• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.393-398
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• 2013

Purpose: The purpose of this study was to compare muscle activation patterns of lower extremities in stroke patients during stepper climbing, stair-up, and level-ground gait conditions by surface electromyography (EMG). Methods: Subjects included 19 hemiplegic patients comprehensive rehabilitation center for inpatients with stroke. Surface EMG was used to measure the subjects' medial gastrocnemius (GCM), tibialis anterior (TA), biceps femoris (BF), and rectus femoris (RF) activity as they took six steps during stepper climbing, stair-up, and level-ground gait conditions. Results: There was no significant difference in the BF or RF muscle activity for the stepper climbing, stair-up, and level-ground gait conditions. However, there were significant differences in the medial GCM and TA muscle activity between each condition on the patients' hemiplegic side(p<0.05). There was significant difference in the medial GCM, TA, RF, and BF muscle activity between each condition on the patients' non-hemiplegic side (p<0.05). Conclusion: As a result, the overall muscle activity during the level-ground gait was higher than the stair-up condition, and the muscle activity during the stair-up condition was higher than the muscle activity during the stepper climbing condition. As one of the many methods used for gait training, we suggest that the stepper exercise could be applied at an earlier stage in the gait training process.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• Physical Therapy Korea
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• v.2 no.2
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• pp.9-23
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• 1995

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

• The Journal of Internal Korean Medicine
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• v.36 no.4
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• pp.478-485
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• 2015

Objectives: The purpose of this study was to analyze the change of area and average velocity of the center of pressure (COP) according to gait improvement in post-stroke hemiplegic patients.Methods: We measured the area and the average velocity of COP displacement of ten post-stroke hemiplegic patients while they stood quietly on a force plate at the time of dependent and independent gait . We also measured the area and the average velocity of COP displacement of normal persons to verify differences between them and post-stroke hemiplegic patients.Results: The area of COP displacement decreased significantly, and the average velocity of COP displacement tended to decrease, but not significantly. There were significant differences in the area and the average velocity of COP displacement between post-stroke hemiplegic patients and normal persons.Conclusions: The results of this study show that postural control ability improves as gait improves.

• Physical Therapy Korea
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• v.12 no.1
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• pp.11-21
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• 2005

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.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.49-60
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• 2013

■ Objectives The aim of this study is to analyze the change of gait pattern by the taping therapy in a hemiplegic patient. ■ Methods We conducted the taping therapy for 7 days to affected ankle joint of hemiplegic patient and analyzed the change of gait pattern using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) ■ Results In terms of affected side, cadence, total double support, step length and stance phase decreased, while swing phase and step time increased by taping therapy. In terms of unaffected side, step length increased by taping therapy. Center of pressure intersection point moved to posterior and affected side in cyclogram pattern. ■ Conclusion Taping therapy to affected ankle joint of hemiplegic patient would be advantages to gait improvement in hemiplegic patients.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.448-454
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• 2014

Objectives: The aim of this study was to analyze the change of lateral shift of Center of Pressure (CoP) according to the gait improvement in post-stroke hemiplegic patients and to investigate relationship between the change of motor grade and lateral shift of CoP. Methods: We measured the lateral shift of CoP and motor grade of eight post-stroke hemiplegic patients at the beginning of dependent gait and independent gait. Results: We found that CoP tended to be shifted to the non-affected side when patients started to walk independently. Furthermore, there was no relationship between the change of motor grade and lateral shift of CoP. Conclusions: This result may suggest it is more important to control the non-affected side than the affected side, at least until the beginning independent gait.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.11a
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• pp.649-650
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• 2008

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.674-682
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• 2009

The purpose of this study was to investigate the effect of aquatic gait training on plantar foot pressure, foot kinesiology and gait speed in right hemiplegic patients. The subject were 20 stroke patients who elapsed from 12 month to 24 month after stroke(aquatic gait training group(n=10), land gait training group(n=10)). This study measured plantar foot pressure, toe out angle, subtalar joint angle, gait speed from data of gate on 2m long measuring apparatus for RS-scan system(RS scan Ltd. German). This experiment performed in twice, before and after the aquatic gait training and land gait training. Collected data were statistically analyzed by SPSS Ver. 12.0 using descriptive statistics, paired t-test. Aquatic gait training group had more variety pressure area on their foot such as T1(Toe 1), HM(Heel medial), and HL(Heel lateral). But motion of subtalar joint flexibility and toe out angle decreased considerably and gate speed also increased. According to the result, aquatic gait training is considered as more effective way in foot stability and normal gait pattern than land gait training.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.55 no.10
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• pp.452-457
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• 2006

In this paper, an algorithm to detect steps in hemiplegic patients using a 3-axis accelerometer a紅ached on the trunk was proposed. The proposed algorithm consisted of the signal pre-processing, the step detector, the classification of steps and the calculation of stride time. Two FIR band-pass filters were designed and steps were measured by the combination of filtered signals in the vertical and the anteroposterior directions. In addition, the classification of steps and the calculation of stride time were computed by using the detected steps and lateral signals. For the experiment, fourteen hemiplegic patients were participated and the linear accelerations of the trunk and foot switch signals were measured synchronously. To evaluate the system performance, the detected steps and initial contacts by the foot switch were compared. The average error between the steps and initial contacts was 0.024ms and the difference of the average stride time was 0.01s. Finally, all gait events were detected exactly. Results showed that the accelerometry could use for the gait evaluation in clinical rehabilitation therapies.