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KMID : 1034620130030010048
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Korean Journal of Neuromuscular Rehabilitation
2013 Volume.3 No. 1 p.48 ~ p.56
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Community Ambulation: Ultimate Goal for Therapeutic Planning and Clinical Decision-making in Stroke Rehabilitation
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Oh Duck-Won
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Abstract
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The recovery of walking function may be one of main issues in stroke rehabilitation, and in such reason, most clinicians make every effort to improve walking function in their own ways with great care.
Given that community reintegration and social participation is the highest therapeutic goal in stroke rehabilitation, community ambulation should be recognized as a fundamental element for comprehensive therapeutic approaches to return the patients to premorbid life. This study aimed to demonstrate a variety of factors to establish therapeutic strategies for optimizing the performance of movement skills in the requirement of community ambulation and to place emphasis on clinical reasoning of community ambulation and important attitude in therapists’ decision making by reviewing literatures. The findings of recent studies support the effectiveness of walking training in real world for improving the ambulation skill of patients with post-stroke hemiparesis. Although it may not be actually easy to incorporate additional therapeutic efforts to increase activity level in community into the rehabilitation process of stroke patients who need long-term management service, community ambulation should be included as integral part of stroke rehabilitation, considering that community activities influence greatly on their physical function and quality of life. It requires clinicians’ recognition of community ambulation skill for the patients and a full consideration of skill performance in community environment to create beneficial treatment plan in stroke rehabilitation. Thus, study effort should be focused on exploring more favorable training methods to achieve successful community ambulation, ultimate goal in stroke rehabilitation. It will provide the critical basis to develop the feasibility of patient-centered approaches in stroke rehabilitation.
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KEYWORD
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Community ambulation, Stroke, Walking training
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