• 국제물리치료학회지
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• 제6권2호
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• pp.840-845
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• 2015

Improvement in functional gait is one of treatment goals in treatment of cerebral palsy children. This study intended to examine the effects of insoles for postural correction on gait in spastic cerebral palsy patients by investigating changes in gait temporal spatial parameters. As the subjects, 15 spastic bilateral cerebral palsy patients participated in this study. Temporal spatial parameters of gait were measured using GAITRite system under three gait conditions. Bare foot gait, gait in shoes, and gait in insoles for postural correction were conducted. In order to look at differences in temporal spatial parameters according to three gait conditions, repeated one way analysis of variance was conducted. As post hoc test, Bonferroni was conducted. A significant level was set at ${\alpha}=.05$. According to the result of this study, gait velocity, cadence, step length, stride length of the left lower extremity significantly changed. When the subjects put on customized insoles for postural correction, the effect was greatest. There were no significant changes in stance time, single support time, double support time, swing % of gait, and stance % of cycle. Therefore, gait with insoles for postural correction positively influenced functional gait improvement and will be able to be usefully employed for spastic cerebral palsy children as one of gait assistance devices.

• 대한정형도수물리치료학회지
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• 제28권1호
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• pp.9-17
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• 2022

Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.

• 대한물리의학회지
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• 제5권4호
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• pp.655-666
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• 2010

Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.

• 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.

• The Journal of Korean Physical Therapy
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• 제17권1호
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• pp.108-122
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• 2005

The gait training strategy in very important things for central nervous system(CNS) injury patients. There are many method and strategy for regaining of the gait who had CNS injury. A human being has central pattern generator(CPG) is spinal CPG for locomotion. It is a neural network which make the cyclical patterns and rhythmical activities for walking. Sensory input from loading and hip position is essential for CPG stimulation that makes the central neural rhythm and pattern generating structure. From sensory input, the proprioceptive information facilitate proximal muscles that controlled in voluntarily from cortical level and visual and / or acoustical information facilitate distal muscles that controlled voluntarily from subcortical level. Gait training method can classify that is functional level and structural level. Functional level includ level surface gait, going up and down the stair. It is important to facilitate a guide tempo in order to activate the central pattern generators. During the functional test or functional activities, can point out the poor period in gait that have to be facilitate in structural level. There are many access methods with patient position and potentiality. The methods are using of rhythmic initiation, replication and combination of isotonic with standing position. Clinically using it on weight transfer onto the stance leg, loading response, loading response and pre-swing, terminal stance, up and downwards stairs.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.13-16
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• 2005

Background: The purpose of this study is to investigate the effect of the intensive functional electrical stimulation(FES) on the improvement of the gait pattern of the chronic hemiplegic patients. Method: Six hemiplegic patients, who could walk independently but have equinovarus deformity during the gait cycle, participated in this study. The affected peroneus longus and tibialis anterior muscles of all subjects were stimulated for 2 weeks period (20 minutes duration, 6 times/day). We measured the activities (mean voltage) of those muscles during the walking, using dynamic EMG. Results: After treatment, there were significant improvements in the strength of peroneus longus and tibialis anterior muscles and the gait speed, but there was no interval change of the spasticity of plantar flexor. The mean voltages of two muscles are significantly increased in all the patients (p<0.05). Conclusion: The results showed that the intensive FES on affected peroneus longus and tibialis anterior muscles in chronic hemiplegic patients could be useful for the improvement of functional gait.

• 대한의용생체공학회:의공학회지
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• 제26권3호
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• pp.145-150
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• 2005

A new gait detection system using both FSR (force sensing resistor) sensors and a gyrosensor was developed to detect various gait patterns. FSR sensors were put in self-designed shoe insoles and a gyrosensor was attached to the heel of a shoe. An algorithm was also developed to determine eight different gait transitions during four gait phases: heel-strike, foot-flat, heel-off and swing. The developed system was evaluated from nine heathy mans and twelve hemiplegic patients. Healthy volunteers were asked to walk in various gait patterns: level walking, fore-foot walking and stair walking. Only the level walking was performed in hemiplegic patients. The gait detection system was compared with a optical motion analysis system and the outputs of the FSR sensors. In healthy subjects, the developed system detected successfully more than $99\%$ for both level walking and fore-foot walking. For stair walking, the successful detection rate of the system was above$97\%$. In hemiplegic patients, the developed system detected approximately 98% of gait transitions. The developed gait phase detection system will be helpful not only to determine pathological gait phases but also to apply prosthetics, orthotics and functional electrical stimulation for patients with various gait disorders.

• 한국정밀공학회지
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• 제21권10호
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• pp.196-203
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• 2004

In this study, a new gait phase detection system using both FSR(Force Sensing Resister) sensors and a gyrosensor was developed to detect various gait patterns. FSR sensors were put in self-designed shoe insoles and a gyrosensor was attached to the posterior aspect of a shoe. An algorithm was also developed to determine eight different gait transitions among four gait phases: heel-strike, foot-flat, heel-off and swing. The developed system was compared with the conventional gait phase detection system using only FSR sensors in various gait experiments such as level walking, fore-foot walking and stair walking. In fore-foot walking and stair walking, the developed system showed much better accuracy and reliability to detect gait phases. The developed gait phase detection system using both FSR sensors and a gyrosensor will be helpful not only to determine pathological gait phases but to apply prosthetics, orthotics and functional electrical stimulation to patients with gait disorders.

• 대한물리치료과학회지
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• 제4권4호
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• pp.539-548
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• 1997

The purpose of this study was to determine the effects of FES on the clinical test patients who had disturbance gait due to cereberal vascular accident. The subjects for study were 16 hemiplegic patients (9 Male and 7 Female) who can gait with or without device. Their average age was 55 and they received average of 20.19 month of treatment collected data analysis was completed by using one-way analysis variable(ANOVA), Pearson ($-1{\leq}r{\geq}1$). The results were as follows : 1) There was difference in four variable (stride length,gait speed,gait cadence) between at the biginning and at the end of the treatment of FES (p<0.01). 2) There was relationship in capacity of activity between MAS and stride length (r = 0.751), gait speed (r = 0.689) but no relationship gait cadence (r = 0.236). 3) Age revealed relationship of stride length (r = -0.727), gait speed (r = -0.725), gait cadenc (r = -0.362). 4) There was no relationship in months post-CVA with MAS (r = 0.171), stride length (r = -0.110), gait speed (r = -0.096), gait cacedce (r = -0.154).

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.320-324
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• 2015

Purpose: The purpose of this study was to provide methods for assessment of functional balance through study of correlation with the weight bearing ratio, functional balance, and functional gait on patients with stroke. Methods: Thirty-nine patients with stroke participated in this study. The timed up and go test was used to measure balance and the functional ambulation category test to measure functional gait. Weight bearing was measured in the quiet standing posture and weight bearing in the quiet standing posture immediately after performing the standing-task. Results: Both timed up and go test and functional ambulation category test showed significant correlation with balance in the quiet standing posture immediately after performing the standing task. Conclusion: Measurement of balance in the quiet standing posture immediately after performing the standing-task was considered a meaningful scale for measurement of both balance function and gait function of patients with stroke.