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.

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.

Background: Foot drop is a common symptom in stroke patients. Tape applications are widely used to manage foot drop symptoms. Previous studies have evaluated the effects of static and dynamic balance and gait on foot drop using kinesiology tape; however, only few studies have used dynamic tape application in stroke patients with foot drop. Objects: The purpose of this study was to investigate the immediate effects of dynamic taping, which facilitates the dorsiflexor muscle, on static and dynamic balance and gait speed in stroke patients with foot drop. Methods: The study included 34 voluntary patients (17 men, 17 women) with stroke. The patients were randomly assigned to the experimental group (n = 17), wherein dynamic taping was used to facilitate the dorsiflexor muscle, or the control group (n = 17), wherein kinesiology taping was used. Before the taping application, velocity average, path-length average, Berg balance scale, and timed up and go test (TUG) were recorded to measure static and dynamic balance, whereas the 10-meter walk test (10MWT) was used to measure gait speed. After the taping application, these parameters were re-evaluated in both groups. Repeated measure analysis of variance was used. Statistical significance levels were set to α = 0.05. Results: Except for the 10MWT scores in the control group, significant differences were noted in all the parameters measured for static and dynamic balance and gait speed between the pre and post-test (p < 0.05). However, the parameters showed significant interaction effects between group and time in the TUG and 10MWT (p < 0.01). Conclusion: These results indicate that compared with kinesiology taping, dynamic taping used in chronic stroke patients with foot drop had a more significant effect on dynamic balance and gait speed.

Background: Stroke patients have dosiflexor weakness. Functional electrical stimulation (FES) for motor and sensory threshold stimulation has been applied to patients with stroke. Objectives: To investigate effects of FES intervention for motor and sensory threshold on balance and gait in subacute patients with stroke. Design: A randomized controlled trial. Methods: In all, 34 patients with subacute stroke were recruited and randomly assigned to the motor threshold (MTG, n=17) and sensory threshold group (STG, n=17). The measured variables were static balance (BioRescue), dynamic balance (BBS), and gait (TUG test). The study period was 5 weeks, twice a day, 5 days a week. Results: There was a significant difference in all variables except the speed variable (open eye Romberg test) after the intervention; MTG improved more significantly except for the speed variable of the Romberg test (open eye). BBS score increased significantly only in the MTG group after the intervention, and the increase was more significant in the MTG group than in the STG group. The TUG test significantly decreased in both groups after the intervention, and the decrease was more significant in the MTG group than in the STG group. Conclusion: FES for motor threshold applied to patients with subacute stroke appears to be more effective in improving balance and gait ability than FES for sensory threshold.

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

Background: Patients with stroke have limited ankle range of motion (ROM) due to soft tissue abnormalities around the ankle and thus experience functional impairment. Increased muscle tension and reduced ankle ROM impair gait and hinder the activities of daily living. Joint mobilization and stretching are effective interventions that improve gait performance by enhancing the ankle ROM. Objectives: To investigate the effects of ankle joint mobilization and calf muscle stretching on gait speed and gait performance in patients with stroke. Design: This was a randomized controlled trial. Methods: Twenty patients with stroke patients were randomized into two groups. The joint mobilization group (JMG) underwent anteroposterior mobilization of the talocrural joint and the joint mobilization stretching group (JMSG) underwent calf muscle stretching in addition to joint mobilization. Gait speed and gait parameters were measured using the 10-meter walk test and the GAITRite. Results: Both the JMG and JMSG groups showed significant improvements in gait speed, affected-side step length, and cadence after the intervention (P<.05). Conclusion: Joint mobilization and stretching were effective interventions for improving gait performance by enhancing ankle function in patients with stroke.

본 연구의 목적은 신체 전신 운동인 맵시 운동 프로그램을 중년여성들에게 8주간 적용하여 보행 시 수직 지면반력 크기, 발생시간, 압력 중심 요인들에 미치는 영향을 분석하는데 있었다. 본 연구의 피험자로 운동군 13명(연령, 41±4.4 세; 신장, 162.5±5.8 cm; 체중, 57.8±6.7 kg; 신체질량지수, 21.9±2.4 kg/m2), 대조군 12명(연령, 41.1±5.6 세; 신장, 160.9±5.5 cm; 체중, 576.2±8.1 kg; 신체질량 지수, 21.7±2.9 kg/m2) 총 25명이 참여하였다. 운동군은 7영역 23종 77동작의 맵시운동 프로그램을 8주간 주 3회 실시하였다. 보행 시 지면반력 요인들의 검증을 위하여 Two-way repeated measures ANOVA 를 실시하였으며, 사후검증은 bonferroni adjustment로 분석하였다(a=.05). 맵시 운동 프로그램의 운동군은 보행 시 FMWA와 FPO 시점까지의 소요 시간, FMWA와 FPO에서 발생한 수직 지면반발력 그리고 AP 방향 COP의 RMS 요인들에서 대조군에 비해 상대적으로 큰 수치를 나타내었다. 그러므로 8주간의 맵시 운동 프로그램은 보행을 수행하는 중년여성들의 가속과 감속 운동 기능을 향상시킨 것으로 나타났다.