In this study, we developed an active controlled ankle-foot orthosis(AAFO) which can control the dorsiflexion/plantarflexion of the ankle joint during gait to prevent foot drop and toe drag for paralysis patients. To prevent dropping foot after heel strike, ankle joint was actively controlled to minimize forefoot collision with the ground. It was also controlled to provide toe clearance and to help push-off during late stance. The 3D gait analysis was performed on two healthy subjects equipped with the developed AAFO to compare with the normal gait and the conventional AFO gait. In the developed AAFO gait, differently from the conventional AFO gait, significant push-off was observed during pre-swing and the maximum flexion moment during pre-swing phase was similar to that of normal gait. A remarkable dorsiflexion also occurred during initial swing. These results indicated that the developed AAFO could have certain clinical benefits to prevent foot drop for paralysis patients, compared to conventional AFOs.
Purpose: This study was conducted in order to investigate the kinematic gait parameter of lower extremities with different gait conditions (level walking, stair, ramp) in hemiplegic patients. Methods: Ten hemiplegic patients participated in this study and kinematic data were measured using a 3D motion analysis system (LUKOtronic AS202, Lutz-kovacs-Electronics, Innsbruk, Austria). Statistical analysis was performed using one-way repeated measure of ANOVA in order to determine the difference of lower extremity angle at each gait phase with different gait conditions. Results: Affected degree of ankle joint in the heel strike phase showed significant difference between level walking and climbing stairs, and toe off phase showed significant difference between level walking and climbing stairs, ramps, and climbing stairs. Affected degree of knee joint showed no significant difference in all attempts. Affected degree of hip joint in the toe off phase showed significant difference between level walking, ramps and stairs, and climbing ramps. Swing phase showed significant difference between sides for level walking and stairs, climbing ramps. Affected ankle joint of heel strike and toe off, and affected hip joint of toe off and the maximum angle of swing phase in the angle was increased. Unaffected side of the ankle joint, knee joint, and hip joint showed a significant increase in walking phase. Conclusion: These findings indicate that compared with level walking, different results were obtained for joint angle of lower extremity when climbing stairs and ramps. In hemiplegia patient's climbing ramps, stairs, more movement was observed not only for the non-affected side but also the ankle joint of the affected side and hip joint. According to these findings of hemiplegic patients when climbing stairs or ramps, more joint motion was observed not only on the unaffected side but also on the affected side compared with flat walking.
Journal of Korea Entertainment Industry Association
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v.14
no.3
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pp.363-373
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2020
The purpose of this study was to improve the gait ability and quality of life of stroke patients by combining virtual reality technology and a visual feedback gait training program with entertainment elements. Ten stroke patients with circumduction gait were selected. The visual feedback treadmill gait training program using virtual reality technology and a force plate measurement system was conducted 30 minutes a day, 5 days a week, with 25 sessions in 5 weeks. To investigate the effects of this gait training program, evaluations using the joint range-of-motion test, muscle activity tests, Berg balance scale (BBS), gait analysis, and stroke-specific quality-of-life scale (SS-QOL) were performed before and after intervention. Statistically significant differences were found in the joint range of motion and muscle activity of the affected side from the initial swing phase to the mid-swing phase of the gait cycle, dynamic balance, gait function, and quality of life (p <0.05). The results of this study indicate that the gait training program improved the foot drop, muscle activity, dynamic balance, and gait ability of stroke patients with circumduction gait, thereby improving the quality of life of the patients. Therefore, we recommend the application of the visual feedback treadmill gait training program using virtual reality technology and a force plate measurement system to improve gait ability and quality of life of stroke patients with circumduction gait.
Journal of The Korean Society of Integrative Medicine
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v.8
no.1
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pp.203-217
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2020
Purpose : This study aimed to determine whether task-oriented trunk training can improve muscle strength, muscle activity, balance, and gait in stroke patients. Methods : A total of 27 stroke patients who agreed to participate in the study were randomly divided into the following two groups: (1) experimental group 1, task-oriented training applied to the proximal part (n=14) and (2) experimental group 2, task-oriented training applied to the distal part (n=13). Thereafter, task-oriented trunk training was accordingly applied in each group for 60 minutes per session, 5 times per week for 6 weeks. Muscle power, muscle activity, balance, and gait were assessed using a digital dynamometer, surface electromyograph, Timed Up and Go (TUG) test, and gait analyzer (G-WALK), respectively, before and after training. Results : Trunk muscle strength significantly increased in both groups after training (p<.05). and there was a significant difference between the groups. Muscle activity in the stance phase during gait significantly increased in both groups after training (p<.05), and there was a significant difference between the groups. Muscle activity in the swing phase during gait significantly increased in both groups after training (p<.05), and there was a significant difference between the groups. The TUG test values significantly increased in both groups after training (p<.05), and there was a significant difference between the groups. Gait significantly increased in both groups after training (p<.05), and there was a significant difference between the groups. Conclusion : The results of this study show that task-oriented training can improve trunk muscle strength, muscle activity, balance, and gait in stroke patients.
Heo, Won ho;Kim, Euntai;Park, Hyun Sub;Jung, Jun-Young
Journal of Institute of Control, Robotics and Systems
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v.21
no.6
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pp.518-523
/
2015
This paper proposes a gait phase classifier using a Recurrent Neural Network (RNN). Walking is a type of dynamic system, and as such it seems that the classifier made by using a general feed forward neural network structure is not appropriate. It is known that an RNN is suitable to model a dynamic system. Because the proposed RNN is simple, we use a back propagation algorithm to train the weights of the network. The input data of the RNN is the lower body's joint angles and angular velocities which are acquired by using the lower limb exoskeleton robot, ROBIN-H1. The classifier categorizes a gait cycle as two phases, swing and stance. In the experiment for performance verification, we compared the proposed method and general feed forward neural network based method and showed that the proposed method is superior.
Purpose: The aim of this research was to verify the relationship between three-dimensional (3D) ground reaction force (GRF) and severity of leg length discrepancy (LLD) while walking at a normal speed. It used a 3D motion analysis system with force platforms in standing workers with LLD. Methods: Subjects comprising 45 standing workers with LLD were selected. Two force platforms were used to acquire 3D GRF data based on a motion analysis system during gait. Vicon Nexus and Visual3D v6 Professional software were used to analyze kinetic GRF data. The subjects were asked to walk on a walkway with 40 infrared reflective markers attached to their lower extremities to collect 3D GRF data. Results: The results indicated the maximal force in the posterior and lateral direction of the long limb occurring in the early stance phase during gait had significant positive correlation with LLD severity (r = 0.664~0.738, p <0.01). In addition, the maximal force medial direction of the long limb occurring in the late stance phase showed a highly positive correlation with the LLD measurement (r = 0.527, p <0.01). Conclusion: Our results indicate that greater measured LLD severity results in more plantar pressure occurring in the foot area during heel contact to loading response of the stance phase and the stance push-off period during gait.
Purpose: Backward walking has shown positive effects on gait recovery in rehabilitation patients. It is increasingly used as an aerobic training method in rehabilitation populations, inducing more sensory and motor stimulation than forward walking. Therefore, the purpose of this study is to investigate the effects of visual stimulation during backward walking. Methods: Twenty-seven healthy adults with a visual acuity of 0.8 or higher participated in the study. To compare the effects of visual stimulation during various walking conditions among healthy individuals, the participants randomly selected cards numbered one to six and walked a distance of 10 meters. Walking ability was measured using Optogait. Results: Statistically significant differences were observed in speed, stride, and percentages of single support and contact phase during backward walking. Within eyes-closed conditions during backward walking, significant differences were found in percentages of single support, terminal stance, and contact phase. Moreover, the percentage of terminal swing significantly differed during backward walking with head turn conditions. Conclusion: Gait parameters such as speed, stride, and percentages of single support and contact phase were higher during backward walking than forward walking. These results indicate that backward walking involves multiple sensory systems and varying conditions.
Park, Hye-Kang;Yu, Ki-Gon;Shin, Jang-Hoon;Lee, Wan-Hee
Physical Therapy Rehabilitation Science
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v.9
no.3
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pp.155-164
/
2020
Objective: This study aimed to compare muscle structure, balance, and gait parameters between healthy adults and persons with stroke and to analyze the correlation among these variables. Design: Cross-sectional study. Methods: Twenty persons with stroke (11 male, 9 female) and twenty healthy participants (9 male, 11 female) were included. Ultrasound images of the triceps surae and the tibialis anterior were acquired in sitting resting, sitting co-contraction, and standing resting positions and also during the functional reach test (FRT) and single leg anterior reaching test (SLART). Muscle thickness and fascicle length were measured. Spatiotemporal parameters of gait were measured using a pressure walkway. Gait speed, cadence, step length, stride length, stance time, and swing time were measured. Results: Changes in percent fascicle length were significantly greater in the gastrocnemius and soleus (SOL) muscles of healthy adults in the sitting co-contraction position (p<0.05). The percent fascicle length of the SOL in FRT and SLART were significantly greater in healthy adults (p<0.05). The mid-stance phase of stroke patients was shorter than healthy adults (p<0.05). A negative correlation was observed between percent fascicle length of the SOL in the sitting co-contraction position and the proportion of the mid-stance phase (p<0.05). Conclusions: The function of the triceps surae is affected in persons with stroke when compared with healthy adults. This can lead to difficulty in performing tasks that involve forward transfer of weight. If the triceps surae is not sufficiently secured, the possibility of compensation in the stance phase increases during gait.
The purpose of this study was to investigate how COP displacement of a hemiplegic foot in stance phase during gait is related to clinical balance measures and the recovery stage in hemiplegic stroke patients. Twenty-eight functionally ambulant hemiplegic patients who had suffered from strokes and thirty age-matched healthy subjects participated in this study. COP parameters were calculated. Clinical balance was measured using the Functional Reach Test (FRT) and Timed Up and Go Test (TUGT). The recovery stage, proprioception, and clonus of the ankles or lower extremities were also measured for physical impairment status. The COPx max-displacement in the medial-lateral side of the stroke patients was significantly longer than that of the normal group (p=.038). The COPy max-displacement in the anterior-posterior side of the stroke patients was significantly shorter than that of normal group (p<.001). Significant differences in the COPx and COPy displacement asymmetry index were found between the two groups (p<.01). The FRT was correlated with the COPx displacement (r=.552) and COPy displacement (r=.765). The TUGT was correlated with the COPy displacement (r=-.588) only. The recovery stage of the lower extremities was correlated with COPy displacement (r=.438). The results of the study indicate that the characteristic of COP displacement in hemiplegic feet in stance phase during gait is related to balance ability and recovery in stroke patients. COP parameters acquired by the mapping of foot pressure in stance phase during gait will provide additional useful clinical information. This information can be used by clinicians to assess objectively the pathologic gait with other diseases and to evaluate the therapeutic effects on gait in stroke patients.
When we see normal gait, gait cycle is seperated as stance phase and swing phase. It needs 6 determinant of gait of pelvic rotation, pelvic tilt, knee joint of stance phase, ankle and foot motion, ankle and knee motion, and pelvic movement to be accomplished. In addition, a joint and muscle action is accomplished biomechanically at the same time with its gait cycle. In oriental medicine, the relationships between chang-fu physiology and meridian physiology are summaried as follows ; ${\bullet}$ chang-fu physiology : Spleen manages the extremities. Liver manages soft tissues. Liver stores blood. Kidney stores essences. Kidney manages bones. ${\bullet}$ meridian physiology : The Leg Greater Yang Meridian and meridian soft tissues The Leg Yang-Myeong Meridian and meridian soft tissues The Leg Lesser Yang Meridian and meridian soft tissues The Leg Greater Yin Meridian and meridian soft tissues The Leg Lesser Yin Meridian and meridian soft tissues The Leg Absolute Yin Meridian and meridian soft tissues Especially, we can find out relations between in a "blood supplied feet can walk well" that explains "blood regulations and by liver nourishing effects"that is the closest concept of muscle. Abnormal gaits are due to three causes as following; first, physical defect secoud, pain third, nervous system or instability of muscle. In oriental medicine, we can know relationship in "atrophy, numbness, stroke, convulsion, muscular dystrophy of knee, rheumatoid arthritis, five causes of infantile growing defects, five causes of softening, sprain". Especially, atrophy is the most important symptom. Gait evaluation should be emphasized where a point can walk 8 feet to 10 feet considering stride width, stride length, the body weight center, stride number, flexion, extension, rotation of a joint as a standard factor. The point is we should find out something strange in a patient's side, front and back view. After that we should find out its cause as an index that we can observe abnormal findings in a joint and muscle.
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