• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.63-73
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• 2021

Background: This study was conducted to investigate the effects of pressure belt during proprioceptive neuromuscular facilitation sprinter pattern training using a Thera-band on leg muscle strength and gait in stroke patients with stroke. Methods: Nine patients with stroke underwent training five times a week for four weeks, and changes in the muscle strength and walking ability of the paralyzed leg before and after training were measured. Muscle strength was measured using a Digital muscle tester, and walking ability was measured using a G-WAKER and the timed up and go (TUG) test. Results: Results showed that the quadriceps, hamstring, tibialis anterior, gastrocnemius, cadence, stride length, and stance phase significantly increased (p<.05). The swing phase, gait cycle duration, and TUG test results significantly decreased (p<.05). Conclusion: This study demonstrated that a pressure belt is a very useful tool for improving muscle strength and walking ability in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.293-302
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• 2012

Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.

• Physical Therapy Korea
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• v.20 no.1
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• pp.64-73
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• 2013

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

• Journal of Mechanical Science and Technology
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• v.17 no.6
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• pp.825-835
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• 2003

Previous studies have demonstrated the importance of joint angle errors mainly due to skin artifact and measurement errors during gait analysis. Joint angle errors lead to unreliable kinematics and kinetic analyses in the investigation of human motion. The purpose of this paper is to present the Joint Averaging Coordinate System (JACS) method for human gait analysis. The JACS method is based on the concept of statistical data reduction of anatomically referenced marker data. Since markers are not attached to rigid bodies, different marker combinations lead to slightly different predictions of joint angles. These different combinations can be averaged in order to provide a "best" estimate of joint angle. Results of a gait analysis are presented using clinically meaningful terminology to provide better communication with clinical personal. In order to verify the developed JACS method, a simple three-dimensional knee joint contact model was developed, employing an absolute coordinate system without using any kinematics constraint in which thigh and shank segments can be derived independently. In the experimental data recovery, the separation and penetration distance of the knee joint is supposed to be zero during one gait cycle if there are no errors in the experimental data. Using the JACS method, the separation and penetration error was reduced compared to well-developed existing methods such as ACRS and Spoor & Veldpaus method. The separation and penetration distance ranged up to 15 mm and 12 mm using the Spoor & Veldpaus and ACRS method, respectively, compared to 9 mm using JACS method. Statistical methods like the JACS can be applied in conjunction with existing techniques that reduce systematic errors in marker location, leading to an improved assessment of human gait.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.63-72
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• 2017

Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.

• Korean Journal of Applied Biomechanics
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• v.17 no.1
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• pp.111-119
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• 2007

The purpose of this study was to investigate muscle activity and gait pattern in lower limb depending on the outsole of heel rockers. Fifteen healthy men volunteered for this experiment. Each subject performed totally three trails with two pairs of different heel rocker shoes and a pair of normal running shoes at speed of 1.33m/s for 1 minute during walking on a treadmill. Kinematic data gathered in 100Hz was recorded and analyzed by using the 3D motion capture system to measure the trunk tilt and joint angle of the right lower limb. And the lower extremity muscle activities were simultaneously recorded in 1000Hz and assessed by using EMG. The statistical analysis was the one-way ANOVA with the repeated measures to compare among the three kinds of shoes. The level of statistical significance for all tests was 0.05. Joint angle of lower limb was showed statistically significant different in MST(hip joint), LHS(ankle joint), and RTO(knee and ankle joint). Muscle activity of rectus femoris and biceps femoris was statistically increased in both heel rocker shoes during gait cycle on treadmill. The maximum peak time of tibialis anterior in the negative heel rocker showed the delay of approximately 23.8%time than normal shoes. Gait pattern variability of the negative heel rocker was increased in the first half of the stance phase and the variability of the positive heel rocker was increased in the terminal stance phase. In Conclusion, stability was decreased in between joints of lower limb on positive heel rocker than negative heel rocker. This study found that there were different joint angle, muscle activity, gait pattern and coordinate system of the lower limb in each kind of shoes. These unstability affected the lower extremity and the whole body. A further study has to be continued with study of rehabilitation and exercise for a long-term.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.181-188
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• 2007

The purpose of this study was to investigate the biomechanical effects of wearing different type of insole shoes on gait characteristics in patients with knee osteoarthritis. Seven patients with knee osteoarthritis (Grade 3 & 4 by Kellgren & Lawrence) were participated in the study. They wore two different type of shoes (with Gel-type Insole: GIS, with Normal insole: NIS) during gait. Three dimensional cinematography and Ground Reaction Force(GRF) data were used to get the maximal value of horizontal distance between the center of pressure in GRF and knee joint center, GRF in mediolateral direction, peak value of GRF in frontal plane, vertical compressive force and adduction moment in knee joint. The results were as follows: The maximal value of horizontal distance between the center of pressure in GRF and knee joint center was smaller in GIS than NIS. The peak value of GRF in mediolateral direction was found in 30% of gait cycle, five subjects wearing GIS showed lower value of peak GRF in mediolateral direction than wearing NIS. The peak value of GRF in frontal plane and vertical compressive force in knee joint did not show any difference between GIS and NIS. The adduction moment in GIS decreased in the late stance of gait and the mean value of the adduction moment in GIS smaller than that in NIS. GIS may help to move quickly knee joint center to the center of pressure in GRF, therefore it may prevent increasing the adduction moment in knee joint.

• Journal of the Korea Safety Management & Science
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• v.11 no.2
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• pp.103-110
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• 2009

The purpose of this study is to suggest a proper tread of stairs using kinematic factors and moments of the lower-limb joints in the stair decent with the 3 different treads with boimechanical method in ergonomics. 9 subjects (body masses; $59.41{\pm}7.49$, $64.03{\pm}6.65$, $67.26:{\pm}7.58$, heights; $160.50{\pm}6.35$ ages; $31.22{\pm}2.99$; parity; $1.67{\pm}0.71$) participated in three experiments that were divided by physiological symptoms (the early (0-15 weeks), middle (16-27 weeks) and last (18-39 weeks). and they walked at self-selected pace on 4 staircases 3 trials. As extending the pregnancy period, cadence was shorter but cycle time were longer more and more. As extending treads of stair decent during pregnancy, speed, stride lengths and cycle time were increased. As extending the treads of stair decent, hip and ankle moments increased but knee moments decreased in sagittal plane. There were increasing or decreasing of moments by means of treads. These changes may account for relation between the treads of stair and moments in pregnant women. The main changes of pregnant women were joint moments and kinematic factors during pregnancy period because pregnancy makes them physical changes. It is possible that joints have connection with compensation each other to maximize stability and to control gait motion. In conclusion, we suggest that the tread of stair is longer than 26cm tread. and exercise programs to improve muscle activity were necessary where joint moments were small.

• The Journal of Korean Physical Therapy
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• v.22 no.2
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• pp.15-23
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• 2010

Purpose: This study was done to establish reference data for temporo-spatial, kinematic and kinetic parameters for normal Koreans as they age. Methods: Normal adults and children without a previous history of musculoskeletal problems were enrolled in this study. The normal subjects were divided by age into three groups: Group I: children ($11.95{\pm}0.29$ years); Group II: young adults ($23.90{\pm}3.67$ years); Group III: older adults ($71.40{\pm}4.08$ years). The temporo-spatial and kinematic data were measured using 6 MX3 cameras while each subject walked through a 10 m walkway at a self-selected speed. The kinetic data were measured using 2 force plates and were calculated by inverse dynamics. Results: Motion patterns are typically associated with a specific phase of the gait cycle. Our results were as follows: 1. There were significant differences between the different age groups in temporo-spatial parameters such as cadence, double support, time of foot off, stride length, step length, and walking speed. 2. There were significant differences between the groups in kinematic parameters such as range of motion (ROM) of the hip, knee and ankle in the sagittal plane, ROM of the pelvis, hip and knee in the coronal plane and ROM of the pelvis, hip and ankle in the transverse plane. 3. There were significant differences between the groups in kinetic parameters such as joint moments of force, joint mechanical power generation or absorption and ground reaction forces. Conclusion: The results of this study can be utilized (a) as a reference for kinematic and kinetic data of gait analysis in normal Koreans, and (b) as an aide in evaluating and treating patients who have problems relating to gait.

• Korean Journal of Applied Biomechanics
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• v.20 no.4
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• pp.387-393
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• 2010

The purpose of this study was to compare pregnant women's gait parameters and mechanical energies caused by changes in hormone levels and anatomical features such as body mass, body-mass distribution, joint laxity, and musculo-tendinous strength from pregnancy to postpartum. Ten subjects (height: $161{\pm}6.5cm$, mass: $62.7{\pm}10.4\;kg$, $66.4{\pm}9.3\;kg$, $68.4{\pm}7.7\;kg$, $57.2{\pm}7.7\;kg$) participated in the four times experiments (the first, middle, last term and after birth) and walked ten trials at a self-selected pace without shoes. The gait motions were captured with Qualisys system and gait parameters were calculated with Visual-3D. Pregnant women's gait velocities were decreased during the pregnancy periods, but increased after birth. Stride width and cycle time were increased during pregnancy, but decreased after birth. Thigh energy (77.4%) was greater than shank energy (19.06%) or feet (3.54%) about total energy of the lower limbs. Their feet (Left R2=0.881, Right R2=0.852) and shank (Left R2=0.318, Right R2=0.226) energies were significantly increased (positive correlation), but double limb stance time (DLST, R2=0.679) and body total energy (R2=0.138) were decreased (negative correlation) for their velocities. These differences suggest that thigh segment may be a dominant segment among lower limbs, and have something to do with gait velocities. Further studies should investigate joint power and joint work to find energy dissipation or absorption from pregnancy period to postpartum.