• PNF and Movement
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• 제16권3호
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• pp.355-363
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• 2018

Purpose: The purpose of this study was to obtain detailed and quantified data concerning the effects of plantarflexor muscle fatigue induced in the non-paretic side on the spatial and temporal gait parameters of the bilateral lower extremities during walking in stroke patients. Methods: This study was conducted on 20 patients with chronic stroke. The load contraction fatigue test was applied to induce muscle fatigue in the non-paretic plantarflexor muscle. Step length, stride length, double support, gait velocity and cadence, and functional ambulatory profile (FAP) score in the bilateral lower extremities were measured using a gait analysis system in order to investigate changes in temporal and spatial gait parameters caused by muscle fatigue on the non-paretic side. The statistical significance of the results was evaluated using a paired t-test. Results: A review of the results for gait parameters revealed a significant increase in double support (p<0.05) and a significant decrease in step length, stride length, gait velocity and cadence, and FAP score (p<0.05). Conclusion: These results indicate that the muscle fatigue in the non-paretic side of the stroke patients also affected the paretic side, which led to a decrease in gait functions. This implies a necessity to perform exercise or training programs in a range of clinical aspects not causing muscle fatigue.

• 대한물리의학회지
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• 제12권2호
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• pp.75-82
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• 2017

PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

• 대한물리치료과학회지
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• 제12권4호
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• pp.33-41
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• 2005

The purpose of this report was to describe the gait pattern and parameters of the complicated bilateral amputee with right transtibial and left tarsometatarsal amputation. Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed at pre and post-test. Treadmill Training with 15 degree, incline was practiced for 8weeks, 3times per week. In linear parameters, the Velocity, Stride length and Single limb support were increased than pre-test. but Cadence and Double limb support were less post-test than pre-test. In kinematics, the maximal pelvic tilt angle showed right side $21.87^{\circ}$, left side $20.67^{\circ}$ at pre-swing phase, and decreased as compared with pre-test. Especially, the inimal hip flexion angle showed right side $-6.83^{\circ}$, left side $1.52^{\circ}$ at pre-swing phase and increased as compared with pre-test. The maximal knee flexion angle disclosed right side $2.66^{\circ}$, left side $21.71^{\circ}$ at stance phase, and decreased as compared with pre-test. In kinetics, the hip extension moment on initial contact stage was right side 0.938NM/Kg, left side 0.09NM/Kg, which was impaired compared with normal person.

• 제어로봇시스템학회논문지
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• 제21권6호
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• pp.553-559
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• 2015

The purpose of this research is to develop a gait assistive device to enhance the gait stability and training efficiency of stroke patients. The configuration of this device is mainly composed of a motored wheel and a single cane whose lower end is attached to a motored wheel frame. A patient can feel haptic information from continuous ground contact from the wheel while walking through the grip handle. In addition, the wheeled cane can avoid using excessive use of the patient's upper limb for weight support and motivate the patient to use a paralyzed lower limb more actively. Moreover, the proposed device can provide intuitive and safe user interaction by integrating a force sensor and a tilt sensor equipped to the cane frame, and a switch sensor at the cane's handle. The admittance control has been implemented for the patient to change the walking speed intuitively by using the interaction forces at the handle. A hemi-paretic stroke patient participated in the walking assistive experiments as a pilot study to verify the effectiveness of the proposed haptic cane system. The results showed that the patient could improve walking speed and muscle activations during walking with a constant speed mode of the haptic cane. Moreover, the patient could maintain the preferred walking speeds and gait stability regardless of the magnitude of resistance forces with the admittance control mode of the haptic cane. The proposed robotic gait assistive device with a simple and intuitive mechanism can provide efficient gait training modes to stroke patients with high possibilities of widespread utilizations.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.7-12
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• 2014

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

• 대한정형도수물리치료학회지
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• 제22권1호
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• pp.9-15
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• 2016

Background: This study was conducted to investigate the effects of unstable modified wall squat exercises accompanied by abdominal drawing-in on the gait variables of healthy adults. Methods: The total number of subjects was 30, and 15 were randomly placed in the training group (TG) and 15 in the control group (CG). To determine the gait variables of TG and CG, step length difference (SLD) stance phase difference (STPD), swing phase difference (SWPD), single support difference (SSD), and step time difference (STD) were measured using OptoGait, a gait analysis system. Results: When the pre-intervention and post-intervention results of TG and CG were compared, statistically significant differences in SLD, STPD, SWPD, SSD and STD of TG were seen. Conclusion: Unstable modified wall squat exercises accompanied by abdominal drawing-in might help reduce the deviation between left and right gait variables during walking.

• 한국산학기술학회논문지
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• 제12권9호
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• pp.3834-3842
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• 2011

본 연구에서는 선천적으로 관절 느슨함과 낮은 근 장력을 갖고 있는 다운증후군아동 보행의 운동학적 특성을 알아보고자 한다. 특히 자료수집의 편리성과 재현성이 높고, 유용한 보행훈련도구로서 그 사용이 증가되는 추세인 트레드밀에서 보행을 실시하였다. 다른 중복장애가 없는 다운증후군 남자아동 10명을 대상으로 적외선카메라로 3차원 보행 자료를 수집하여 시공간적 변인과 운동학적 변인을 산출하여 이들의 보행특성을 분석하였다. 그 결과, 다운증후군아동들은 선천적인 근골격계 특성으로 인한 보행불안정성을 극복하기 위해 엉덩, 무릎, 발목관절 모두를 구부리고 걷는 구부정 걸음(crouch gait)형태를 보였으며, 모든 다리관절의 신전을 작게 하여 결과적으로 추진력이 자제하였다. 이는 더 크게 신체를 추진할수록 발뒤꿈치 착지 시에 체중수용의 부담이 증가하기 때문인 것으로 판단된다. 이 연구 결과는 다운증후군의 관절불안정성을 개선하기 위해 효과적인 근 골격계 강화훈련 프로그램을 마련하는데 유용한 자료를 제공할 것으로 기대되며, 다운증후군뿐만 아니라 선천적 또는 후천적 근골격계 장애를 개선하거나 극복할 수 있는 운동프로그램 개발에도 참고 자료가 될 것으로 예상된다.

• 한국생산제조학회지
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• 제22권3_1spc호
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• pp.587-592
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• 2013

Until recently, the primary users of wheelchairs were people with lower body disabilities. However, the number of patients recovering from accidents or surgery, as well as the number of elderly people using wheelchairs, is constantly increasing. This study examined the design and manufacture of standing and gait assist wheelchairs that assist temporary gait disturbed patients to take rehabilitation training and elderly people to engage in walking exercise. A kinematic analysis was used to select a drive motor and design a four-bar linkage mechanism for lifting the backrest vertically. Using a multibody dynamic simulation, detailed design was performed taking into consideration the spatial motion and partial interference, and the necessary push force and stroke of the linear actuator were also calculated. To ensure structural safety, the von-Mises equivalent stresses of the upper and lower brackets of the linear actuator were verified through a finite element analysis. The manufactured wheelchair was shown to operate successfully as intended, using the developed controller for the drive motors and linear actuator.

• Physical Therapy Rehabilitation Science
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• 제2권2호
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• pp.81-86
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• 2013

Objective: The objective of this study was to investigate the feasibility and effects of balance training using a newly developed elastic band orthosis (aider) for improvement of mobility and balance in chronic stroke patients. Design: Cross-sectional study. Methods: Ten patients with chronic hemiplegia participated in this study. There were six males and four females; two patients had right hemiplegia and eight had left hemiplegia. This study investigated the effect of the elastic band orthosis on balance and gait ability compared with bare foot condition. Gait parameters were measured using the opto-gait system for analysis of the spatial and temporal parameters of walking in stroke patients. In addition, balance ability in stroke patients was evaluated using the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Results: This study investigated the effect of the elastic band orthosis on balance compared with bare foot condition. The TUG and BBS showed significant improvement with use of the elastic band orthosis (p<0.05). Use of the Elastic band orthosis resulted in significantly improved velocity, cadence, less-affected step length, less-affected stride length, and less-affected single limb support in stroke patients (p<0.05). Conclusions: We demonstrated a significant improvement in dynamic balance and gait ability in chronic stroke patients using the elastic band orthosis. This orthosis may aid in prevention of spastic foot drop, leading to improvement of walking ability.

• The Journal of Korean Physical Therapy
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• 제27권6호
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• pp.407-412
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• 2015

Purpose: This study aimed to evaluate changes in the balance ability of patients whose head positions were altered due to stroke. Subjects were divided into three groups to determine the effects of the training on dynamic balance and gait. Methods: Forty-two stroke patients were enrolled. The Visual Feedback Training (VFT) group performed four sets of exercises per training session using a Sensoneck device, while the Active Range of Motion (ART) group performed eight sets per training session after receiving education from an experienced therapist. The Visual Feedback with Active Range of Motion (VAT) group performed four sets of active range of motion and two sets of visual-feedback training per session using a Sensoneck device. The training sessions were conducted three days a week for eight weeks. Results: The comparison of changes in dynamic balance ability showed that a significant difference in the total distance of the body center was found in the VFT group (p<0.05) and Significant differences were found according to the training period (p<0.05). The comparison of the 10 m walk test showed that the main effect test, treatment period and interactions between group had statistically significant differences between the three groups (p<0.05). Conclusion: Head-adjustment training using visual feedback can improve the balance ability and gait of stroke patients. These results show that coordination training between the eyes and head with visual feedback exercises can be used as a treatment approach to affect postural control through various activities involving the central nervous system.