Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on strength, proprioception, and walking ability in persons with stroke. Design: Randomized control trial. Methods: Twenty eight subjects participated in the study in which they were randomly assigned to either the underwater backward treadmill training (UBTT) group (n=13) or the BTT group (n=15). In both groups, forward gait training was performed for 20 minutes on the ground treadmill. The UBTT group performed backward gait on an underwater treadmill for 20 minutes while the BTT group performed backward gait on a ground treadmill for 20 minutes. The gait training in each group was performed twice a week for a total of six weeks. Muscle strength, proprioception, and gait ability was assessed using a digital power meter, joint angle recurrence method using the smartphone protractor application, the Figure-of-Eight walk test (F8W) and the functional gait assessment (FGA) respectively. Results: Both groups showed significant improvement in strength, F8W and FGA scores after training (p<0.05). However, there was no statistically significant difference between the two groups. Both groups showed significant improvement in proprioception after training (p<0.05). In the comparison between the two groups, there was a greater significant change in the UBTT group for joint proprioception (p<0.05). Conclusions: In this study, it was found that both backward treadmill gait training programs were effective on strength, proprioception, and gait ability, and that underwater training was particularly effective on proprioception compared to ground training.

Balance is the foundation for all active daily livings. Evaluation of balance has been conducted to measure postural sway of center of pressure(COP). The purpose of this study is to introduce the Balancia and to examine the validity and inter-, intra-reliability for measure of balance with stroke patients. COP was measured by Wii balance board. The subjects Participated in this study were 39 stroke patients. Intra-and inter-reliability was examined using intraclass correlation coefficient(ICC) with 95% confidence interval. In the result of intra-and inter-reliability, all COP parameters of postural sway showed high to very high reliability with ICC=.793-.939 and ICC=.791-.955. Validity was determined by correlation with Accusway force plate. There were high validity with ICC=.851-.955 between tools. According to these results, the Balancia showed high validity and reliability. It is a useful clinical tool for evaluating balance in stroke patients.

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cutoff values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cutoff point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

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The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk