SUBJECTS AND METHODS
The participants in this study were fifteen hemiplegic
patients who had been diagnosed with stroke (Table 1) who
were receiving inpatient or outpatient treatment at hospital P
rehabilitation center. The following were the conditions for
inclusion in the study. The present study had a single-group
pre-post design. All the subjects participated in a four-week
six-method hip extensor strengthening exercise (HESE)
program. This program was performed by a therapist manipulating
the subjects for about half an hour a day in the
supine position, side-lying position, and prone position on
a treatment table. The HESE program comprised six steps:
1. Hip extension and posterior tilt movement;
2. Rotation extension movement of both the legs;
3. Hip joint and pelvis movement using a therapeutic ball;
4. Hip joint and pelvis movement using a therapeutic ball;
5. Hip joint extension muscle strengthening movement in
the side-lying position; and
6. Hip joint extension muscle strengthening movement in
the prone position.
The program was performed three times a week for four
weeks. Each session consisted of three sets of 15 performances
of the 6-step program lasting about half an hour,
with 30 seconds of relaxation time between the sets11)
. Each
participant was assessed by a physical therapist before and
after the intervention in order to examine its effects on gait
performance and stability. The 10-m walking velocity test
and the Berg Balance Scale (BBS) were used to evaluate the
changes in gait performance and stability. BBS is a widely
used clinical test which was developed to evaluate both
the static and kinetic balance abilities of stroke patients. It
consists of 14 assessment items: sitting to standing, standing
without support, sitting without support, standing to
sitting, transfers, standing with eyes closed, performing the
Romberg test with eyes open, reaching, turning and looking
over the shoulder, making 360° turn to the right and left, and
standing on one leg. Each item is scored from 1 to 5. It has
been shown that subjects with BBS scores >41 have a low
risk of fall, medium risk of fall for BBS scores of 21–40,
and high risk of fall for BBS scores of less than 20. BBS