Background:Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP.Objects:This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP.Methods:Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement.Results:The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved.Conclusion:SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.
The purpose of this study was to find which spatiotemporal gait parameters gained from stroke patients could be predictive factors for the gait part of Tinetti Performance-Oriented Mobility Assessment (POMA-G). Two hundred forty-six stroke patients were recruited for this study. They participated in two assessments, the POMA-G and computerized spatiotemporal gait analysis. To analyze the relationship between the POMA-G and spatiotemporal parameters, we used Pearson’s correlation coefficients. In addition, multiple linear regression analyses (stepwise method) were used to predict the spatiotemporal gait parameters that correlated most with the POMA-G. The results show that the gait velocity (r=.67, p<.01), cadence (r=.66, p<.01), step length of the affected side (r=.49, p<.01), step length of the non-affected side (r=.53, p<.01), swing percentage of the non-affected side (r=.47, p<.01), and single support percentage of the affected side (r=.53, p<.01) as well as the double support percentage of the non-affected side (r=-.42, p<.01) and the step-length asymmetry (r=-.64, p<.01) correlated with POMA-G. The gait velocity, step-length asymmetry, cadence, and single support percentage of the affected side explained 67%, 2%, 2%, and 1% of the variance in the POMA-G, respectively. In conclusion, gait velocity would be the most predictive factor for the POMA-G.
The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from 15.32±5.98 to 18.16±6.95 ㎏) and knee flexor strength (p=.011, from 7.80±4.80 to 8.15±4.24 ㎏) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.
The purpose of this study was to examine the effects of dual-task training (cognitive and exercise tasks) on the balance and gait performance of chronic stroke patients. Eighteen subjects with chronic stroke were divided equally into two groups, an experimental group and a control group. Subjects in both groups participated in an exercise program, performing the same tasks, for 45 minutes per day, three times per week for four weeks. The experimental group also performed additional cognitive task. The experimental group showed a more significant improvement than the control group on the Berg Balance Scale, the Timed Up and Go Test, the Korean Activities-Specific Balance Confidence Scale, and the Functional Gait Assessment (p<.05). The cognitive task error rates in the final week were significantly less than in the first week in the experimental group (p<.01). These results suggest that dual-task training for chronic stroke patients is effective in improving balance, gait, and cognitive abilities.
The purpose of this study was to determine which spatiotemporal gait parameters obtained during hemiplegic walking could be a predictive factor for the Timed Up and Go test (TUG). Two hundreds nine subjects who had suffered a stroke were recruited for this study. They were participated in two assessments; the TUG test and gait analysis. The relationship between the TUG test and spatiotemporal parameters was analyzed using Pearson’s correlation coefficients. In addition, to predict the spatiotemporal gait parameters that correlated most with the TUG scores, we used multiple linear regression analyses (stepwise method). The results show that the normalized velocity was strongly correlated with the TUG performance (r=-.72, p<.001). Additionally, single support percentage (SSP), double support percentage (DSP), step time difference (STD), and step length difference (SLD) significantly were correlated with the TUG test. Normalized velocity, STD, DSP of affected side, and SSP of non-affected side explained 53%, 8%, 3%, 2%, of variance in the TUG test respectively. In conclusion, an increase in gait velocity and a decrease in STD would be effective indicators of improvement on the functional mobility in the stroke rehabilitation.
The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity (FM-U․L/E). The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (β=.420~.862) had slightly more power in predicting trunk control than the . TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study clearly indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.