Effects of Inspiratory Muscle Training on Respiration and Balance in Patients with Stroke: A Pilot Randomized Controlled Trial

안광빈,전혜주,장우남 한국운동생리학회 2022 운동과학 Vol.31 No.2

PURPOSE: Respiratory function can be adversely affected after a cerebrovascular accident. This study aimed to determine whether inspiratory muscle training (IMT) changes the respiration and balance abilities of patients with stroke. METHODS: Twelve patients with stroke were randomly assigned to the study (n=6) and control (n=6) groups. The study and control groups received IMT and general physical therapy, respectively for 6 weeks, five times a week for 30 min/day. Inspiratory and expiratory functions and balance were measured pre-and post-evaluation. RESULTS: After IMT intervention, the weight distribution ratio (WDR) for balance ability measurement was significantly decreased (p<.05), and the maximum inspiratory pressure (MIP), maximum inspiratory flow rate (MIFR), maximum inspiratory capacity (MIC), peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and limits of stability (LOS) were significantly increased in the study group (p<.05). A comparison of the study and control groups revealed statistically significant differences in MIP (p<0.01), MIFR (p<.01), MIC (p<.05), PEF (p<.05), FEV1 (p<.05), WDR (p<.01), and LOS (p<.05). CONCLUSIONS: This study suggests that IMT is a useful and effective exercise intervention for patients with stroke.

성인의 스마트폰 사용 시 목과 등의 자세 변화에 따른 폐활량의 차이

안광빈,전혜주 대한스포츠물리치료학회 2023 정형스포츠물리치료학회지 Vol.19 No.1

Purpose: In this study, we investigated changes in lung capacity based on cervical and thoracic posturesduring smartphone use in adults. Methods: The study included 47 residents of Seongnam City (27 women and 20 men). Participants wereinstructed to perform the task in the normal sitting position without using a smartphone and in the sittingposition while performing a two-handed video watching task on a smartphone. An iPhone application(Goniometer Pro) was used to measure the cervical and thoracic flexion angles to quantitatively assessparticipants’ range of cervical and thoracic flexion, and a spirometer was used to measure the vital capacity(peak expiratory flow [PEF]) and forced expiratory volume in 1 s [FEV1]) in all participants. Results: Cervical and thoracic flexion angles were significantly greater in the sitting position when using asmartphone than in the normal sitting position without using a smartphone (p<0.05). PEF and FEV1 valueswere significantly lower during sitting while using a smartphone than in the normal sitting position withoutusing a smartphone (p<0.05). Conclusion: Our results suggest that frequent smartphone use while sitting may be a potential risk factor formusculoskeletal disorders and reduced lung function.

발 지각력 강화 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 영향: 단일사례연구

안광빈,이경보,황병용 대한신경치료학회 2019 신경치료 Vol.23 No.3

Purpose The aim of this study was to investigate the effects of foot perceptual training on balance and gait in patient with chronic stroke. Methods This study was designed ABA format in single subject research design. The participants were trained the foot perceptual training for 30 minutes a day, 5 times a week, for two weeks. Before the treatment is implemented, the baseline (A) data was collected for 5 times. Foot perceptual training (B) data was collected 10 times during intervention. Baseline (A’) data was collected 5 times after the intervention. Foot perceptual training proceeded with realignment, facilitation, and activation. The balance was measured by Physiofeedback MTD for static and Timed Up and Go test (TUG) for dynamic. Results As a result of the study, the static and dynamic balance were improved after intervention. These effects were maintained even during the regression baseline period. Conclusion The Results showed that foot perceptual training was effective in the improvement of static or dynamic balance and gait. The foot perceptual training would be the effective therapeutic exercise that could be applied to patient with chronic stroke.

저빈도 반복 경두개 자기자극이 만성 뇌졸중환자의 균형과 보행 및 뇌 활성도에 미치는 영향: 예비 연구

안광빈 ( Kwang-bin ),정혜진 ( Hye-jin Jeong ),한소영 ( So-young Han ),김동원 ( Dong-won Kim ) 대한신경치료학회 2021 신경치료 Vol.25 No.3

Purpose The purpose of this study was to investigate the effects of neuro-developmental treatment (NDT) in combination with low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on balance, gait, and cortical activity in chronic stroke patients. Methods In this study, 6 patients with chronic stroke were divided into 3 patients in the LF-rTMS group combined with neuro-developmental treatment (NDT) and 3 patients in the sham-rTMS group combined with NDT. In this study, the MTD-balance system, AMTI, MEP amplitude, and MEP latency were evaluated before and after the intervention. Results First, there was a significant difference in weight bearing rate and foot pressure evaluation pre and post intervention in the study group (p<0.05) (p<0.01). Second, there was a significant difference in the study group as a result of the ground reaction force evaluation (p<0.05). Third, there was a statistically significant difference in the MEP latency of the study group as a result of cerebral cortical activity evaluation (p<0.05). Conclusion The result suggests that LF-rTMS combined with NDT were found to be effective in improving balance and gait ability and cerebral cortical activity in chronic stroke patients.

Relationship between Plantar Tactile Sensory Thresholds and Balance for Life-Care Increase in Patients with Stroke

Kwang-Bin An(안광빈),Hye-Joo Jeon(전혜주) 한국엔터테인먼트산업학회 2020 한국엔터테인먼트산업학회논문지 Vol.14 No.8

감각장애는 뇌졸중에서 흔히 나타나며, 발에서 나오는 촉각의 감각정보는 균형을 위해 중추신경계에 중요한 정보를 제공한다. 본 연구의 목적은 뇌졸중 환자의 발바닥 감각역치와 균형의 상관관계를 연구하는 것이다. Semmes-Weinstein Monofilaments를 사용하여 발바닥의(엄지발가락과 뒤꿈치) 감각역치를 평가하였다. 균형은 버그균형척도와 MTD system을 이용하여 정적 선 자세와 앉은 자세에서 일어서기 동안의 마비쪽과 비마비쪽의 체중 분포 정도를 측정하였다. 정적 선 자세와 앉은 자세에서 일어서기 동안 체중 분포 정도는 비마비쪽보다 마비쪽에서 더 낮았다(P<0.05). 버그균형척도는 36.00±1.53이었다. 마비쪽의 엄지발가락 감각역치는 버그균형척도(r=-0.444, P<0.05), 정적 선 자세(r=-0.332, P<0.05), 앉은 자세에서 일어서기(r=-0.390, P<0.05)와 상관관계가 있었다. 마비쪽의 뒤꿈치 감각역치는 버그균형척도(r=-0.467, P<0.05), 정적 선 자세(r=-0.532, P<0.05), 앉은 자세에서 일어서기(r=-0.516, P<0.05)와 상관관계가 있었다. 이러한 결과는 발바닥의 높은 감각역치가 균형 능력 저하에 영향을 미칠 수 있음을 시사한다. 앞으로 뇌졸중 환자의 감각 역치에 대한 연구는 뇌졸중 환자의 재활과 감각 평가에 도움이 될 것이다. Sensory impairment is common following a stroke. Tactile afferent inputs from the plantar foot provide important information to the central nervous system to generate balance. The present study, which recruited 50 stroke patients, aims to determine the relationship between plantar tactile sensory threshold (PTST) and balance in patients with stroke. The PTST was evaluated at two sites (hallux and heel) using Semmes–Weinstein monofilaments. The balance abilities were measured by the degree of weight distribution in quiet standing (QS) and sitting-to-standing position (STS) using a MTD system and Berg balance scale (BBS). The hallux and heel sensory thresholds (ST) in the affected side were higher than the non-affected side (P < 0.05). The degree of weight distribution in the affected side was lower than the non-affected side. QS and STS showed P < 0.05, with BBS score of 36.00 ± 1.53. The hallux ST in the affected side correlated with BBS (r = −0.444, P < 0.05), QS (r = −0.332, P < 0.05), and STS (r = −0.390, P < 0.05), whereas the heel ST in the affected side correlated with BBS (r = −0.467, P < 0.05), QS (r = −0.532, P < 0.05), and STS (r = − 0.516, P < 0.05), suggesting that higher detected PTST might have an influence on the decreasing balance abilities. The study of sensory threshold in patients with stroke will help their rehabilitation and sensory evaluation.

뒤로걷기훈련이 편마비 환자의 균형과 보행에 미치는 영향

김병후,안광빈,이수용,장우남 대한신경치료학회 2023 신경치료 Vol.27 No.3

Purpose The purpose of this study was to investigate the effects of backward walking training(BWT) on range of motion of ankle joint, foot pressure, balance, and gait in patients with hemiplegia. Methods The participants were randomly assigned to study group and control group with 16 participants in each group. The study group performed BWT while the control group performed conventional physical therapy. The respective intervention was performed three times a week for six weeks and 30minutes per session in each group. This study evaluated by range of motion(ROM) of ankle joint, foot pressure, limits of stability(LOS), functional reach test(FRT), Berg balance scale(BBS), 10m walk test(10MWT) and ground reaction force(GRF) were evaluated to confirm the effects of the interventions. Paired ttest was performed to compare the difference between before and after intervention within groups. And independent ttest was used to compare with control group. Results The study group that underwent BWT showed a significant increase in ROM of ankle joint (p<.001), left․right symmetry(p<.01), weight distribution at the hindfoot of the affected side(p<.01), LOS(p<.001), FRT(p<.001) and BBS(p<.001) postintervention compared to the control group(p<.05). In addition, the study group showed significant improvement in gait velocity(p<.05), step length(p<.05), and cadence(p<.01) of measured in a 10MWT, which evaluated gait ability, postintervention. However, the increase was not significant when compared to that in the control group(p>.05). GRF showed significantly improved postintervention(p<.001) compared to the control group(p<.05). Conclusion BWT significantly improved ROM and control of ankle joint of the affected side, foot pressure, balance and gait ability compared with the control group. Therefore, it was confirmed that BWT is an effective intervention for restoring balance and gait ability in patients with hemiplegia.

마비쪽 발활 강화가 뇌졸중 환자의 다리근 활성도, 균형 및 보행에 미치는 영향

이승혁,안광빈,장우남 대한신경치료학회 2023 신경치료 Vol.27 No.2

Purpose The aim of this study was to investigate the effects of strengthening the foot arch on the paretic side on lower limb muscle activity, balance, and gait in individuals with stroke. Methods A total of 34 stroke individuals were selected from a single medical institution and divided into study and control groups, with 17 participants in each group. One participant from the study group and two participants from the control group dropped out, resulting in a final analysis of 31 participants. Both groups underwent their respective interventions three times a week for 6 weeks, with each session lasting 30 minutes. The study group received foot arch strengthening intervention on the paretic side, while the control group received general physical therapy. The effects of the study intervention were evaluated using the following measurements: navicular drop test (NDT), weight distribution ratio (WDR), and surface electromyography (sEMG). Balance was assessed using the limit of stability (LOS), Berg balance scale (BBS), and functional reach test (FRT). Gait evaluation was performed using the 10meter walk test (10MWT), measuring gait velocity, cadence, and step length. Results The results of the NDT, WDR, sEMG, LOS, BBS, FRT, 10MWT demonstrated significant differences between pre and post intervention. Additionally, there were significant differences observed between the study and control groups in terms of WDR, LOS, and gait speed. Conclusion These findings demonstrate that strengthening the foot arch on the paretic side is an effective intervention for improving lower limb muscle activity, balance, and gait in individuals with stroke.

마비쪽 안쪽세로활 가동성 증진 운동이 뇌졸중 환자의 균형과 보행, 근활성도에 미치는 영향 : 증례 보고

이승혁,안광빈,전혜주 대한신경치료학회 2022 신경치료 Vol.26 No.3

Purpose The aim of this study was to investigate the effects of medial longitudinal arch mobility of paretic foot on balance and gait, and muscle activity in stroke patients. Methods Twelve stroke patients who were hospitalized at B hospital in Gyeonggido during the period from January 2022 to February 2022 were enrolled in this study. The subjects were divided into the medial longitudinal arch mobility training group of the paretic foot (n = 6) and the conventional physical therapy group (n = 6). The intervention was performed for 30 minutes a days, 5 times a weeks, and two weeks. The effectiveness of the intervention was assessed pre and postevaluated using the 10M Walk Test(10MWT), Berg Balance Scale(BBS), the BioRescue Platform(BRP) and the surface ElectroMyoGraphy(sEMG). Results As the result of the medial longitudinal arch mobility training on the paretic foot showed significantly improved balance and gait after exercise than before exercise in 10MWT, BBS and BRP. Conclusion Medial longitudinal arch mobility training of the paretic foot was effective in improving balance and gait speed through weightbearing on the paretic side in hemiplegic patients with stroke.

뒤로걷기훈련이 만성 뇌졸중 환자의 균형과 보행에 미치는 영향: 단일사례연구

김병후,안광빈,장우남 대한신경치료학회 2022 신경치료 Vol.26 No.2

Purpose The aim of this study was to investigate the effects of the backward walking training on balance and gait ability in patient with chronic stroke. Methods This study was designed the ABA format in a single subject research design. The subject was a men aged 49 with Rt. hemiplegia due to stroke. The backward walking training was carried out the stable standing posture, the backward stepping and the eccentric activation of the calf muscle. The intervention was performed for 30 minutes a day, 5 times a week, for two weeks. The effectiveness of the intervention was measured before each session with the Functional Reach Test (FRT), the BioRescue Platform (BRP) and the Time Up and Go test (TUG). Results As the result of the FRT, BRP and TUG show, there have been significant improvements in the balance and gait of the subject in both during intervention and during regression period. Conclusion The eccentric activation of the calf muscle with the backward walking training was effective in improving the symmetry of weight distribution, postural stability and speed of gait in hemiplegic patient with stroke.

Effects of Reaching to Sit-Up Training on Trunk Muscle Activation and Balance in Patients with Chronic Stroke

이수용,안광빈 국제물리치료연구학회 2023 Journal of International Academy of Physical Ther Vol.14 No.3

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.