• 대한물리치료과학회지
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• 제10권2호
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• pp.42-52
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• 2003

An assessment of the subtalar joint in cerebral palsies can contribute to predict the function of ambulation in CP children. Ambulation is one of the most important function to guarantee the CP children independent life. This paper is to investigate some relationships between the function of standing and walling and the assessment of the subtalar joint in children with Cerebral palsy. And also to present the correlation between the ambulation and the Gross Motor Function Measures in children with cerebral palsy. Sixty-eight children with cerebral palsy were participated in this study. Evaluations of the subtalar pint parameters were performed by the goniometer and the angle finder, and the GMFM scores were measured by their teacher and researcher trained technically. A regression analysis was applied to figure out the relationship between the subtalar pint parameters(ROM and RCSP) and the function of standing and walking. A correlation analysis was employed to see how much the subtalar pint parameters could be predicted from GMFM scores in walling and standing. The results were as follows: 1) The significant differences were not observed between the total ROM, RCSP and the function of standing(F=8.065, p<.001) and walking(F=6.511, p<.001) in CP children. 2) The subtalar pint parameters(total ROM, RCSP) have the lower relevance to the function of standing and walling in CP children.(p>.05) 3) The total ROM and RCSP in both feet have the significant differences between the CP children and the normal children.(p<.001) 4) The GMFM scores were significantly correlated with the function of walling and standing in CP children.(r=247, p<.05) In this research, it is found that the significant relevance between the quantitative analysis of subtalar pint in children with cerebral palsy and the gross motor function of ambulation in standing and walling. However, it is difficult to predict the direct relationship of subtalar pint parameters and the function of ambulation, because subtalar pint scores and GMFM are only measured as quantities not qualities. Therefore, it is more reasonable to investigate the influence of subtalar pint parameters on ambulation in children with cerebral palsies, adding to the multifocal assessment of the children, rather than vice versa.

• 대한물리의학회지
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• 제13권1호
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• pp.137-146
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• 2018

PURPOSE: This study examine the effect of community ambulation training on gait, depression and self - efficacy of stroke patients in order to develop more effective training methods of community rehabilitation. METHODS: In the experimental group, community ambulation training combined with indoor and outdoor walking was performed for 30 minutes three times a week for six weeks. In the control group, general indoor walking training was performed. The physical factors were assessed by a 10-meter walking test, six-minute walking test and community gait test. Psychological factors were assessed by the Korean version of the Epidemiology Center Depression Scale and Activity-Specific Balance Confidence Scale. RESULTS: In the 10-meter walking test, the normal walking speed was significantly improved after the intervention in both the experimental group and the control group (p<.05). However, the fast walking speed was significantly improved only in the experimental group (p <.05). ln the community gait test, the experimental group showed significant improvement (p<.05), but the control group did not. Depression and self-efficacy were significantly improved in the experimental group (p<.05) but not in the control group. CONCLUSION: Community ambulation training may improve the gait ability of stroke patients and reduce their depression and improve self-efficacy.

• 기본간호학회지
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• 제13권2호
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• pp.249-256
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• 2006

Purpose: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. Method: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. Results: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. Conclusion: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

• 대한물리의학회지
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• 제1권1호
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• pp.1-12
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• 2006

Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.

• 대한간호
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• 제9권3호통권47호
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• pp.22-27
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• 1970

• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.136-139
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• 2014

Purpose: The purpose of this study will demonstrate that relationship between scoliosis and gait factor and foot weight bearing in ambulation. Methods: Subjects were 40 elementary students. A normal control group consisted of a total of 20 children without any known musculoskeletal disorders and an AIS group of 20 children with mild AIS (defined by a Cobb angle between 10 and $25^{\circ}$) were recruited. Measurements were scoliometer screening test, Cobb angle, gait parameter (rate of swing/stance phase, gait velosity), foot weight bearing (entire, fore, hind). Results: Scoliometer screening test (P = 0.000) and X-ray Cobb angle (P = 0.000) significant difference of group which was significantly higher in the AIS group. Gait parameter not showed significant difference. Forefoot weight bearing was significantly higher in the AIS group than more normal group. Conclusion: It seems that the results of weight bearing analysis in ambulation may be used in modifying rehabilitation programs for individual needs of patients with idiopathic scoliosis.

• 대한물리치료과학회지
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• 제18권2호
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• pp.17-28
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• 2011

Purpose: The aim of this study was to ascertain the effects of the lower extremity muscle strengthening exercise on balance and ambulation of children with cerebral palsy. Methods: 10 subjects who participated in this research undertook the 12-week the lower extremity muscle strengthening exercise program, which consisted of a series of mat exercises and sling exercises. The statistical significances were examined by using Wilcoxon signed-rank test, a non-parametric test, for evaluating the improvement of balance and ambulation of the subjects. In order to evaluate the correlation among the variables, Pearson's correlation coefficients were also calculated. In all statistical analyses the significance level was selected as ${\alpha}$=0.05. Results: Berg balance scale(BBS) was significantly increased after the intervention(p<.05). Percentage weight bearing(PWB) was decreased after the intervention, but there was no significant difference. Time up and go test(TUG) value was significantly decreased(p<.05). Gait velocities was increased after the intervention, but there was no significance. Stride length, step lengths of the affected side and the sound side were significantly increased after the intervention(p<.05). In the correlation analyses of the measures before the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). In the correlation analyses of the measures after the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). BBS revealed significant positive correlations to stride length, step lengths of the sound side and the affected side(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). Conclusion: Based upon the outcomes as above, it is likely that the muscle strength exercises have substantial effects on balance and ambulation of children with cerebral palsy. Thus various lower extremity muscle strengthening exercise programs are required to be studied and developed in order to contribute to functional improvements of children with cerebral palsy.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.1-9
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• 2017

Background: The method of measuring the walking function of patients with chronic stroke differs depending on patients walking capability and environmental conditions. Objects: This study aimed to demonstrate the influences of walking capacity and environmental conditions on the results of short- and long-distance walk tests in patients with chronic stroke. Methods: Forty patients with chronic stroke volunteered for this study, and allocated to group-1 (<.4m/s, household walking, $n_1=13$), group-2 (.4~.8m/s, limited community ambulation, $n_2=16$), and group-3 (>.8m/s, community ambulation, $n_3=11$) according to their walking capacity. The 10-meter walk test (10MWT) and 6-min walk tests, (6MWT) were used to compare the short- and long-distance walk tests results, which were randomly performed under indoor and outdoor environmental conditions. Results: The comparison of the results obtained under the indoor and outdoor conditions revealed statistically significant differences between the groups in the 6MWT and 10MWT (p<.05). Post-hoc tests' results showed significant differences between groups-1 and -2 and between groups-1 and -3 in the 10MWT, and between group-1 and -3 in the 6MWT. Furthermore, in group-2 the 10MWT and 6MWT results significantly differed between the indoor and outdoor conditions, and the values measured under the indoor and outdoor conditions significantly differed between 10MWT and 6MWT (p<.05). Group-3 showed a significant difference in 10MWT results between the indoor and outdoor conditions (p<.05). Conclusion: These findings suggest that the results of the short- and long-distance walk tests may differ depending on the walking capacity of patients with chronic stroke and the environmental condition under which the measurement is made, and these effects were greatest for the patients with the limited community ambulation capacity.

• 대한통합의학회지
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• 제4권4호
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• pp.67-75
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• 2016

Purpose: The purpose of this study was to compare Hip-Knee-Ankle(HKA) angle and muscle activation ratio between vastus medialis(VM), rectus femoris(RF), and vastus lateralis (VL), and by this, to examine their relationship. It is aimed to explore how the activation ratio among the muscles involved in patellofemoral kinetics would vary in relation with the frontal alignment of the lower extremity. Subjects and Methods: 26 healthy subjects were recruited for the study. The HKA angles were measured with radiograph. The VM, RF, VL muscle activation level were measured by surface electromyography while each participant performed 4 different types of movement (isometric knee extension, squat, ambulation, step-up) and VM/RF, VM/VL, RF/VL ratios were calculated. Pearson correlation was used to estimate the relationship between the HKA angle and the muscle ratio. Results: There was significant moderate correlation between HKA angle and VM: RF on the left side during ambulation (p<0.05). Moderate correlations were also observed during step-up and squat with less significance (p<0.1). Conclusion: The frontal alignment of the knee measured by the HKA angle was conditionally associated with muscle activation ratio between VM and RF (VM:RF); On the left, during ambulation, step-up, and squat, the more valgus knee tended to correlate with the more VM muscle activation ratio, which is expected to induce more stabilizing effect to the patella and its tracking. It suggests that the frontal alignement measured by the HKA-angle can affect PF kinetics. It also indicates a possibility that increase in valgus alignment of the knee, by the HKA measurement, may not act unfavorably to generate PFP.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.562-570
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• 2014

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.