무동력 트레드밀 훈련이 뇌졸중 환자의 폐 기능, 하지 근력, 균형 및 보행능력에 미치는 영향 = EFFECT OF NON-MOTORIZED CURVED TREADMILL TRAINING ON PULMONARY FUNCTION, LOWER EXTREMITY STRENGTH, BALANCE AND GAIT ABILITY IN PATIENTS WITH STROKE

국문 초록 (Abstract)

무동력 트레드밀 훈련이 뇌졸중 환자의 폐 기능, 하지 근력, 균형 및 보행능력에 미치는 영향 본 연구는 무동력 트레드밀 훈련이 뇌졸중 환자의 폐 기능, 하지 근력, 균형 및 보행능력에 미치는 영향을 알아보고, 동력 트레드밀 훈련과의 효과를 비교하기 위해 실시하였다. 연구의 대상자는 뇌졸중 환자 35명으로 실시하였고, 무동력 트 레드밀 훈련군 12명, 동력 트레드밀 훈련군 11명, 대조군 12명이 실험에 참여하였 다. 무동력 트레드밀 훈련군과 동력 트레드밀 훈련군은 목표 심박수의 40%에서 시작해서 60%까지 환자분이 감당할 수 있는 범위내에서 훈련을 20분간 시행하였 고, 목표 심박수의 30%에서 준비운동과 정리운동을 각 5분간, 총 30분간 무동력 트레드밀 보행훈련과 동력 트레드밀 보행훈련을 실시하였다. 대조군은 30분간 편 안한 속도로 평지 보행을 실시하였다. 모든 대상자는 1회 30분, 주 5일 4주간 총 20회 훈련을 실시하였고, 일반적인 물리치료를 1회 30분, 하루 2회, 주 5일 4주간 실시하였다. 훈련 전, 후 폐활량계 평가를 이용하여 폐 기능을 측정하였다. 디지털 근력계를 이용하여 마비측 엉덩관절 벌림근, 엉덩관절 폄근, 무릎관절 폄근, 무릎 관절 굽힘근, 발목관절 발바닥 굽힘근의 근력을 평가하였으며, Medical Research Council(MRC) 척도를 이용하여 하지 근력을 측정하였다. 균형 능력을 측정하기 위한 버그 균형 척도, 기능적 뻗기 검사와 일어서서 걷기 검사를 측정하고, 시·공 간적 보행능력을 측정하기 위한 보행분석기 평가를 이용하여 측정하였다. 그 결 과, 무동력 트레드밀 훈련군은 동력 트레드밀 훈련군과 대조군보다 노력성 폐활 량, 마비측 엉덩관절 벌림근, 엉덩관절 폄근, 무릎관절 굽힘근, 무릎관절 폄근, 발 목관절 발바닥 굽힘근, 버그 균형 검사, 일어서서 걷기 검사, 마비측 보장, 활보장, 비마비측 보장, 활보장, 비마비측 유각기, 마비측 단하지 지지기에서 실험 후 유의 한 효과를 확인할 수 있었다(p<0.05). 무동력 트레드밀 훈련군과 동력 트레드밀 훈련군은 대조군보다 MRC 척도, 기능적 뻗기 검사, 보행속도에서 실험 후 유의한 효과를 확인할 수 있었다(p<0.05). 무동력 트레드밀 훈련군은 대조군보다 마비측 유각기, 비마비측 단하지 지지에서 실험 후 유의한 효과를 확인할 수 있었다 (p<0.05). 본 연구의 결과 고강도 반복의 무동력 트레드밀 훈련이 호기근과 흉곽 확장을 통하여 최대산소 섭취량을 증가시켜 폐 기능이 증진하였고, 벨트의 저항을 이겨내기 위해 마비측 하지 근력이 증진하였으며, 증진된 마비측 하지 근력과 불 안정한 지지면에서의 훈련이 균형을 증진하여 보행능력을 증진한 것으로 사료된 다. 주요어 : 근육, 뇌졸중, 보행, 트레드밀 검사, 폐 기능 검사

목차 (Table of Contents)

• 감사의 글 i
• 국문요약vii
• I. 서론1
• A. 연구의 배경 및 필요성1
• B. 연구의 목적5
• C. 연구의 가설6
• D. 용어의 정의 7
• II. 문헌고찰 8
• A. 무동력 트레드밀 연구에 대한 동향 8
• B. 뇌졸중 환자의 동력 트레드밀과 폐 기능에 관한 연구16
• III. 연구방법23
• A. 연구설계23
• B. 연구의 대상 및 절차24
• C. 실험 방법 28
• D. 측정 도구와 자료 수집 과정34
• E. 변수의 선정 44
• F. 분석방법 45
• IV. 연구결과 46
• A. 연구 대상자의 일반적 특성과 동질성 검정 46
• B. 연구 대상자의 의학적 특성과 동질성 검정 48
• C. 폐 기능의 변화 50
• D. 하지 근력의 변화 53
• E. 균형능력의 변화 63
• F. 보행능력의 변화 68
• V. 논의84
• A. 훈련 방법에 대한 논의 84
• B. 폐 기능에 미치는 효과 87
• C. 하지 근력에 미치는 효과 91
• D. 균형에 미치는 효과 95
• E. 보행에 미치는 효과 99
• VI. 결론106
• 참고문헌 107
• Abstract 127
• 부록 1. 연구 참여 동의서 130
• 부록 2. 버그 균형 척도 평가지132
• 부록 3. 훈련 시스템의 구성138
• 부록 4. 평가 시스템의 구성142

참고문헌 (Reference)

1. Hemiparetic gait, Sheffler, L. R., & Chae, J, 26(4), 611-623, , 2015

2. Characteristics of gait in hemiplegia, Woolley, S. M., 7(4), 1-18, , 2001

3. Gait disturbances in patients with stroke, Balaban, B., Tok, F., 6(7), 635-642, , 2014

4. The role of leisure in stroke rehabilitation, Parker, C., Gladman, J., & Drummond, A, 19(1), 1-5, , 1997

5. Gait in stroke: assessment and rehabilitation, Malouin, F., Richards, C. L., Dean, C., 15(4), 833-856, , 1999

6. Muscle and joint function in human locomotion, Pandy MG, Andriacchi TP, 12, 401-433, , 2010

7. Gait analysis. Normal and pathological function, Perry, J., & Burnfield, J. M., 2nd ed, , 2010

8. A review of standing balance recovery from stroke, Geurts, A. C., De Haart, M., Van Nes, I. J., & Duysens, J, 22(3), 267-281, , 2005

9. Chest wall kinematics in patients with hemiplegia, Lanini, B., Bianchi, R., Romagnoli, I., Coli, C., Binazzi, B., Gigliotti, F., Pizzi, A., Grippo, A., & Scano, G., 168(1), 109-113, , 2003

10. Muscular activity in treadmill and overground running, Baur, H., Müller, S., Gollhofer, A., Mayer, F., Hirschmüller, A., 15(3), 165-171, , 2007

11. 한글화된 Berg 균형 검사법의 신뢰도 분석, 박진희, 황미령, 심재진, 김세현, 김명종, 정한영, 대한재활의학회지: 제, 30(6), , 2006

12. Kisner Therapeutic exercise: Foundations and techniques, LA, C., Kisner, C., 5th ed. Philadelphia, PA: FA Davis Company, p149, , 2007

13. Spinal cord infarction in a patient with sickle cell anemia, Rothman, S. M., & Nelson, J. S., 30(10), 1072-1072, , 1980

14. Aerobic Walking Exercise for Non-ambulatory Stroke Survivors, Alqahtani, A. S., University of Kansas, , 2019

15. Assessments of upper limb ability following stroke: a review, Rowland, T. J., & Gustafsson, L., 71(10), 427-437, , 2008

16. Distribution of muscle strength impairments following stroke, Bohannon, R. W., Andrews, A. W., Clinical Rehabilitation, 14(1), 79-87, , 2000

17. Gait post-stroke: Pathophysiology and rehabilitation strategies, Beyaert, C., Vasa, R., & Frykberg, G. E., 45(4-5), 335-355, , 2015

18. Improvements in speed-based gait classifications are meaningful, Schmid, A., Duncan, P. W., Studenski, S., Lai, S. M., Richards, L., Perera, S., & Wu, S. S., 38(7), 2096-2100, , 2007

19. MaximizingRelating an Individual’s Interventions Outcomes: Needs, Frownfelter, D., Dean, E., Cardiovascular and Pulmonary Physical Therapy: Evidence to Practice, 228, , 2012

20. Energy expenditure while walking on a Non-Motorized Curved Treadmill, Snyder, A., Weiland, N., Bednarek, J., Myatt, C., 25, S109, , 2011

21. Hemiplegic gait: a kinematic analysis using walking speed as a basis, Wagenaar, R. C., & Beek, W., 25(9), 1007-1015, , 1992

22. Efficacy of Interventions to Improve Respiratory Function After Stroke, Teixeira-Salmela, L. F., Nascimento, L. R., Alvarenga, M. T. M., Menezes, K. K., Avelino, P. R., 63(7), 920-933, , 2018

23. Reliability of power output derived from the nonmotorized treadmill test, Chia, M. Y., Lim, J. M., 21(3), 993-996, , 2007

24. Functional reach: predictive validity in a sample of elderly male veterans, Duncan, P. W., Studenski, S., Prescott, B., Chandler, J., 47(3), M93-M98, , 1992

25. Changing patterns of postural hip muscle activity during recovery from stroke, Wing, A. M., Jenner, J. R., Simpson, D. S., Kirker, S. G., 14(6), 618-626, , 2000

26. Comparison of VO2peak performance on a motorized vs. a nonmotorized treadmill, Morgan, A. L., Laurent, C. M., & Fullenkamp, A. M., 30(7), 1898-1905, , 2016

27. Reliability of measurements of muscle tone and muscle power in stroke patients, Sharma, A. K., Watkins, C. L., Smith, T. L., Moore, A. P., Leathley, M. J., Gregson, J. M., 29(3), 223-228, , 2000

28. A novel exercise for improving lower-extremity functional fitness in the elderly, Shigematsu, R., Okura, T., Aging Clinical and Experimental Research, 18, 242-248, , 2006

29. The timed Up Go: a test of basic fu nctional mobility for frail elderly persons, Podsiadlo D, Richardson S., 39(2), 142-148, , 1991

30. Measurement of paretic–lower-extremity loading and weight transfer after stroke, Mercer, V. S., Freburger, J. K., Chang, S.-H., Purser, J. L., 89(7), 653-664, , 2009

31. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review, Blum, L., Korner-Bitensky, N., 88(5), 559-566, , 2008

32. Respiratory muscle training for patients with chronic obstructive pulmonary disease, Reid, W. D., & Samral, B, 75(11), 996-1005, , 1995

33. Tactile stimulation promotes motor recovery following cortical injury in adult rats, Wegenast, W., Gibb, R. L., Kolb, B. E., Gonzalez, C. L., 214(1), 102-107, , 2010

34. Incidence of and risk factors for medical complications during stroke rehabilitation, Roth, E. J., Lovell, L., Harvey, R. L., Heinemann, A. W., Semik, P., & Diaz, S., 32(2), 523-529, , 2001

35. The role of proprioception in the management and rehabilitation of athletic injuries, Lephart, S. M., Giraido, J. L., Pincivero, D. M., Fu, F. H., 25(1), 130-137, , 1997

36. HEMIPLEGIC GAIT: Relationships between walking speed and other temporal parameters: 1, Roth, E. J., Merbitz, C., Mroczek, K., Dugan, S. A., & Suh, W. W., 76(2), 128-133, , 1997

37. Gait characteristics of post-stroke hemiparetic patients with different walking speeds, Tsuchiyama, K., Saitoh, E., Matsuda, F., Wang, Y., Yamada, J., Tanikawa, H., Ohtsuka, K., Otaka, Y., Mukaino, M., 43(1), 69-75, , 2020

38. The validity of endurance running performance on the Curve 3TM non-motorised treadmill, Stevens, C. J., Hacene, J., Wellham, B., Sculley, D. V., Callister, R., Taylor, L., & Dascombe, B. J, 33(11), 1141-1148, , 2015

39. Treadmill training is effective for ambulatory adults with stroke: a systematic review, Dean, C. M., Ada, L., Teixeira-Salmela, L. F., Polese, J. C., Nascimento, L. R., 59(2), 73-80, , 2013

40. Tectonic implications of post–30 Ma Pacific and North American relative plate motions, Bohannon, R. G., Parsons, T., 107(8), 937-959, , 1995

41. Investigating the reliability and validity of two balance measures in adults with stroke, Pal, J., Skinner, M., Hale, L., 12(7), 308-315, , 2005

42. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity, Sharp, S. A., & Brouwer, B. J, 78(11), 1231-1236, , 1997

43. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients, Oh, D.-S., Park, S.-E., 28(6), 1896-1900, , 2016

44. A Systematic review of effects and methods of treadmill training applied to stroke patients, Kim, J. J., Lee, J. W., 27(2), 63-79, , 2020

45. Therapeutic effects of functional electrical stimulation on gait in individuals post-stroke, Kafri, M., Laufer, Y., 43, 451-466, , 2015

46. Loss of strength contributes more to physical disability after stroke than loss of dexterity, Adams, R., Ada, L., Canning, C. G., O'Dwyer, N. J., 18(3), 300-308, , 2004

47. Effect of respiratory muscle training on respiratory function of patients with subacute stroke, Yu, C., Li, X., Lin, Q., Cheng, K., Cai, Y., Zhang, H., Zhao, Q., & Xia, P., 68(10), 735-739, , 2016

48. Decreased tidal volume may limit cardiopulmonary performance during exercise in subacute stroke, Sisante, J.-F. V., Mattlage, A. E., Arena, R., Rippee, M. A., & Billinger, S. A, 35(5), 334-341, , 2015

49. Effect of antigravity treadmill gait training on gait function and fall risk in stroke patients, Im, N., Ryu, S., Lee, Y., Cho, T., Oh, K., Yoon, S., Lim, N., 46(3), 114, , 2022

50. Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients, Do, H. K., Jo, G. Y., Choi, H. E., Lee, M. E., Kim, W. J, 41(3), 376-386, , 2017

51. Increased physiologic intensity during walking and running on a non-motorized, curved treadmill, Smoliga, J. M. Hegedus, E. J., Ford, K. R., 16(3), 262-267, , 2015

52. Muscles that influence knee flexion velocity in double support: implications for stiff-knee gait, Goldberg, S. R., Anderson, F. C., Pandy, M. G., & Delp, S. L., 37(8), 1189-1196, , 2004

53. Respiratory pressures and thoracoabdominal motion in community-dwelling chronic stroke survivors, Teixeira-Salmela, L. F., Parreira, V. F., Britto, R. R., Brant, T. C., Inácio, É. P., Alcântara, T. O., & Carvalho, I. F., 86(10), 1974-1978., , 2005

54. A comparison of both motorized and nonmotorized treadmill gait kinematics to overground locomotion, Laurent, C. M., Tolusso, D. V., Fullenkamp, A. M., Campbell, B. M., Cripps, A. E., 27(4), 357-363, , 2018

55. Assessment of Apple Watch Series 6 pulse oximetry and electrocardiograms in a pediatric population, Littell, L., Roelle, L., Dalal, A., Orr, W. B., Van Hare, G. F., Avari Silva, J. N., Miller, N., 1(8), e0000051, , 2022

56. The relative and absolute reliability of two balance performance measures in chronic stroke patients, Lee, S., Lo, S.-K., Lin, J.-H., Chen, H.-M., Liaw, L.-J., Hsieh, C.-L., 30(9), 656-661, , 2008

57. Transcranial magnetic stimulation (TMS) of the supramarginal gyrus: a window to perception of upright, Zee, D. S., Lasker, A., Kheradmand, A., 25(3), 765-771, , 2015

58. Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews, Lazzarini, S. G., Pollock, A., Arienti, C., Negrini, S., 14(7), e0219781, , 2019

59. Stimulation of human somatosensory cortex: tactile and body displacement perceptions in medial regions, Richer, F., Martinez, M., Robert, M., Bouvier, G., Saint-Hilaire, J.-M., 93, 173-176, , 1993

60. Systemic exercise-induced hypoalgesia following isometric exercise reduces conditioned pain modulation, Hoeger Bement, M., Vaegter, H. B., Alsouhibani, A., Pain Medicine, 20(1), 180-190, , 2019

61. The reliability and validity of short-distance sprint performance assessed on a nonmotorized treadmill, Highton, J. M., Nicholas, C., Twist, C., Lamb, K. L., 26(2), 458-465, , 2012

62. Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: a randomized controlled trial, Pohl, M., Mehrholz, J., Ritschel, C., & Ruckriem, S., 33(2), 553-558, , 2002

63. Peak cardiorespiratory responses of patients with subacute stroke during land and aquatic treadmill exercise, Han, E. Y, Lee, Y. K., Kim, B. R.,, 96(5), 289-293, , 2017

64. Effectiveness of water aerobics in improving chest mobility and pulmonary function in chronic stroke patients, Muralidharan, C., Kiruthika, K., Senthil, P., & Swathi, S., 42(3), 616-619, , 2022

65. Changes in three dimensional lumbo-pelvic kinematics and trunk muscle activity with speed and mode of locomotion, Saunders, S. W., Schache, A., Rath, D., & Hodges, P. W., 20(8), 784-793, , 2005

66. Evaluation of gait symmetry after stroke: a comparison of current methods and recommendations for standardization, Patterson, K. K., Gage, W. H., Brooks, D., Black, S. E., & McIlroy, W. E., 31(2), 241-246, , 2010

67. Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility, Nadeau, S., Pinet, H., Leroux, A., 85(10), 820-830, , 2006

68. Effects of aerobic training on physical activity in people with stroke: protocol for a randomized controlled trial, Martins, J. C., Faria, C. D. C. d. M., Britto, R. R., Nadeau, S., Aguiar, L. T., Teixeira-Salmela, L. F., Trials, 19, 1-8, , 2018

69. Functional electrical stimulation assisted cycling of patients with subacute stroke: kinetic and kinematic analysis, Szecsi, J., Krewer, C., Müller, F., & Straube, A, 23(8), 1086-1094, , 2008

70. Temporal, kinematic, and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach, Olney, S. J., Griffin, M. P., & McBride, I. D., 74(9), 872-885, , 1994

71. Functional gait of patients with stroke after strength training: a systematic review of randomised controlled trials, Himalowa, S., Mwansa, M. R., Kunda, R., 11, 144-158, , 2021

72. Magnitude and pattern of 3D kinematic and kinetic gait profiles in persons with stroke: relationship to walking speed, Eng, J. J., Kim, C. M., &, Gait & Posture, 20(2), 140-146, , 2004

73. Speed and temporal adaptations during nonmotorized treadmill walking in Parkinson disease and nondisabled individuals, Wang, J. C., Penn, I. W., Kuo, C. Y., Chuang, E., Sung, W. H., Chuang, T. Y., Lin, P. H., 42(2), 126-132, , 2019

74. High-intensity treadmill training and self-management for stroke patients undergoing rehabilitation: a feasibility study, Kuys, S. S., Paratz, J. D., Brauer, S. G., Ada, L., Pilot Feasibility Stud, 7(1), 215, , 2021

75. Reliability and validity of spirometry measurements in a paperless home monitoring diary program for lung transplantation, Finkelstein, S. M., Hertz, M., Snyder, M., Prasad, B., Edin, C., Wielinski, C., Lindgren, B., 22(6), 523-533, , 1993

76. Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly, Pijnappels, M., Van Dieen, J. H., Maganaris, C. N., Reeves, N. D., 18(2), 188-196, , 2008

77. Effect of Pulmonary Function Training with a Respirator on Functional Recovery and Quality of Life of Patients with Stroke, Sheng, Y., Peng, T., Xie, L., Liu, Z., Zhao, Q., Yang, D., Wei, H., Contrast Media Mol Imaging, 2022, 6005914, , 2022

78. The reliability of physiological and performance measures during simulated team-sport running on a non-motorised treadmill, Coutts, A. J., Sirotic, A. C., 11(5), 500-509, , 2008

79. Feasibility and trend of pulmonary function in a pilot trial of aerobic walking exercise in non-ambulatory stroke survivors, Alajam, R., Eickmeyer, S. M., Alqahtani, A. S., Vardey, R., Liu, W., Top Stroke Rehabil, 27(3), 190-198, , 2020

80. Effects of visual center of pressure feedback on postural control in young and elderly healthy adults and in stroke patients, de Haart, M., Geurts, A. C., Arts, I. M., Dault, M. C., Nienhuis, B., 22(3), 221-236, , 2003

81. Speed and temporal-distance adaptations during Non-Motorized Curved Treadmill walking in stroke and non-disabled individuals, Chuang, T. Y., Wu, S. H., Chang, Y. L., Wang, J. C., Sung, W. H., 53(6), 863-869, , 2017

82. Effects of body weight-supported treadmill training combined with ball-kicking on balance and gait of subacute stroke patients, Lee, E., Lee, S., Cho, J., 4(2), 73-78, , 2015

83. Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite®), Van Uden, C. J., & Besser, M. P., 5, 1-4, , 2004

84. Effects of treadmill training with optic flow on balance and gait in individuals following stroke: randomized controlled trials, Chung, Y., Hwang, S., Kim, Y., Kang, H.-K., 26(3), 246-255, , 2012

85. Effect of high aerobic intensity interval treadmill walking in people with chronic stroke: a pilot study with one year follow-up, Gjellesvik, T. I., Brurok, B., Hoff, J., Torhaug, T., & Helgerud, J, 19(4), 353-360, , 2012

86. Evidence for cognitive processes involved in the control of steady state of walking in healthy subjects and after cerebral damage, Regnaux, J., Smail, D. B., David, D., Daniel, O., Bussel, B., Combeaud, M., 19(2), 125-132, , 2005

87. Comparison of the 6-minute walk distance test performed on a non-motorised treadmill and in a corridor in healthy elderly subjects, Janaudis-Ferreira, T., Sundelin, G., Wadell, K., 96(3), 234-239, , 2010

88. Effects of various gait speeds on the latissimus dorsi and gluteus maximus muscles associated with the posterior oblique sling system, Yoo, W.-g., Shin, S.-j., Kim, T.-y., 25(11), 1391-1392, , 2013

89. Load effects of thigh wearable resistance on angular and linear kinematics and kinetics during non-motorised treadmill sprint-running, Nuell, S., Fosch, P., Diewald, S., Cronin, J. B., Forster, J., Macadam, P., Rowley, R., 21(4), 531-538, , 2021

90. Decreased respiratory muscle function is associated with impaired trunk balance among chronic stroke patients: a cross-sectional study, Lee, K., Lee, W., Hwang, D.-Y., Cho, J.-E., 245(2), 79-88, , 2018

91. Effects of inspiratory muscle exercise using biofeedback on inspiratory muscle activity and pulmonary function in patients with stroke, Yang, D.-J., Park, S.-K., Kang, J.-I., Kim, J.-H., & Kim, S.-Y, 27(5), 287-291, , 2015

92. Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: a pilot randomized controlled trial, Park, D., Lee, K., Lee, G., 28(5), 1200-1211, , 2019

93. Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review, Avelino, P. R., Menezes, K. K., Polese, J. C., Nascimento, L. R., Ada, L., Teixeira-Salmela, L. F., 62(3), 138-144, , 2016

94. Implementing the exoskeleton Ekso GTTM for gait rehabilitation in a stroke unit–feasibility, functional benefits and patient experiences, Høyer, E., Jørgensen, V., Opheim, A., Disability and Rehabilitation: Assistive Technology, 17(4), 473-479, , 2022

95. Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review, Sasaki, S., Yamamoto, R., Kuwahara, W., Kaneko, F., Kawakami, M., 19(1), 143, , 2022

96. Effects of lumbar joint mobilization on trunk function, postural balance, and gait in patients with chronic stroke: A randomized pilot study, Lee, J., Lee, S., Choi, W., 36(1), 79-86, , 2023

97. Comparison of the effects of core stabilization and chest mobilization exercises on lung function and chest wall expansion in stroke patients, Min, K.-O., Lee, J.-H., Park, S.-J., 29(7), 1144-1147, , 2017

98. Sprint running kinematics and kinetics in pre-peak-height-velocity male children on a non-motorised treadmill: reliability and normative data, Rumpf, M. C., Hughes, M., Oliver, J., Cronin, J., 18(3), 256-263, , 2019

99. Strength of the respiratory and lower limb muscles and functional capacity in chronic stroke survivors with different physical activity levels, Parreira, V. F., Polese, J. C., Britto, R. R., Pinheiro, M. B., Teixeira-Salmela, L. F., Faria, C. D., 17(5), 487-493., , 2013

100. Non-Motorized Curved Treadmill running is associated with higher cardiometabolic demands compared with overground and motorized treadmill running, Tofari, P. J., Cormack, S. J., Whyte, D. G., Edwards, R. B., Frontiers in Physiology, 8, 298274, , 2017

101. Tibial impacts and muscle activation during walking, jogging and running when performed overground, and on motorised and non-motorised treadmills, Dobson C, Montgomery G, Ditroilo M., Smith T, Abt G, Gait & Posture, 49, 120-126, , 2016

102. Respiratory muscle training improves cardiopulmonary function and exercise tolerance in subjects with subacute stroke: a randomized controlled trial, Sutbeyaz, S. T., Koseoglu, F., Inan, L., & Coskun, O, 24(3), 240-250, , 2010

103. The effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke: a pilot study, Guo, L.-Y., Yang, C.-C., Tanaka, T., Yen, C.-W., Lin, C.-M., Chang, K.-W., 18(5), 2376., , 2021

104. The influence of gait training combined with portable functional electrical stimulation on motor function, balance and gait ability in stroke patients, Kim, K., Lee, Y., 35(6), 1171-1178, , 2022

105. Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients, Hatta, T., Abe, M., Kishigami, H., Ukita, A., 15(4), e0231860, , 2020

106. High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial, Pedrinolla, A., Schena, F., Saltuari, L., Smania, N., Munari, D., Picelli, A., Gandolfi, M., 54(3), 408-418., , 2018

107. The effects of social media use on preventive behaviors during infectious disease outbreaks: The mediating role of self-relevant emotions and public risk perception, Han, C., Oh, S.-H., Lee, S. Y., 36(8), 972-981, , 2021

108. Cognitive and motor functioning in a patient with selective infarction of the left basal ganglia: evidence for decreased non-routine response selection and performance, Troyer, A. K., Black, S. E., Armilio, M. L., & Moscovitch, M., 42(7), 902-911, , 2004

109. Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: a randomized crossover study, Werner, C., Von Frankenberg, S., Treig, T., Konrad, M., & Hesse, S., 33(12), 2895-2901, , 2002

110. Combined effects of backward treadmill training and botulinum toxin type A therapy on gait and balance in patients with chronic stroke: A pilot, single-blind, randomized controlled trial, Gandolfi, M., Smania, N., Modenese, A., Munari, D., Disarò, J., Picelli, A., Filippetti, M., Serina, A., NeuroRehabilitation, 46(4), 519-528., , 2020

111. The effects of sit-to-stand training combined with real-time visual feedback on strength, balance, gait ability, and quality of life in patients with stroke: A randomized controlled trial, Lee, B.-H., Hyun, S.-J., Lee, J., 18(22), 12229, , 2021

112. Effects of gait training with a cane and an augmented pressure sensor for enhancement of weight bearing over the affected lower limb in patients with stroke: a randomized controlled pilot study, In, T.-S., Jung, K., Hur, Y.-G., Chung, Y., Cha, Y., Kim, Y., 29(2), 135-142, , 2015

113. The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial, Björklund, M., Möller, M. C., Borg, J., Bergqvist, M., Palmcrantz, S., 18(3), e0281212, , 2023