Background: Treadmill training is an effective intervention method for improving the walking ability of stroke patients, and taping is effective for stabilizing joints. However, taping interventions have not been implemented during treadmill training. Objectives: To examine whether treadmill training with an elastic tape or treadmill training with a non-elastic tape could be more effective in stroke patients. Design: A single blinded, randomized, controlled, comparative study. Methods: 22 stroke patients were randomly allocated to two groups: the elastic group (treadmill gait training with ankle elastic tape on the paretic side) or the non-elastic group (treadmill gait training with non-elastic tape on the paretic side). All participants performed 60 min of comprehensive rehabilitation therapy and treadmill training with an elastic tape or non-elastic tape for 20 min. Results: 10-meter walk test and timed up-and-go test results after training differed significantly from baseline in both groups (P<.05), but significantly larger gains were observed in the elastic group (10-meter walk test, -17.1%; timed up-and-go test, -18.49%; P<.05, respectively). Conclusion: Treadmill gait training with elastic tape on the affected ankle joint might be more effective at improving the walking and balancing abilities of stroke patients.

Background: Although several studies have reported functional improvements after forward walking training on a treadmill and after backward walking training on a treadmill, there is a lack of immediate effects data, investigating spatiotemporal parameter, neuromuscular recruitment. Objectives: To compare the immediate effects between forward and backward walking on treadmill training, present study measured muscle activities of the lower extremity, gait parameters, and dynamic balance. Design: Cross-sectional study. Methods: The twenty-four asymptomatic young male subjects were participated in this study. Subjects have performed 15-min of forward and backward walking on treadmill. Before and after treadmill walking, the gait parameters were measured with the GAITRite. The dynamic balance abilities were assessed with the Y-balance test. Muscular activities were collected from the tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris during forward and backward walking. Results: Muscular activities of the biceps femoris and tibialis anterior were significantly different between forward and backward walking conditions, which were higher with the backward walking (P<.05). Compared to the pre-measurement, the normalized dynamic balance composite score of the post-measurement was significantly higher with the backward walking (P<.05). Regardless of the treadmill training method, there were no significant differences between pre and post measurement, both the stride length and step length (P>.05). Conclusion: The performing backward walking training has positive effects for dynamic balance.

서로 다른 감각 정보의 불일치가 가상현실 멀미를 유발하는 것으로 알려져 있다. 본 연구에서는 트레드밀 기반의 가상현실 보행을 통해 감각 정보 일치의 멀미 완화 효과를 검증하고 나아가서 가상현실에서의 광학 흐름(optic flow) 단서에 의한 시각적 속도감과 트레드밀 보행을 통한 보행 속도감의 불일치가 멀미 완화 효과에 미치는 영향을 검증 하였다. 실험1에서는 트레드밀 보행의 멀미 완화 효과를 검증하기 위해 HMD를 통해 앞으로 이동하는 가상현실 체험을 하면서 가만히 서 있을 때와 트레드밀 보행을 할 때의 멀미 수준을 비교하였다. 실험 결과 가상현실 속에서 이동을 하며 트레드밀 보행을 할 때 더 적은 멀미를 느끼고 실재감과 몰입감은 증가하였다. 실험2와 실험3에서는 가상현실 속에서 이동하는 속도에 대한 시각적 속도감과 트레드밀 보행의 속도감을 조작해 두 속도감이 일치할 때와 불일치할 때의 멀미 수준을 비교하였다. 흥미롭게도 참가자들은 시각적 속도감이 보행속도감보다 빠르게 느껴지는 불일치 조건에서 일치조건보다 더 낮은 멀미를 경험하였다. 이와 같은 실험결과는 가상현실 속에서 이동할 때 시각적 정보와 일관되게 트레드밀 보행을 하게 하는 것이 가상현실 멀미를 완화시키지만 속도감의 일치가 필수적인 것이 아님을 시사한다.

Background : There is lack of studies on the effects of the bag-carrying style on the shoulder muscles and body alignment in adults with rounded shoulder posture (RSP). Objective: The purpose of this study was to investigate the effects of various bag-carrying styles on muscle tone, muscle stiffness and spinal alignment in 20 adults with RSP as they were walking on a treadmill. Design : Crossover Study Design. Methods: A subject performed treadmill walking for 15 minutes at a speed of 4 ㎞/ｈ while carrying three different types of bags: a backpack, a cross bag, and a shoulder bag. Results : The results showed that the main effect of timing was observed in the muscle tone for all the variables and in muscle stiffness only for the upper and lower trapezius muscles. As for the main effect of timing, the muscle tone of the upper trapezius and the pectoralis major significantly increased in all conditions, while the muscle tone of the lower trapezius significantly decreased in all conditions. The muscle stiffness of the upper trapezius significantly increased in all conditions, while the muscle stiffness of the lower trapezius significantly decreased in all conditions. As for the spinal alignment, the dimple distance data values significantly decreased for the cross-bag style. Conclusions : This study demonstrated that walking with a heavy bag, regardless of the bag-carrying style, increased muscle stiffness around the shoulders in adults with rounded shoulder posture, and walking with a crossbag also induced changes in spinal alignment.

Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

The purpose of this study was to investigate the effect of somatotype on the VO2max and hormone (adrenaline and noradrenaline) during treadmill walking. Forty healthy men participated and were randomized to four groups: Male 1 (M1) group, Male 2 (M2) group, Male 3 (M3) group, and Male 4 (M4) group. M4 group is the largest body type, and M1 group is the smaller the body type. Participants walked at a speed of 3.5 km/h for five minutes at an incline angle of 0°, 5°, and 10° in the treadmill. Maximum oxygen consumption and hormone (adrenaline and noradrenaline) were measured. In the results, VO2max has significantly increased according to the degree of the treadmill inclination, and M4 group (larger body type) consumed more oxygen than the M1 group (smaller body type). In the hormone, there was a significant increase in adrenaline concentration after walking in all groups, and there was a significant difference in M1-M4, M2-M4 and M3-M4. The noradrenaline concentration significantly increased after treadmill gait in all groups, and there was no significant difference in noradrenaline between groups. This study suggests that the larger body type consumes more oxygen during walking, and treadmill walking contributes to an increase in the concentration of adrenaline and noradrenaline.

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group (n1=15), which walked backward, and the control group (n2=15), which walked forward. To measure the improvement of the patients’ gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at α=.05. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

Background: Many studies regarding task-oriented training have recently demonstrated functional improvement in patients with post-stroke hemiparesis. The task-oriented approach is very diverse, and chronic stroke patients must have access to a sustained systematic treatment program to enhance their walking ability. Objectives: This study aimed to compare the effects of the task-oriented circuit training and treadmill training on walking function and quality of life in patients with chronic stroke. Methods: Fourteen patients with chronic stroke volunteered for this study. The subjects were randomly divided into a task-oriented circuit training group and a treadmill training group with 7 patients in each. Each training regimen was performed for 30 min a day and 3 days a week for 4 weeks. Assessment tools included the Timed Up-and-Go Test (TUGT), 10-m Walk Test, 6-min Walk Test (6MWT), and the Stroke Impact Scale (SIS). Results: The change in results of the TUGT, 6MWT, and SIS measured prior to and following the training regimens appeared to be significantly different between the two groups (p<.05). In addition, after the intervention, significant differences were found for all parameters in the task-oriented circuit training group and for the TUGT, 6MWT, and SIS in the treadmill training group (p<.05). Conclusion: The findings suggest that task-related circuit training and treadmill training may be helpful to improve walking function and quality of life of patients with post-stroke hemiparesis. Additionally, a task-related circuit training program may achieve more favorable outcomes than a treadmill program.

The purposes of this study were 1) to determine the effects of low-dye taping on peak plantar pressure following treadmill walking exercise, 2) to determine whether the biomechanical effectiveness of low-dye taping in peak plantar pressure was still maintained following removal of the tape during treadmill walking, and 3) to determine the trend towards a medial-to-lateral shift in peak plantar pressure in the midfoot region before and after application of low-dye taping. Twenty subjects with flexible flatfoot were recruited using a navicular drop test. The peak plantar pressure data were recorded during five treadmill walking sessions: (1) un-taped, (2) baseline-taped, (3) after a 10-minute treadmill walking exercise, (4) after a 20-minute treadmill walking exercise, and (5) after removal of the taping. The foot was divided into six parts during the data analysis. One-way repeated measures analysis of variance was performed to investigate peak plantar pressure variations in the six foot parts in the five sessions. This study resulted in significantly increased medial forefoot peak plantar pressure compared to the un-taped condition (p=.017, post 10-minute treadmill walking exercise) and (p=.021, post 20-minute treadmill walking exercise). The peak plantar pressure in the lateral forefoot showed that there was a significant decrease after sessions of baseline-taped (p=.006) and 10-minute of treadmill walking exercise (p=.46) compared to the un-taped condition. The tape removal values were similar to the un-taped values in the five sessions. Thus, the findings of the current study may be helpful when researchers and clinicians estimate single taping effects or consider how frequently taping should be replaced for therapeutic purposes. Further studies are required to investigate the evidence in support of biomechanical effectiveness of low-dye taping in the midfoot region.

The purpose of this study was to investigate the effects of visual cue deprivation during sideways treadmill training in individuals with stroke. Twenty-eight stroke patients were divided into two groups, and each group participated in a sideways treadmill training session for 20 minutes, three times per week for 4 weeks. The eyes close group (15 subjects) performed this treadmill training with visual cue deprivation, while the eyes open group (13 subjects) performed it without visual cue deprivation. Gait function was measured in both groups before and after the training sessions with the Biodex Gait Trainer 2, which determined walking speed, distance, step length, and time on each foot. Balance was measured before and after each training period in both groups using the Five-Times Sit-to-Stand Test (FTSST), the Timed Up and Go test (TUG), and the seven-item Berg Balance Scale-3P (7-item BBS-3P). The eyes close group showed significantly improved gait function, walking speed, distance, step length, and time on each foot after training (p<.05). The eyes close group showed improved balance ability, FTSST, TUG, and 7-item BBS-3P test after training (p<.05). The findings indicated that sideways treadmill training with visual cue deprivation positively affects gait ability of stroke patients. Therefore, sideways treadmill training with visual cue deprivation may be useful for the recovery of gait ability of stroke patients.

The study aimed to compare the effect of the treadmill walking training combined with obstacle-crossing (TWT-OC) and treadmill walking training (TWT) on the walking function of patients with chronic stroke. 29 subjects volunteered to participate in this study; they were randomly assigned to either TWT-OC group (15 subjects) or TWT group (14 subjects). Subjects from the TWT-OC group underwent a treadmill walking combined with obstacles-crossing for 30 minutes daily, three days a week for four weeks, whereas subjects from the TWT group received only a treadmill walking. The 10 m walk test (10MWT), 6-min walk test (6MWT), berg balance scale (BBS), timed up and go test (TUG), activities-specific balance confidence-Korean version (ABC-K), and walking ability questionnaire (WAQ) were measured before and after the 4-week training. The TWT-OC group showed significantly better functional mobility of walking and balance measured by 6MWT (p<.01), BBS (p<.01), and TUG scores (p<.05) when compared with those of the TWT group. Further, within-group comparison showed significant improvement in all variables (p<.01) except for 10MWT. These findings suggest that the TWT-OC and TWT may be helpful for improving the walking function of patients with chronic stroke, and the TWT-OC has probably more favorable outcomes for chronic stroke, however, further trials with wider range of subjects are warranted for generalization and clinical relevance.

The purpose of this study was to compare the effects of treadmill walking in underwater and overground which affects gait and physical function of people who have had a stroke. Twenty people after a stroke who have become hemiplegic over 6 months were participated. Participants were divided into two groups: underwater treadmill group(UTG) and overground treadmill group(OTG). The intervention was done 4 times per weeks for 6 weeks and 1 session lasted for 30 minutes. Gait and physical function elements were measured at baseline, at the middle(3 weeks) and at the end of the intervention(6 weeks). For the elements of gait, walking velocity, affected stance phase, affected weight bearing were assessed. For the elements of physical function, Short Form 8(SF-8) health survey was used. The result of this study showed that both groups improved similarly in walking velocity. However participants in UTG improved more than those in OTG in affected stance phase(p<.05), affected weight bearing( p<.05) and emotional aspect(p<.001). Based on the results of this study, it can be suggested that treadmill walking both in underwater and on the ground can be effective in improving hemiplegic gait and physical function of people who have had a stroke. The result also suggest that the underwater treadmill exercise can be more effective than overground treadmill in restoration of gait in people after stroke.

To compare the effects of forward walking and backward walking on surface electromyographic analysis of quadriceps muscles at treadmill grades of 0%, 5% and 10%, subjects were randomized to eleven athletics (5 females, 6 males), with a mean age of 17.8 years, and a SD of 4.66 years. The values of the surface electromyographic (SEMG) activity of the rectus femoris (RF), vastus lateralis (VL) and vastus medialis oblique (VMO) were measured during forward walking and backward walking on a treadmill at grades of 0, 5 and 10%. The subjects walked for approximately 10 seconds at 4.0 km/h. The data were analyzed by repeated measuring of the two-way ANOVA and analyzed by a paired t-test between forward walking and backward walking. The SEMG activity levels of the RF, VL and VMO were the highest when both the forward walking and backward walking increased incrementally for treadmill grades of 0% to 10%, but the VMO/VL ratio had no significant changes. The SEMG activity levels of the RF, VL and VMO were significantly different between directions. However, SEMG activity levels of the RF, VL, VMO and VMO/VL ratio did not show significant difference among the treadmill grades. No statistically significant interactions were detected between the direction of walking and treadmill grade. Backward walking on the treadmill at 4 km/h and grades of 0%, 5%, 10% elicited a greater SEMG activity on the quadriceps muscles than did forward walking under the same conditions. The results suggest that the quadriceps may be effectively activated by performance at treadmill grades of 10%. This investigation confirms that backward walking up an incline may place additional muscular demands on individuals.