• The Journal of Korean Physical Therapy
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• 제29권2호
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• pp.50-54
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• 2017

Purpose: This investigation aimed to determine the effects of treadmill training (TT) and high frequency chest wall oscillation (HFCWO) on pulmonary function and walking ability in stroke patients as well as propose an exercise program to improve cardiovascular function. Methods: Twenty hemiplegic stroke patients were randomized to either the control group (CG) (n=10) or the experimental group (EG), which received TT and HFCWO (n=10). Pulmonary function was quantitated using patient forced vital capacity (FVC) and forced expiratory volume at one second (FEV1) while walking speed was assessed by the 10m walking test (10MWT). Further, walking endurance was determined utilizing the 6-minute walk test (6MWT). Subjects of the EG performed the study protocol for 60 minutes, five times a week for six weeks; CG patients did not participate in regular exercise. To determine significance for the differences observed before and after exercise, within-group and between-group comparisons were conducted utilizing paired and independent t-tests, respectively, with the level of significance set at ${\alpha}=0.05$. Results: Within-groups, significant differences were observed in both FVC and FEV1 (p<0.01) following completion of the study protocol. Further, between-group comparisons demonstrated significant differences in both FVC (p<0.05) and FEV1 (p<0.01). Post-exercise, significant changes in the 10MWT and 6MWT score were observed between the EG and CG (p<0.01). Further, statistically significant differences were observed in 6MWT scores between-groups (p<0.05). Conclusion: The TT and HFCWO effectively improved pulmonary function and walking ability in subjects with stroke. The proposed program can be applied to stroke patients as a useful therapy.

• 한국운동역학회지
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• 제26권1호
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• pp.135-142
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• 2016

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

• 한국운동역학회지
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• 제29권2호
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• pp.79-88
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• 2019

Objective: The aim of this study was to determine the peak torques of the knee and ankle joint and local stability of the lower extremity's joints, and muscle activation patterns of the lower extremity's muscles between fallers and non-fallers in the elderly women during walking. Method: Four elderly women (age: $74.5{\pm}5.2yrs.$; height: $152.1{\pm}5.6cm$; mass: $55.3{\pm}5.4kg$; preference walking speed: $1.19{\pm}0.06m/s$) who experienced falls within six months since experiment had been conducted (falls group) and thirty-six subjects ($74.2{\pm}3.09yrs.$; height: $153.6{\pm}4.9cm$; mass: $56.7{\pm}6.4kg$; preference walking speed: $1.24{\pm}0.10m/s$) who had no experience in falls (non-falls group) within this periods participated in this study. They were measured torque peaks of the knee and ankle joint using a Human Norm and while they were walking on a treadmill at their natural pace, kinematic variables and EMG signals were collected with using a 3-D motion capture system and a wireless EMG system, respectively. Lyapunov Exponent (LyE) was determined to observe the dynamic local stability of the lower extremity's joints, and muscles activation and their co-contraction index were also analysed from EMG signals. Hypotheses between falls and non-falls group were tested using paired t-test and Mann-Whitey. Level of significance was set at p<.05. Results: Local dynamic stability in the adduction-abduction movement of the knee joint was significantly lower in falling group than non-falling group (p<.05). Conclusion: In conclusion, muscles which act on the abduction-adduction movement of the knee joint need to be strengthened to prevent from potential falls during walking. However, a small number of samples for fallers make it difficult to generalize the results of this study.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.77-82
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• 2010

Purpose: The purpose of this study was to compare the pathway of COP and plantar foot pressure and to determine the correlation between plantar regions during the ascending and descending of a ramp. Methods: Fifteen healthy adults who had no musculoskeletal problems participated in our study. They were asked to walk on a level surface and on an ascending and descending ramp in their bare feet. Pathway of COP and plantar foot pressures were recorded using the Matscan system (Tekscan, Boston, USA). For pressure measurements, the plantar foot surface was divided into seven regions: two toe regions, three forefoot regions, a midfoot region, and a heel region. To determine whether there was a statistically significant difference between pathway of COP and plantar foot pressures during walking, we used repeated measuremes ANOVA. Results: In comparison to results for a level walking, pathway of COP while ascending a ramp had a tendency to be shifted medially in the forefoot and became longer till the big toe. Pathway of COP while descending a ramp also was shifted medially, but ended in the forefoot. Plantar foot pressure of the second and third metatarsal head and the fourth and fifth metatarsal heads was significantly decreased while descending the ramp. Conclusion: These results indicated that plantar foot pressure is changed while ascending and descending a ramp and demonstrated that ramp walking can affect the structure and function of the foot. Therefore, gait environment is associated with significant changes in foot characteristics, which contribute to altered plantar loading patterns during gait.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.398-404
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• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• 대한의용생체공학회:의공학회지
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• 제26권2호
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• pp.111-116
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• 2005

This study was designed to apply the stimulation system developed in our laboratory to investigate how the stimulation conditions affect the muscle contractile characteristics in the isometric condition as well as during the FES standing/walking. Four paraplegic and ten healthy subjects participated in this study, and their knee extensors were voluntary contracted or electrically stimulated to measure the muscle force and the fatigue index for different waveforms of the pulse train. We also investigated different combinations of the electrode positions during standing/walking. It was confirmed that continuous and high-frequency stimulation causes faster fatigue than intermittent and low-frequency stimulation. Fatigue resistance was higher around the optimal muscle length than at a stretched position in healthy subjects, whereas the opposite was observed in paralyzed subjects. The paired t-test results with the level of significance at 0.01 indicated that the sinusoidal waveform generated the largest torque among the four typical waveforms. Although statistically not very significant, the sinusoidal waveform also generated, in general, the highest fatigue resistance at an intensity level below the supramaximal stimulation. One of the paraplegic subject who participated in the standing/walking program can now stand up for 1 minute and 50 seconds with the knee extensors, and walk for about 5 minutes at the speed of 12m/sec.

• 대한물리의학회지
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• 제4권2호
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• pp.125-131
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• 2009

Purpose：This study performed to evaluate the effect of hip fracture among persons over 50 years old, in Jeju-do, Korea, on mortality, activity of daily living(ADL). Methods：Three hundred eighteen patients over to 50 years of age who lived in Jeju-do and sustained a hip fracture from January 1st 2003 to December 31th 2004 were recruited. The information collected from the hospital records for each patient included age, sex, date of onset, and patients investigated activity grade, ADL, outdoor walking aid on 3month, 6month and 12month. Results：The incidence was 12.5/10,000 for total patients(female 17.0/10,000, male 6.3/10,000) in population over 50 years old. Patients who had lower activity grade and ADL level, showed higher mortality, and patients using outdoor walking aid showed higher mortality. Conclusion：The activity grade, ADL level, Using of outdoor walking aid affect mortality, so more programs about ADL must be developed for the life span and quality of life.

• 대한물리의학회지
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• 제17권1호
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• 한국운동역학회지
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• 제16권3호
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• pp.105-115
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• 2006

The purpose of this study is to elucidate the mechanical characteristics of lower extremity joint movements at different walking speeds in obese people and suggest the very suitable exercise for obese person's own body weight and basic data for clinical application leading to medical treatment of obesity. This experimental subjects are all males between the ages of 20 and 30, who are classified into two groups according to Body Mass Index(BMI): one group is 15 people with normal body weight and the other 15 obese people. Walking speed is analysed at 3 different speeds ($1.5^m/s$, $1.8^m/s$, $2.1^m/s$) which is increased by $0.3^m/s$ from the standard speed of $1.5^m/s$. We calculated joint moments of lower extremity during stance phase through video recording and platform force measurement.Two-way ANOVA(Analysis of Variance, Mix) is applied to get the difference of moments according to walking speeds between normal and obese groups. Pearson's Correlation Analysis is applied to look into correlation between walking speeds and joint moments in both groups. Significance level of each experiment is set as ${\alpha}=.05$. As walking speed increases maximum ankle plantar flexion moment in the stance phase is smaller in obese group than in normal group, which is suggestive of weak toe push-off during terminal stance in obese group, and the highest maximum ankle plantar flexion moment in obese group during the middle speed walking($1.8^m/s.$). Maximum ankle dorsal flexion moment in obese group is relatively higher than in normal group and this is regarded as a kind of compensatory mechanism to decrease the impact on ankle when heel contacts the floor. Maximum knee flexion and extension moments are both higher in normal group with an increase tendency proportional to walking speed and maximum hip flexion and extension moments higher in obese group. In summary, maximum ankle plantar flexion moment between groups(p<.025), maximum knee moment not in flexion but in extension(p<.001) within each group according to increasing walking speed, and maximum hip flexion and extension moment(p<.001 and p<.004, respectively according to increasing walking speed are statistically significant but knee and hip moments between groups are not. Pearson correlation are different: high correlation coefficients in maximum knee flexion and extension moments, in maximum hip extension moment but not hip flexion, and in maximum ankle dorsal flexion moment but not ankle plantar flexion, in each group. We suspect that equilibrium imbalance develops when the subject increases walking speed and the time is around which he takes his foot off the floor.

• 한국컴퓨터그래픽스학회논문지
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• 제25권3호
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• pp.11-20
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• 2019

본 연구는 시각 장애인의 도보 적응을 위한 새로운 가상현실 체험 환경을 제안한다. 제안하는 가상현실 체험 환경의 핵심은 몰입형 보행 상호작용과 딥러닝 기반 점자 블록 인식으로 구성된다. 우선, 시각 장애인의 입장에서 현실적인 걷기 경험을 제공함을 목적으로 제자리 걸음을 감지하여 걷기를 판단하는 트래커 기반 걷기 처리과정과 시각 장애인의 보행 보조 도구를 가상현실에 적용한 컨트롤러 기반 VR 흰지팡이를 설계한다. 또한, VR 흰지팡이를 활용한 길 안내 과정에서 도로 위의 점자 블록 인지 및 반응 등 종합적인 의사결정을 수행하는 학습 모델을 제안한다. 이를 기반으로 가상현실 도보 체험 환경에 대한 실험을 위하여 실외 도시 환경으로 구성된 가상현실 어플리케이션을 제작하고, 참가자를 대상으로 설문 실험 및 성능 분석을 진행하였다. 결과적으로 제안한 가상현실 체험 환경이 시각 장애인의 입장에서 현존감 높은 도보 체험을 제공하고 있음을 확인하였다. 그리고 제안한 학습과 처리과정이 인도와 차도, 인도 위의 점자 블록을 높은 정확도로 인지함을 확인하였다.