Effect of Underwater Gait Training with a Progressive Increase in Speed on Balance, Gait, and Endurance in Stroke Patients

PURPOSE: This study aimed to investigate the effect of progressive speed increase during underwater gait training on stroke patients' balance, gait, and endurance, as well as to compare the effects of underwater gait training and land gait training. METHODS: Subjects were randomly allocated into three groups. Underwater gait training group (n=10), land gait training group (n=9) and control group (n=9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. The patients were assessed before and after the experiment in terms of the Berg balance scale, characteristics of gait, and 6-minute walking test. RESULTS: The beneficial effect perceived in the speed increase underwater gait training (UGT) group was significantly greater than in the groups who were trained with speed increase land gait training (LGT) group, and the control group regarding the following aspects: the Berg balance scale, the affected step length, the affected stride length, and the 6-minute walking test (p<0.05). The LGT group showed a more significant effect on the Berg balance scale, the affected step length, the affected stride length, and the 6-minute walking test (p<0.05), compared to the control group. Furthermore, the UGT group showed a significantly greater effect on the gait speed when compared to the control groupb (p<0.05). CONCLUSION: This study shows that progressive UGT is effective in improving balance, gait, and endurance in stroke patients. Therefore, we believe that progressive UGT may be used as a method for general physical therapy in patients with stroke.

The Effect of Plank Exercises with Hip Abduction Using Sling on Trunk Muscle Activation in Healthy Adults

PURPOSE: The purpose of this study is to investigate the effects of healthy persons performing a plank exercise with hip abduction and use of sling on trunk muscle activity. METHODS: Twenty-three subjects participated in this study. Muscle activities of the multifidus, rectus abdominis, external oblique and internal oblique were assessed with electromyography (EMG) while the subjects performed 6 various types of plank exercises in random order. RESULTS: There was a significant difference in multifidus and internal oblique on the supported side and the multifidus, external oblique, and internal oblique on the elevated side (p<0.05), and differences in plank methods were significantly higher in the multifidus, rectus abdominis, external oblique, internal oblique of the supported side and the rectus abdominis, external oblique and internal oblique on the elevated side (p<0.05). In addition, post-hoc analysis of the various plank methods showed that muscle activity was significantly higher during the general plank exercise compared with the knee-supported-in-sling plank exercises (p<0.05), and was significantly higher with the ankle-supported-in-sling plank exercises compared with the general plank exercise. CONCLUSION: There was greater trunk muscle activity with plank exercises performed with the ankle-supported-in-sling and hip abduction plank exercises compared with the general or knee-supported-in-sling plank exercises. Through this study, various plank exercises have been discovered that can be selected at different intensities for core muscle training purposes based on trunk muscle strength.

A Comparison of Underwater Gait Training with Additional Weight Application and Over-ground Gait Training to Improve Balance and Lower Extremity Strength in Persons with Stroke

PURPOSE: This purpose of this study was to compare additionally applied weight underwater gait training and over-ground gait training to improve balance and lower extremity strength in stroke patients. METHODS: Subjects were randomly allocated into two groups. Underwater gait training group (n=10) and Over-ground gait training group (n=9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 6 weeks. All subjects were assessed with the Berg balance scale test, the timed up and go test, and the medical research council test pre and post in-tervention. A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set at p<0.05. RESULTS: The results showed that subjects in the underwater gait training group had a significantly increased Berg balance scale, timed up and go, and medical research council scores (p<0.05), and over-ground gait training group showed a significantly increased medical research council score (p<0.05) after intervention. The underwater gait training group showed a more significant improvement in medical research council, Berg balance scale and the timed up and go test scores compared to the over-ground gait training group (p<0.05). CONCLUSION: Findings of this study suggest that applying additional weight during underwater gait training improves lower extremity strength and balance in stroke patients. It' findings can contribute to the development of more efficient rehabilitation for stroke patients.