Background: Balance disorder is a prevalent clinical manifestation following stroke, often causing considerable discomfort and gait disability. Various water-based therapeutic approaches have been developed to address balance and gait disorder. Objects: The purpose of this study was to investigate the effects of water-based gait training using auditory stimulation on balance and gait abilities in stroke patients. Methods: All subjects were randomly divided into three groups: water-based gait training using auditory stimulation group (WAG) (n = 24), water-based gait training group (WG) (n = 24), and control group (n = 22). Subjects in WAG and WG underwent water-based gait training for 30 minutes, 3 times a week for 6 weeks. All Subjects were assessed for muscle strength, balance, gait, motor function, and activity of daily living pre- and post-intervention. Results: Results showed that all outcome measures significantly improved post-intervention (p < 0.05). Additionally, WAG was found to significantly improve in Medical Research Council (MRC), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test compared to WG, and WG showed significant differences compared to the control group in MRC and Fugl-Meyer Assessment (FMA) (p < 0.05). WAG exhibited significant differences in all areas except Modified Bathel Index (MBI) in the between-group comparison with the control group (p < 0.05). Conclusion: These results suggest that water-based gait training using auditory stimulation may be effective strategy to improve muscle strength, balance and gait ability for with stroke.

Background: Functional sarcopenia, a subcategory of sarcopenia, has recently been introduced. It is defined by muscle weakness and reduced physical performance, regardless of muscle mass reduction, and may potentially affect overall rehabilitation outcomes in patients. Objectives: This study aimed to classify stroke patients into two groups based on the presence or absence of functional sarcopenia and to compare changes in balance and gait ability after receiving the same rehabilitation intervention. Design: A quasi-experimental design. Methods: A total of 44 stroke patients participated in this study and were classified into functional sarcopenia (n=22) and non-functional sarcopenia groups. Physical function tests were used to assess balance (Timed Up and Go, Berg Balance Scale) and gait (10-Meter Walk Test, Functional Ambulation Category). All participants underwent a four-week convalescent rehabilitation program, receiving five sessions per week, with each session lasting four hours per day. Results: After four weeks of convalescent rehabilitation, both groups showed significant improvements in all outcome measures (P<.05). However, when comparing the pre-post changes, no significant differences were found between the two groups in the changes of balance and gait outcomes (P>.05). Conclusion: These findings suggest that stroke patients with functional sarcopenia can achieve a similar level of functional recovery as those without functional sarcopenia when provided with appropriate rehabilitation interventions.

Background: Multiple fractures, particularly femoral fractures, are increasingly prevalent and associated with high mortality rates and significant functional impairments. This highlights the urgent need for effective rehabilitation strategies, such as robot-assisted training, to enhance recovery and improve quality of life. Objectives: This study aimed to evaluate the clinical effectiveness of robotassisted rehabilitation for multiple femoral fractures. Design: Single-subject design. Methods: A 15-day A-B-A' single-subject design was employed. A man in his 30s with multiple fractures underwent standard rehabilitation during the baseline (A) and regression baseline (A') phases, with robotic therapy introduced during the intervention phase (B). Daily assessments of mobility and balance were analyzed using the two-standard deviation method. Results: Robotic therapy led to significant improvements: the TUG test time decreased from 16.21±0.64 seconds (A) to 10.63±0.46 seconds (B) and 9.64±0.35 seconds (A'). The 10 MWT time improved from 6.31±0.64 seconds (A) to 5.41±0.17 seconds (B) and 5.01±0.12 seconds (A'). LOS increased from 364.01±35.83 cm² (A) to 484.67±29.97 cm² (B) and 518.03±18.82 cm² (A'). Plantar pressure imbalance (59.2% right, 40.8% left in A) was corrected to nearly equal distribution in B (49.4%/50.6%) and A' (50.8%/49.2%). Conclusion: Robotic rehabilitation therapy improves balance and weightbearing capacity in patients with multiple fractures, suggesting its effectiveness as an early intervention following bone union.

Background: Stroke patients commonly experience functional declines in balance and gait due to decreased muscle strength and coordination issues caused by brain damage. Through repetitive training, robot-assisted gait training (RAGT) can aid in promoting neuroplasticity in stroke patients and help them acquire effective gait patterns. Additionally, convalescent rehabilitation hospitals help to ensure rapid recovery through intensive rehabilitation training. Objects: This study investigated the effects of RAGT frequency on gait and balance recovery in stroke patients in convalescent rehabilitation hospitals, providing data to optimize rehabilitation efficiency, enhance functional recovery, and support the development of personalized strategies to ensure safer and more rapid returns to daily life. Methods: This study compared the frequency of RAGT by analyzing a group receiving two units of RAGT per day for 5 days per week with a group receiving two units of RAGT per week as part of a comprehensive rehabilitation program, totaling 16 units daily, in a convalescent rehabilitation hospital. Results: In the 10-minute walking test, statistical significance was observed both within and between groups, whereas the Functional Ambulation Category, Fugl-Meyer Assessment–lower extremities, Berg Balance Scale, and timed up-and-go tests showed significance only within groups. Conclusion: End-effector RAGT and traditional gait training significantly improve gait ability, balance, and lower limb function in stroke patients.

This study investigates the kinetic compensatory gait changes in a small-sized dog (4.2 kg, 2-year-old spayed female poodle) with experimentally induced lameness. Reversible lameness was induced by applying silicone pads to the dog's forelimbs and hindlimbs. A force plate analysis system was used to measure Peak Vertical Force (PVF) and Symmetry Index (SI) during normal and induced lameness conditions. The results showed significant reductions in PVF in the induced limbs. Specifically, the left forelimb’s PVF decreased from 139.00 ± 9.85% in normal gait to 88.00 ± 19.05% after lameness induction, and the right forelimb’s PVF decreased from 130.33 ± 5.51% to 78.00 ± 18.52%. In contrast, compensatory increases were observed in the contralateral limbs, with the PVF of the contralateral forelimb increasing to 125.33 ± 1.15%. Similar patterns were observed in the hindlimbs, although the changes were less pronounced. The Symmetry Index (SI) values also increased in the induced limbs, particularly in the forelimbs (ILF: 53.10 ± 22.85%, IRF: 72.17 ± 15.08%), indicating greater asymmetry. These results suggest that forelimb lameness in small dogs results in more significant compensatory gait changes than hindlimb lameness.

Gait analysis can objectively assess abnormal walking, and some walking parameters can help recognize the disease. Existing commercial systems are either too expensive and require attachments to the body or have limitations in detecting abnormal gait. A vision system has been proposed to address this. However it had limitations where the accuracy was inferior in some parameters such as gait phase, step length and width, etc. Therefore we developed a Tactile sensor-based treadmill to detect gait phase, step length, and width. A pilot test was performed and analyzed through an infrared marker-based motion capture system to compare the accuracy of the proposed system. The measured spatiotemporal gait parameters were analyzed through mean and standard deviation and compared to the baseline system. As a result of the experiments, it was confirmed that higher step width performance was achieved compared to previous studies. Future studies will validate the system with many participants and conduct clinical studies on gait recognition through abnormal gait analysis.

Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger’s regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger’s regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.

Background: Mobilization with movement (MWM) is an effective intervention for increasing range of motion (ROM) and function without pain. Objectives: The purpose of this study is to comprehensively characterize the functional effects of MWM applied to the ankle joint in patients with stroke. Design: Systematic Review and Meta-analysis. Methods: International electronic databases, CINAHL, Embase, MEDLINE, PubMed, and Google scholar were included and identified after review by two investigators in July 2023 according to PRISMA guidelines. Data were synthesized using software provided by Cochran and analyzed using a random effects model with reweighting to account for heterogeneity between participants. Results: After excluding duplicate studies, 14 of the 19 articles screened through the abstracts were excluded, resulting in a total of five studies involving 109 participants with stroke. MWM showed significant differences in ankle ROM [overall effect (Z=3.27, P=0.00)], gait speed [overall effect (Z=3.33, P=0.00)], and cadence [overall effect (Z=2.49, P=0.01)]. Conclusion: The results of the meta-analysis confirmed that MWM is effective in improving ankle ROM and gait parameters in patients with stroke.

Background: Among the various rehabilitation methods for stroke patients, one method involves the use of vibration. Recently, vibration foam rollers, combining vibration with foam rolling, have been developed and are widely used. Objectives: The purpose of this study was to investigate the effects of vibration foam rolling on ankle range of motion (ROM), and gait speed in patients with stroke. Design: A randomized controlled trial. Methods: Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the non-vibrating foam roller group (n=15). Active dorsiflexion ROM, and 10-meter walk (10MW) were used to evaluate ankle ROM, and gait speed before and after each exercise. The two groups performed a 30-minute foam roller exercise program. The non-vibrating foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Results: The within-group change in active dorsiflexion ROM after the exercise was significant for both the vibrating foam roller group and the non-vibrating foam roller group (P<.05). The within-group change in 10MW after the exercise was significant for the vibrating foam roller group (P<.05), while it was not significant for the non-vibrating foam roller group (P>.05). Additionally, there was no significant difference in active dorsiflexion ROM and 10MW between the vibrating foam roller group and the non-vibrating foam roller group (P>.05). Conclusion: This study confirmed that a vibrating foam roller exercise program immediately improves ankle ROM and gait speed in stroke patients.

Background: Kinesio taping is being applied to improve ankle dorsiflexion in stroke patients. Currently, the elasticity of kinesio taping is applied in various ways. Objectives: To investigated the effect of tibialis anterior kinesio taping elasticity level on gait speed in stroke patients. Design: A randomized cross-over pilot study. Methods: A total of 12 study subjects were allowed to experience three conditions within a single group. The three conditions are strong elastic taping condition, weak elastic taping condition, and non-elastic taping condition. Study subjects were randomly assigned to each condition sequentially. For the evaluation, gait variables (cadence, gait speed, stride length) were measured 24 hours after applying the taping appropriate for each condition. Results: The strong elastic taping condition significantly increased gait variables compared to the weak elastic taping and non-elastic taping conditions (P<.05). Weak elastic taping significantly increased gait variables compared to non-elastic taping (P<.05). Conclusion: As tibialis anterior kinesio taping elasticity increased, gait variables significantly improved in stroke patients.

Background: Stroke patients experience a variety of physical problems due to neurological problems, including difficulties with trunk control. Trunk taping is used to improve gait in stroke patients. Objectives: To investigated the immediate effect of thoracic and abdominal elastic taping on gait parameters (the dynamic balance and gait speed) in stroke patients. Design: Quasi experimental study. Methods: A total of 24 study subjects were randomly assigned to the experimental group (thoracic and abdominal taping, 12 people), and the control group (sham taping, 12 people). All subjects had timed up and go (TUG) test and 10 meter walk test (10MWT) measured before and after taping. Results: After taping, the TUG test and 10MWT results were significantly reduced only in the study group (P<.05). The TUG test and 10MWT results of the study group were significantly decreased compared to the control group. Conclusion: The thoracic and abdominal taping was found to improve trunk control in stroke patients, thereby improving dynamic balance and walking speed.

Background: In community-dwelling elderly individuals, slower gait speed is closely related to the ground reaction force. In the elderly with fall experience, stride length and gait speed, and other gait parameters are closely related to gastrocnemius activation. Objectives: To investigate whether medial gastrocnemius stiffness influences gait parameters in community-dwelling elderly people who experienced falls. Design: Cross sectional study. Methods: A total of 149 community-dwelling older adults were assigned to the faller and non-faller groups. Gait parameters (step length, stride length, step width, cadence, heel and toe ground reaction force, heel and toe contact time), and stiffness of the medial and lateral gastrocnemius and tibialis anterior were measured using shear wave elastography. Results: Elderly fallers had shorter step and stride length, lower cadence and toe ground reaction force and heel contact time, and lower medial gastrocnemius stiffness than non-fallers. In elderly fallers, medial gastrocnemius stiffness was significantly correlated with step and stride length, step width, toe ground reaction force, and heel contact time. Conclusions: Lower medial gastrocnemius stiffness in the elderly fallers decreases gait parameters, which can be a risk factor for falls. Therefore, medial gastrocnemius stiffness is a major factor that may associated gait parameters that can determine the risk of fall in community-dwelling elderly individuals.

Background: Ankle sprains occur frequently among humans who undertake various body movements. Diverse walking environments and dual tasks, that can affect ankle sprains, have been studied. However, there is a lack of research on inter-trial variability according to the changes in gait speed. Objects: The purpose of this study was to compare the adaptive ability of walking between the subjects with chronic ankle instability and healthy adults while performing a walking task with different walking speeds. Methods: In this study, 24 people in the chronic ankle instability group and 24 people in the healthy ankle group were selected as subjects. The length of the pre-measurement and the actual walking measurement were both set to 4.6 m. Once the subjects entered the measurement section, they changed their gait speed according to the randomly assigned speed change. Gait was measured twice and the average value was used for the analysis. Results: The coefficient of variation (CV) of cycle time in subjects with chronic ankle instability showed a significant difference in all cases except when the subjects changed their speed from preferred to slow and from slow to preferred. The CV of step length demonstrated a significant difference in all cases except for the change from slow to preferred and from preferred to fast. The cycle time and step length differential showed a significant difference only when the subjects changed the speed from slow to fast. Conclusion: The subjects with chronic ankle instability were found to have significantly reduced walking adaptability while performing inter-trial variability tasks with different gait speeds compared to healthy subjects.

Background: Some patients may not fully recover their daily activity capabilities even after the total hip replacement (THR), and may continue to experience functional limitations for up to a year after the procedure, according to reports. Objectives: The purpose of this study was to examine the effects of machine squat on muscle strength, balance and gait in patients after THR. Design: A randomized controlled trial. Methods: Thirty-three patients after THR were randomly allocated into slide (n=11), reformer (n=11), and control groups (n=11). Each group underwent their respective squat regimens for thirty minutes, seven times a week, for two weeks. Muscle strength changes were assessed using the manual muscle test (MMT), balance was evaluated using the Berg Balance Scale (BBS), and gait analysis was performed using the 10-meter walk test (10MWT). Results: Significant changes in hip flexor and abductor strength were observed in the slide and reformer groups within each group (P<.05). The reformer group showed significant changes in hip extensor strength (P<.05). Significant improvements in BBS were observed in all three groups (P<.05). There were significant changes in 10MWT in the slide and reformer groups (P<.05). A significant difference in hip extensor strength was found between the reformer and control groups after the intervention (P<.0167). Significant differences in BBS were observed between the slide and reformer groups and between the reformer and control groups after the intervention (P<.0167). Conclusion: Our findings suggest that machine squat regimens can be effective for early rehabilitation after THR, improving muscle strength, balance, and gait.

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were “Stroke”, “Hemiplegia”, “Taping”, “Tape”, “Balance”, and “Gait” with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and nonelastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.

Background: In order to improve the daily life of stroke patients, it is necessary to restore walking performance. Improving gait performance is one of the main goals for stroke rehabilitation. Objectives: To investigate the change in gait parameters through evaluation of one stroke patient before, during, and after wearing the weight vest. Design: A case study. Methods: This study is an ABA study design. In principle, one assessment per day (A1) was measured three times without wearing the weight vest. Intervention assessment (B) was performed 6 times while wearing the weight vest. The second baseline evaluation (A2) was measured three times with the weight vest removed again. Results: The gait speed was increased when the weight vest was removed than when the weight vest was worn. Also, gait symmetry increased when wearing the weight vest. Conclusion: Wearing the weight vest can reduce the gait asymmetry in stroke patients and increase the gait speed after wearing the weight vest.

Background: Total hip replacement (THR) is performed in patients with femur fractures and osteoarthritis. THR patients have balance problems even after surgery. There is a lack of research on vibration stimulation interventions for balance in THR patients. Objectives: To investigated the effect of vibration stimulation intervention on the balance and gait of THR patients. Design: Randomized controlled trials. Methods: 44 subjects were randomly assigned to a vibration stimulation group (VSG) and a non-vibration stimulation group (N-VSG). Seven study subjects dropped out, and 37 completed the study. Timed up and go (TUG) and Berg balance scale (BBS) were used for balance assessment, and 10-meter walk (10MW) was used for gait assessment. The intervention program was conducted three times a week for 4 weeks. Results: Significant differences within the groups in balance (BBS, TUG) and gait (10MW) between the VSG and the N-VSG. There was no difference between the two groups in any variable. Conclusion: The VSG improved the balance and gait of THR patients without any difference from the N-VSG. However, VSG showed a higher effect size than N-VSG.

Background: A weight-bearing jacket during treadmill gait training is being used for rehabilitation in stroke patients. However, the effect on various gait parameters has not been confirmed. Objectives: The purpose of this study was to investigate the comparison of exercise intensity through speed increase and weight-bearing jacket during treadmill gait training to restore gait ability in stroke patients. Design: Randomized controlled trials. Methods: This study recruited 24 stroke patients. The subjects were randomly assigned to the experimental group (wearing a weight-bearing jacket during treadmill gait training, n=12) and the control group (speed increase during treadmill gait training, n=12). Gait measurement device (G-walk) was used to measure the gait parameters of the subjects. Results: Both the experimental group and control group showed a significant increase in cadence, gait speed, stride length, and gait symmetry index post intervention (P<.05). In comparison between the two groups, the experimental group showed a significant increase in the gait symmetry index post the intervention than the control group (P<.05). Conclusion: Through this study, it was found that wearing a weight-bearing jacket was a more effective method for improving the gait symmetry index than increasing speed during treadmill gait training in stroke patients.

Background: There is a research report that lumbar mobilization for healthy people improves the knee extension angles and Q-angle related muscle activity (Q: quadriceps muscle). However, there is a lack of research on the effect of lumbar mobilization on gait variables such as cadence and gait speed, especially when mobilizing the central part of the lumbar spine from posterior to anterior. Objectives: To examine the effect of lumbar central PA mobilization in healthy people on cadence and gait speed. Design: Pilot study. Methods: There were 34 participants in this study. In the experimental group, lumbar posterior-anterior joint mobilization was performed once in Grade III-IV for 5 minutes, focusing on the segment with reduced movement. In the control group, lumbar posteroanterior mobilization was performed once in a total of Grade I-II for 5 minutes. To measure cadence and gait speed, STT-IWS and iSen System (San Sebastian, Spain) were used. Results: The comparison of cadence between groups, CG (Control group) increased cadence was about 6 more than EG (Experimental group) cadence, but it was not statistically significant. The gait speed of EG and CG was .30- .31, which was similar between the two groups, and the before and after values were also similar. There is no statistically significant difference Conclusion: The cadence and gait speed of the experimental group were not statistically significantly different than those of the placebo group.