• PNF and Movement
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• v.15 no.3
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• pp.361-371
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• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• Physical Therapy Korea
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• v.21 no.2
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.59-66
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• 2017

PURPOSE: The purpose of this study was to determine the effects of postural control training on balance and walking ability in chronic stroke patients. METHODS: Eighteen chronic stroke patients were allocated equally and randomly to an experimental group (n=9) or a control group (n=9). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received a postural control training for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held five times per week for three weeks. Balance was assessed using Berg balance scale (BBS) and walking ability (gait speed, cadence, step length, and double limb support) 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 measured outcomes (p<.05). The experimental group exhibited greater improvement in the gait speed (p=.01; 95% CI .08-.16), cadence (p=.04; 95% CI .34-4.79), step length (p=.02; 95% CI 1.50-5.17), double limb support period (p=.04; 95% CI -2.18 to -.14), and BBS (p=.01; 95% CI 1.04-6.74) compared to the control group. CONCLUSION: The findings of this study suggest that postural control training may be beneficial for improving balance and walking ability of patients with chronic stroke.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.93-102
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• 2016

PURPOSE: The purpose of this study is to evaluate the functional effects of action observation plus functional electrical stimulation (FES) treatment on the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities, and stride lengths of stroke patients. METHODS: The subjects, who were all more than six months post stroke, were randomly divided into two groups of ten each: an experimental group and a control group. TETRAX (Tetrax Interactive Balance System) and GAITRite (GAITRite$^{TM}$ computerized gait analysis system) were measured at baseline, six weeks after treatment. Participants in both the groups received functional electrical stimulation treatment, but the experimental group was provided with additional action observation. Independent t-tests were used to compare the differences between the groups, and repeated measured two-way ANOVA was used to compare the interaction between the groups. RESULTS: The result of the interactions between the groups and the periods showed significant increases in the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities and stride lengths (p<0.05). However, a comparison between the groups showed no significance in the weight distribution indexes (heel and toe), stability indexes, and stride lengths (p>0.05). CONCLUSION: Action observation plus functional electrical stimulation treatment should be considered as a therapeutic method for physical therapy for stroke patients to improve the weight distribution indexes, stability indexes, gait velocities, and stride lengths.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.49 no.1
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• pp.20-28
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• 2012

Gait analysis is an examination which extracts objective information from observing human gait and assesses the function. The equipments used recently for gait analysis are expensive due to multiple cameras and force plates, and require the large space to set up the system. In this paper, we proposed a method to measure human gait motions in 3D from a monocular video. Our approach was based on particle filtering to track human motion without training data and previous information about a gait. We used dynamics to make physics-based motions with the consideration of contacts between feet and base. In a walking sequence, our approach showed the mean angular error of $12.4^{\circ}$ over all joints, which was much smaller than the error of $34.6^{\circ}$ with the conventional particle filter. These results showed that a monocular camera is able to replace the existing complicated system for measuring human gait quantitatively.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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• pp.49-58
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• 2013

PURPOSE: The purpose of this study was to determine if auditory cues velocity has a greater effect on the gait pattern of patients with Parkinson's disease (PD) than the cues applied individually. METHODS: The subjects were 15 elderly patients diagnosed with PD, 15 healthy elderly persons. Patients were measured of three conditions performed in random order: slow, general, fast. The auditory cue velocity consisted of a metronome beat ${\pm}20%$ than the subject's general gait speed. Using a motion analysis and a force platform measurement system, changes in spatiotemporal variables, kinetic and kinematic variables were compared to gait analysis. RESULTS: Comparison between the auditory cues velocity, there was a significant difference in the spatiotemporal variables with regard to the cadence, stride length, support time, step length, double support time (p<.05). Comparison between the auditory cues velocity, there was a significant increase general and fast velocity gait than slow velocity gait in the maximum flexion in swing phase of knee joint (p<.05). There appears to be the aspect of an increasing ground reaction force (GRF) on the first peak in the vertical axis (p<.05). CONCLUSION: Auditory cues velocity improved of spatio-temporal factors, kinematic and kinetic factors depending on the velocity of the faster. Therefore at the rehabilitation training of PD patients auditory cues velocity would be used for recovery and gait reeducation, may arise through the patients functional ability.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.89-98
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• 2018

PURPOSE: While underwater, patients with hemiplegia experience unwanted limb flotation on their paretic side due to low muscle mass and high body fat. However, only a limited number of studies support the effectiveness of this practice. Therefore, the purpose of this study was to determine how the balance and walking abilities of patients with hemiplegia due to stroke were affected by wearing an aquatic cuff on their ankles during underwater treadmill walking. METHODS: Twenty stroke patients were divided into an experimental group comprised of 20 patients who would wear an aquatic cuff and a control group comprised of 10 patients without an aquatic cuff. Both groups underwent a six-week intervention for 30 minutes a day three times a week. To evaluate the groups' balance and walking abilities before and after the intervention, the 10 m walking test, timed up go test, Berg Balance Scale, functional reaching test, and the GAITRite system were used. RESULTS: The results of the 10 m walking test, timed up go test, differences between the left and right gait cycles, and functional reaching test showed statistically significant differences in the rates of change between the two groups (p<.05). CONCLUSION: The study results suggest that underwater treadmill training in stroke patients can be more effective when they wear an aquatic cuff on their ankles compared to wearing no aquatic cuff.

• The Journal of Korean Physical Therapy
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• v.16 no.2
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• pp.54-62
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• 2004

The propose of this study was to evaluate the effect of body weight support treadmill training on the patients with chronic stroke. Body weight support(BWS) treadmill training has recently been shown to be effective for gait training following stroke, and few researchers have measured the usefulness of this intervention in enhancing function, and there are reports in which BWS overground ambulation was studied. This study were 1) to report the feasibility and patient tolerance for using a BWS system for treadmill ambulation, 2) to measure the function of patients with chronic stroke prior to and following BWS treadmill and overground ambulation training, and 3) to describe a protocol used for patient treatment progression using BWS treadmill training.

• Journal of the Korean Society for Precision Engineering
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• v.19 no.12
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• pp.38-44
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• 2002

A walking training robot is proposed to provide stable and comfortable walking supports by reducing body weight load partially and a force control of an arm of walking training robot using sliding mode controller is also proposed. The current gait training apparatus in hospital are ineffective for the difficulty in keeping constant unloading level and for the constraint of patients' free walking. The proposed walking training robot effectively unloads body weight during walking. The walking training robot consists of an unloading manipulator and a mobile platform. The manipulator driven by an electro-mechanical linear mechanism unloads body weight in various levels. The mobile platform is wheel type, which allows patients to walt freely. The developed unloading system has advantages such as low noise level, lightweight, low manufacturing cost and low power consumption. A system model fur the manipulator is established using Lagrange's equation. To unload the weight of the patients, sliding mode control with p-control is adopted. Both control responses with a weight and human walking control responses are analyzed through experimental implementation to demonstrate performance characteristics of the proposed force controller.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.1-9
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• 2020

PURPOSE: Many patients with stroke have difficulties in walking with foot-drop. Various types of ankle-foot orthoses (AFOs) have been developed, but their weight needs to be reduced with the assistance of the ankle dorsiflexor. Therefore, an elastic AFO (E-AFO) was devised that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study examined the effects of an E-AFO, on the walking patterns of foot-drop patients with stroke. METHODS: Fourteen patients walked with and without an E-AFO, and the gait parameters were assessed using the GAITRite system. The spatiotemporal data on the gait patterns of stroke patients with foot-drop were compared using paired t-tests; the level of statistical significance was set to α<.05. RESULTS: No significant differences were observed in the velocity (p=.066) and affecte+d step length (p=.980), but the affected and less-affected stance (p=.022, p=.002) and swing time (p=.012, p=.005) were significantly different. The E-AFO produced a significant difference in the less-affected step length (p=.032). CONCLUSION: The E-AFO has a significant effect on the walking patterns of individuals with foot-drop and stroke. The E-AFO could be a useful assistive device for gait training in stroke patients.