• 대한정형도수물리치료학회지
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• 제28권1호
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• pp.71-80
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• 2022

Background: This study investigated the effect of robot-assisted arm training on muscle activity of arm and weight bearing in stroke patients. Methods: The study subjects were selected 20 stroke patients who met the selection criteria. 10 people in the robot-assisted arm training group and 10 people in the task-oriented arm training group were randomly assigned. The experimental group performed robot-assisted arm training, and the control group performed task-oriented arm training for 6 weeks, 5 days a week, 30 minutes a day. The measurement tools included surface electromyography and smart insole system. Data were analyzed using independent sample t-test and the paired sample t-test. Results: Comparing the muscle activity of arm within the group, the experimental group and the control group showed significant differences in muscle activity in the biceps brachii, triceps brachii, anterior deltoid, upper trapezius, middle trapezius, and lower trapezius. Comparing the muscle activity of arms between the groups, the experimental group showed significant difference in all muscle activity of arm compared to the control group. Comparing the weight bearing within the groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings and there were significant differences in anterior and posterior weight bearing. The control group showed significant difference only in the non-affected side weight bearing. Comparing the weight bearings between groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings compared to the control group. Conclusion: This study confirmed that robot-assisted arm training applied to stroke patients for 6 weeks significantly improved muscle activity of arm and weight bearing. Based on these results, it is considered that robot-assisted arm training can be a useful treatment in clinical practice to improve the kinematic variables in chronic stroke patients.

• 한국산학기술학회논문지
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• 제11권10호
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• pp.3658-3665
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• 2010

최근 고령화 사회로의 진입 및 장애 인구의 증가로 인해, 인간의 복지를 위한 자동화 시스템에 대한 수요가 늘고 있다. 특히 재활 자동화와 관련한 로봇 시스템은 환자 본인 및 치료 보조자에 대한 수고를 덜어주면서도 기존의 전통적인 재활효과에 상응하는 성과를 얻을 수 있을 것으로 기대되고 있다. 본 연구는 하지 근력이 약화된 사용자들의 신체 자중을 보상해줌과 동시에 정상인과 같은 패턴의 보행 훈련을 수행할 수 있는 모바일형 보행 재활 시스템을 제안하고자 한다. 특히, 자중보상 시스템은 신체의 자세 변화 특징을 반영하여, 기구학적인 분석을 통해 구현하였으며 보행 가이드를 위한 제어 알고리즘과 더불어 메인 컨트롤 시스템이 내장된 모바일 플랫폼에 통합 적용되었다. 이러한 모바일 플랫폼은 사용자의 보행 속도의지를 반영하는 UCS(User Command System)와 플랫폼 자체에 내장된 자율주행 알고리즘의 병합되어 운용되도록 고안되었으며, 본 논문에서는 보행 훈련시의 BWS(Body Weight Support)의 효과에 대한 검증에 집중하고자 한다. 이를 위해 인체의 근전도 신호를 측정할 수 있는 EMG(Electromyography) 센서를 활용하여, BWS 및 모바일로봇을 활용한 자중 보상 시의 피험자의 하지 근력 패턴을 측정 및 분석하여, 정상 보행자와의 차이점을 비교함으로서 본 연구의 타당성을 검증하였다.

• 재활치료과학
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• 제12권2호
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• pp.9-23
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• 2023

목적 : 작업치료 분야에서 편측무시 중재를 사용한 연구 중 단일대상연구를 적용한 문헌들의 내용과 특성을 확인하고, 중재 효과 및 질적 수준을 분석하기 위해 실시하였다. 연구방법 : 본 연구는 체계적 고찰이며, 2012년부터 2022년까지 최근 10년간 국내 학회지에 게재된 단일대상연구로 진행된 논문을 대상으로 하였다. 결과 : 논문 분석 결과 뇌졸중 환자를 대상으로 시행하였으며 중재제거설계가 7편으로 가장 많은 비율을 차지했고 2편이 복수 기초선 설계였다. 중재제거설계 중 4편이 ABA설계를 사용하였다. 편측무시에 적용한 중재 효과 크기를 분석한 결과 중재 효과 크기는 '매우 효과적인 중재'는 7회, '효과적인 중재'는 18회, '의심스러운 중재'는 5회, '비효과적인 중재'는 6회로 나타났다. 논문들의 질적 수준을 분석한 결과 높은 수준이 6편, 중간 수준이 3편으로 낮은 수준의 연구는 한 편도 없었다. 결론 : 연구 결과 편측무시 중재들은 불빛 자극, 로봇 보조 능동운동, 진동 자극 등 다양한 방법을 적용하고 있었다. 본 연구의 분석을 통해 임상에서 편측무시 환자에게 중재를 적용할 수 있을 것으로 생각된다.

• PNF and Movement
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• 제20권2호
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• pp.295-306
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• 2022

Purpose: This study aimed to investigate the effect of robot-assisted gait training on the active ranges of motion, gait abilities, and biomechanical characteristics of gait in patients who underwent lower extremity surgery, and to verify the effectiveness and clinical usefulness of robot-assisted gait training. Methods: This study was conducted on 14 subjects who underwent lower extremity surgery. The subjects participated in robot-assisted gait training for 2 weeks. The active ranges of motion of the lower extremities were evaluated, and gait abilities were assessed using 10-m and 2-min walk tests. An STT Systems Inertial Measurement Unit was used to collect data on biomechanical characteristics during gait. Spatiotemporal parameters were used to measure cadence, step length, and velocity, and kinematic parameters were used to measure hip and knee joint movement during gait. Results: Significant improvements in the active ranges of motion of the hip and knee joints (flexion, extension, abduction, and adduction) and in the 10-m and 2-min walk test results were observed after robot-assisted gait training (p < 0.05). In addition, biomechanical characteristics of gait, spatiotemporal factors (cadence, step length, and velocity), and kinematic factors (gait hip flexion-extension, internal rotation-external rotation angle, and knee joint flexion-extension) were also significantly improved (p < 0.05). Conclusion: The results of this study are of clinical importance as they demonstrate that robot-assisted gait training can be used as an effective intervention method for patients who have undergone lower extremity surgery. Furthermore, the findings of this study are clinically meaningful as they expand the scope of robot-assisted gait training, which is currently mainly applied to patients with central nervous system conditions.

• 대한물리의학회지
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• 제17권4호
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• pp.65-73
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• 2022

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

• PNF and Movement
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• 제21권1호
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• 대한방사선치료학회지
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• 제23권1호
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• pp.13-19
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• 2011

목 적: 체부 정위방사선치료 시 치료 효과 향상을 위해서는 병소 부위의 정확한 위치 파악과 함께 호흡에 의한 종양의 움직임을 최소화하는 것이 필수적이다. 이에 본 연구에서는 기존에 자체 개발하여 사용 중인 호흡운동 감소기구를 보다 사용이 편리하고 효과적이도록 개선하여, 체부 정위방사선치료에 있어서 임상 적용의 유용성을 평가하였다. 대상 및 방법: 자체 개발하여 사용 중이던 기존 호흡운동 감소기구의 장단점을 분석하여 재현성과 사용 정확도를 개선하였다. 그리고 개선된 호흡운동 감소기구를 체부 정위방사선치료에 활용하기 위한 유용성 평가 방법으로 첫째, 8명의 폐종양 환자에 대해 들숨(inhalation)과 날숨(exhalation) 상태에서 획득한 고속(spiral) 전산화단층촬영 영상을 통해, 호흡에 따른 종양 움직임을 3차원적으로 정량 분석하였다. 둘째, 선량 평가를 위해 EBT2 필름(Gafchromic, ISP, USA)을 장착할 수 있는 폴리에틸렌 팬텀과 3차원적 종양 움직임을 재현하기 위한 2축의 직교좌표 로봇(Cartesian Robot-2Axis, FARA RCM4H, Samsung Mechatronics, Korea)을 제작하였다. 그리고 전산화단층촬영에서 획득한 결과를 바탕으로 호흡운동을 재현하여, 등선량 곡선 및 2차원 등선량 프로파일을 분석하였다. 결 과: 벨크로 벨트로 제작된 사용이 편리하고 재현성이 우수한 호흡운동 감소기구를 개발하였다. 전산화단층촬영 영상으로 분석한 폐암환자의 호흡에 따른 3차원적인 종양의 움직임은 좌우, 전후, 두미측 방향에 따라 평균 3.2 mm, 4.3 mm, 13.0 mm로 나타났다. 팬텀과 직교좌표 로봇을 이용한 호흡에 의한 선량분포 특성변화의 결과로는, 치료계획 선량보다 방사선을 적게 받은 영역은 두미측 방향으로 각각 8.0%와 16.8%, 좌우측 방향으로 각각 8.1%와 10.9%로 후미측 방향의 선량 왜곡이 가장 크게 나타났고, 길이는 평균 4.2 mm이었다. 호흡주기에 따른 선량 왜곡의 변화는 크게 나타나지 않았다. 결 론: 본 연구를 통해 장기의 움직임을 최소화할 수 있는 사용이 편리하고 효과적인 호흡운동 감소기구를 개발하였다. 개발된 기구를 사용할 경우 평균 6 mm 정도의 CTV-PTV 마진을 사용하면 호흡에 따른 과소선량(underdose)을 극복할 수 있을 것으로 결과를 통해 확인하였다. 이로서 개발된 호흡운동 감소기구는 체부 정위방사선치료에 있어서 호흡동조 방법을 병행할 수 있는, 임상 적용이 용이한 효과적인 보조기구로 활용할 수 있을 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.195-203
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• 2013

Purpose: The purpose of this study was to determine the effect of early Robot-assisted training on gait ability, function and ADL in patients with stroke. Methods: 26 patients with stroke were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 13 patients in each group. All subjects received a routine physical therapy. The robot-assisted training was for 30 min in the case of the EG subjects. The assessment tools of this study involved the gait ability, balance ability, function and ADL. The measurements were recorded before the intervention and after the intervention. Results: EG subjects and CG subjects, the variables measured after the intervention significantly differed from gait ability, balance ability, function and ADL without the FMA (p<0.05). The FMA was only effective experimental group after intervention. Also, there were significant differences in gait ability, balance ability, function and ADL without the FMA at post-test between the 2 groups (p<0.05). Conclusion: The findings indicate that early robot-assisted training exerts a positive effect on gait ability, balance ability, function and ADL in patients with stroke. This result indicates the possibility of application of the early Robot-assisted training to the management for stroke patients. Further studies are required to generalize the result for this study.

• 대한화상학회지
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• 제23권2호
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• pp.31-36
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• 2020

Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR^® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1^st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

• 대한통합의학회지
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• 제10권1호
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• pp.91-99
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• 2022

Purpose : The goal of this study is to examine the effect of robot assisted gait training (RAGT) on the kinematic factors (temporospatial gait parameters, gait cycle ratio, and gait line length) of gait in stroke patients. Methods : The subjects of this study were 24 stroke patients selected by inclusion criteria. Participants were randomly allocated to two groups: robot assisted gait training (n=11) and general neurological physical therapy group (n=11). In the robot-assisted gait training group, robot-assisted gait training was mediated for 30 minutes a day in addition to general neurological physical therapy. The general neurological physical therapy group was mediated by general neurological physical therapy for 30 minutes a day in addition to general neurological physical therapy. The number of interventions was 5 times a week for 5 weeks. In order to compare the kinematic factors of walking between the two groups, gait analysis was performed before and after 5 weeks of training using the Zebris gait analysis system. Results : As a result of the gait analysis of the two groups, there were significant differences in temporospatial gait variables (step length, stride length, step width, step time, stride time), gait cycle ratio (swing phase, stance phase) and gait line length. However, there was no significant difference in the cadence (temporospatial gait parameters) in the robot assisted gait training group compared to general neurological physical therapy group. Conclusion : It is considered to be a useful treatment for stroke patients to promote the recovery of gait function in stroke patients. Based on the results of this study, continuous robot assisted gait training treatment is considered to have a positive effect on gait ability, the goal of stroke rehabilitation. In the future, additional studies should be conducted on many subjects of stroke patients, the kinematic factors of the legs according to the severity of stroke and treatment period, and the effect of gait training.