• Physical Therapy Korea
• /
• v.26 no.2
• /
• pp.49-60
• /
• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• Physical Therapy Rehabilitation Science
• /
• v.11 no.1
• /
• pp.16-23
• /
• 2022

Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

• Journal of Korean Physical Therapy Science
• /
• v.7 no.2
• /
• pp.683-696
• /
• 2000

To examine the blood lipids, muscle strength and flexibility at low back, and muscle strength in the knee joint, 44 women, who were diagnosed as chronic low back pain patients and aged between 40 to 50 years old, were recruited as the subjects. The women were divided into two groups: 1) body fat content less than 25% and 2) body fat content more than 30%. The results were: 1) No differences were found between two groups in blood lipids status. 2) The total cholesterol were less 3.78% in the normal group than the obese group. 3) The HDL-cholesterol were higher 4.85% in the normal group than the obese group. 4) The TG were less 13.1% in the normal group than the obese group. 5) No differences were found between two groups in muscle strength and flexibility 6) No differences were found between two groups in the peak torque of knee joint 7) The total work of the knee joints were higher in the normal group than the obese(P<.05). 8) The abdominal strength were higher 34.04% in the normal group than the obese group. 9) The flexibility of low back were higher 44.54% in the normal group than the obese group.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.27 no.2
• /
• pp.37-43
• /
• 2021

Background: The purpose of this study is to compare and analysis the changes in strength and endurance of the knee extensor muscles after Anterior cruciate ligament reconstruction. Methods: Twelve male subjects with ligament injury were seated on Biodex and the hip joint was flexed at 110°, and torso, lower extremities, and legs were fixed using Velcro. The resistance device was placed at a point 3cm above the ankle, and measurements were taken before and a surgery at 60°/sec and 180°/sec when the knee was maximally extended. The postures ingeniously combine forward-bending poses countered with backward-bending ones. Results: There was no significant difference in the comparison of muscle strength of 60°/sec and 180°/sec before surgery. But there was a significant difference after surgery. There was significant difference in muscle endurance both before and after surgery. There was a significant difference in the pre- and post- operative comparison values of muscle strength and endurance in isokinetic movements at 60°/sec and 180°/sec during knee extension on the injured side. Conclusion: For cruciate ligament tears, Orthopedic reconstruction is recommended. Correct alignment of the knee ligament after surgery can enhance the strength and endurance of the quadriceps femoris during knee extension rejuvenated.

• Korean Journal of Applied Biomechanics
• /
• v.24 no.2
• /
• pp.167-172
• /
• 2014

The purpose of this study was to investigate walking standard time and joint powers of the lower extremities on the changes of illuminations in the elderly women. Ten older women ($70.90{\pm}3.28$ years, $154.70{\pm}3.47$ cm, $53.80{\pm}5.39$ kg) with normal vision and no gait disabilities participated in this study. All the experiments were performed on a level walkway from low to high lighting (six conditions). A 3-dimensional motion capturing system, force-plate, and EMG were used to acquire and analyze walking motion, force, and muscle activity data; the sampling frequency was 100 Hz, 1000 Hz and 1000 Hz respectively. To test the differences on walking standard time and joint powers of the lower extremities between the six lighting conditions, one-way repeated ANOVAs were evaluated. The following results were drawn: First, mean standard time was about 1.3 sec/stride, and velocities were smaller with lighting increasing except 100 Lx. Second, the joint power patterns of ankle and knee were not consistent, but only hip joint power was a greatest in 6 Lx and a smallest in 400 Lx. Third, standard times(100 Lx<300 Lx, 400 Lx) were statistically significant, and hip joint max powers (100 Lx>others) were also statistically significant. But ankle and knee joint max power were not statistically significant. These results showed that standard times from low to high lighting were not consistent, and hip joint of 100 Lx has a greatest rotational torque. We suggested that gait strategies of them as to changing illuminations were not consistent and findings may represent a lack of adaptability in the elderly women.

• The Journal of Korean Physical Therapy
• /
• v.23 no.6
• /
• pp.37-42
• /
• 2011

Purpose: The aim of this study is to suggest the basic materials for proposing effective and efficient methods when stretching by measuring isokinetic muscular strength according to static, dynamic and PNF stretching. Methods: This study was conducted on 45 healthy persons (male and female) in their twenties who are attending universities. The subjects are randomly divided into three (3) groups, and static stretching is applied in group 1, dynamic stretching is applied in group 2 and PNF stretching is applied in group 3. After carrying out static, dynamic and PNF stretching, peak torque was measured using isokinetic muscular strength measurement. Results: According to the results, at $60^{\circ}$/sec and $180^{\circ}$/sec isokinetic peak torque of the knee joint according to types of stretching, the largest changes were shown in Group 2 extension and flexion, and the least changes were shown in Group 1. There were significant differences among the three groups (p<0.05), and the result of after-analysis by LSD showed that there were significant differences between Groups 1 and 2, and Groups 1 and 3 (p<0.05). Conclusion: The intention of this study was to determine the peak torque using Cybex after applying three stretching methods to hamstring muscles, and the case of dynamic and PNF stretching was found to be more significant in both the $60^{\circ}$/sec and $180^{\circ}$/sec angular speeds than that of static stretching. Using the results of such studies, if dynamic and PNF stretching are applied together with warming-up before performing sports, the risk of suffering wounds would reduce and the exactness of sports would increase.

• Journal of Institute of Control, Robotics and Systems
• /
• v.20 no.2
• /
• pp.193-199
• /
• 2014

In this paper, we present an overview of the structure of a lab-built powered knee prosthesis and the control of it. We build a powered prosthesis prototype on the basis of previous researches and aim at obtaining the essential technology related with its control. We adopt the slider-crank mechanism with a DC motor as an actuator to manipulate the knee joint. We also build an embedded control system for the prosthesis with a 32-bit DSP controller as a main computation unit. We divide the gait phase into five stages and use a FSM (Finite State Machine) to generate a torque reference needed for each stage. We also propose to use a position-based impedance controller for driving the powered knee prosthesis stably. We perform some walking experiments at fixed speeds on a tread mill in order to show the feature of the built powered prosthesis. The experimental results show that our prosthesis has the ability to provide a functional gait that is representative of normal gait biomechanics.

• 제어로봇시스템학회:학술대회논문집
• /
• 2003.10a
• /
• pp.215-219
• /
• 2003

In this paper, we generate a trajectory minimized the energy gait of a biped robot for walking a staircase using genetic algorithms and apply to the computed torque controller for the stable dynamic biped locomotion. In the saggital plane, a 6 degree of freedom biped robot that model consists of seven links is used. In order to minimize the total energy efficiency, the Real-Coded Genetic Algorithm (RCGA) is used. Operators of genetic algorithms are composed of a reproduction, crossover and mutation. In order to approximate the walking gait, the each joint angle is defined as a 4-th order polynomial of which coefficients are chromosomes. Constraints are divided into equality and inequality. Firstly, equality constraints consist of position conditions at the end of stride period and each joint angle and angular velocity condition for periodic walking. On the other hand, inequality constraints include the knee joint conditions, the zero moment point conditions for the x-direction and the tip conditions of swing leg during the period of a stride for walking a staircase.

• Journal of the Korean Institute of Intelligent Systems
• /
• v.23 no.3
• /
• pp.238-243
• /
• 2013

This paper analyzes a virtual work of the knee and hip joints of bipedal walking robots. For the purpose, we consider a model of bipedal leg mechanism with a compliant foot and a typical walking pattern. We also check the torque characteristics at the joint space propagated from the space of the foot contacting a flat and stiff surface, and present the works accumulated at the joint space. As a result, it is shown that this analysis is useful for evaluating the fatigue of the leg mechanism by the physical walking contact between the foot and the surface, and it is applicable for improving the compliant characteristics at the foot space by employing a proper footgear.

• Journal of Institute of Control, Robotics and Systems
• /
• v.17 no.10
• /
• pp.1021-1028
• /
• 2011

The objective of this paper is to optimize the design parameters of a novel mechanism for a robotic knee orthosis. The feature of the proposed knee othosis is to drive a knee joint with independent actuation during swing and stance phases, which can allow an actuator with fast rotation to control swing motions and an actuator with high torque to control stance motions, respectively. The quadriceps device operates in five-bar links with 2-DOF motions during swing phase and is changed to six-bar links during stance phase by the contact motion to the patella device. The hamstring device operates in a slider-crank mechanism for entire gait cycle. The suggested kinematic model will allow a robotic knee orthosis to use compact and light actuators with full support during walking. However, the proposed orthosis must use additional linkages than a simple four-bar mechanism. To maximize the benefit of reducing the actuators power by using the developed kinematic design, it is necessary to minimize total weight of the device, while keeping necessary actuator performances of torques and angular velocities for support. In this paper, we use a SGA (Simple Genetic Algorithm) to minimize sum of total link lengths and motor power by reducing the weight of the novel knee orthosis. To find feasible parameters, kinematic constraints of the hamstring and quadriceps mechanisms have been applied to the algorithm. The proposed optimization scheme could reduce sum of total link lengths to half of the initial value. The proposed optimization scheme can be applied to reduce total weight of general multi-linkages while keeping necessary actuator specifications.