• Journal of Biomedical Engineering Research
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• v.44 no.3
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• pp.190-203
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• 2023

The purpose of this study is to provide basic data to ensure the safety and essential performance of a Lower Extremity robotic assisted gait training system and to provide advanced technology and technical basis to the industry handling the system. Based on IEC 60601-1:2012/AMD2:2020 (Medical Electrical Equipment - General requirements for basic safety and essential performance of medical electrical equipment), IEC 62366-1:2015/AMD1:2020 (Medical devices - Part 1: Application of usability engineering to medical devices) and EN ISO 14971:2019 (Medical devices - Application of risk management to medical devices), the requirements for ensuring the safety and essential performance of the Lower Extremity robotic assisted gait training system were derived. Through the Delphi survey method and scenario analysis, which reflects the opinions and knowledge of experts in the fields of development, testing and review of technical documents, and quality assurance of medical devices, validity and reliability were conducted and obtained results with adequate content validity ratio (CVR; 0.7≤) and excellent reliability (Cronbach's α; 0.9≤). As a result, it was confirmed that the reliability and validity of the risk management process to ensure the safety and essential performance of the Lower Extremity robotic assisted gait training system are required a model can be established to provide measures to reduce risks according to the level of risk exposure caused by usage.

• Journal of Music and Human Behavior
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• v.7 no.2
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• pp.65-81
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• 2010

This single case study is to examine the gait parameter changes of a 12-year old patient with Cerebellar Astrocytomas using RAS in gait training program. Kinematic and temporospatial changes were analyzed using VICON 370 Motion Analysis System. A total of nine RAS gait training sessions was provided and each training program took 30 minutes. Gait analysis revealed that the patient showed improvement in cadence, velocity, stride length, and step length and improved the range of joint movements by showing gait patterns similar to normal distribution from a pathological pattern. This study showed possibilities to apply the RAS technique to the various population including clients with cerebellum damaged; however more further research should be done in this area.

• Physical Therapy Korea
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• v.25 no.2
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• pp.53-61
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• 2018

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

• Physical Therapy Rehabilitation Science
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• v.9 no.2
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• Physical Therapy Korea
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• v.19 no.3
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• pp.81-90
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• 2012

The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.6 no.2
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• pp.23-30
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• 2012

In this study, we developed a wireless rehabilitation auditory feedback gait training system for symmetrical weight-bearing in patient with CVA. The device consists of an instantaneous shoe equipped with two load-cell sensors. Auditory feedback can be applied according to the weight-bearing. For gait patterns analysis, cadence, walking velocity, stance/swing phase ratio and gait cycle were examined. The clinical test with six healthy volunteers and two hemiplegic patients was performed applying the auditory feedback system. Both normal subjects and hemiplegic patients were increased strength on weight-bearing in affected limb, walking velocity, and cadence after biofeedback device. Also, the stance time with weight-bearing was increased while the swing time was decreased in gait phase. It can be expected that by using the feedback system, the patient with lower limb disorder will be able to reach a better quality of weight-bearing during gait.

• PNF and Movement
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• v.18 no.1
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• pp.55-64
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• 2020

Purpose: The purpose of this study was to compare the strength and walking ability of chronic stroke patients following either proprioceptive neuromuscular facilitation (PNF) pattern training with pressure biofeedback units (feedback group) or PNF pattern training without pressure biofeedback units (control group). Methods: Eighteen participants with chronic stroke were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n = 8) and a control group (n = 10). They all received 30 minutes of neurodevelopmental therapy and PNF training for 15 minutes five times a week for three weeks. Muscle strength and spatiotemporal gait parameters were measured. Muscle strength was measured by hand-held dynamometer; gait parameters were measured by the Biodex Gait trainer treadmill system. Results: After the training periods, the feedback group showed a significant improvement in hip abductor muscle strength, hip extensor muscle strength, step length of the unaffected limb, and step time of the affected limb (p<0.05). Conclusion: The results of this study showed that proprioceptive neuromuscular facilitation pattern training with pressure biofeedback units was more effective in improving hip muscle strength and walking ability than the proprioceptive neuromuscular facilitation pattern training without pressure biofeedback units. Therefore, to strengthen hip muscles and improve the walking ability of stroke patients, using pressure biofeedback units to improve trunk stability should be considered.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.32-39
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• 2021

Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.

• PNF and Movement
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• v.4 no.1
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• pp.37-44
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• 2006

Purpose : Improved walking is a common goal after stroke. Although the neurodevelopmental intervention(PNF) is the most widely used approach in the walking training of hemiparetic subjects. There is little neurophysiological evidence for its presumed effects on gait symmetry and facilitation of paretic muscles during the therapeutic intervention. The study, therefore, investigated the immediate effects of gait entrainment by a PNF techniques. Methods : Included persons with stroke who were living in the community. Sixteen subjects were assigned to the experimental group participated in a measures design that evaluated the subjects with pre-treatment, post-treatment(8 weeks). Temporal-spatial parameter of gait were analysed for using the computerized GAITRite system. Intervention : Training for the experimental group was carried out 3 times a week for 8 weeks. The training sessions were comprised of 50 minutes of walking with pattern and techniques in PNF. Results : The experimental group had improvements in the functional walking ability after 8 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. The treatment group demonstrated significantly post-treatment test improvement in gait velocity, cadence and FAP. Post-treatment test scores were more significant than the pre-treatment score(p<0.05). Conclusion : The results of this study showed that the PNF exercise intervention can improve functional gait ability. This study provides evidence for the efficacy of PNF treatment at improving locomotor function in chronic stroke.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.273-278
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• 2019

Purpose: The purpose of this study was to investigate the effects of three-dimensional virtual reality horse riding simulator training using a head-mounted display on gait and balance in children with cerebral palsy. Methods: Ten children with cerebral palsy were randomly assigned to the horse riding simulator (HRS) group (n=5) or the horse riding simulator with virtual reality (HRSVR) group (n=5). To evaluate balance, center of gravity (COG) sway velocity and total sway distance of each group were assessed using the Wii balance board, and gait speed and stride length of each group were assessed using a gait analysis system. Results: Intra-group comparisons between pre- and post-intervention measures revealed that there were significant changes in all gait and balance variables such as stride length, gait velocity, COG sway velocity and COG sway distance in the HRSVR group (p<0.05). In the HRS group, there were significant changes in all variables except stride length (p<0.05). In addition, inter-group comparisons showed significant differences between the two groups in stride length, gait velocity and COG sway distance except COG sway velocity (p<0.05). Conclusion: The findings of this study suggest that horse riding simulator training combined with 3D virtual reality can be a new positive therapeutic approach for improving functional performance in children with cerebral palsy.