10) and DBM (n2=9) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.