• Title/Summary/Keyword: Lower Extremity Joint

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The Effect of Wrist and Trunk Weight Loading using Sandbags on Gait in Chronic Stroke Patients (모래주머니를 이용한 팔목과 몸통의 무게 증가가 만성 뇌졸중 환자들의 보행에 미치는 영향)

  • Park, Sangheon;Lim, Hee Sung;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.31 no.1
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    • pp.50-58
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    • 2021
  • Objective: This study aimed to determine the effect of wrist and trunk weight loading using sandbags in stroke patients in order to provide the quantitative data for enhancement of gait movement. Method: Twelve stroke patients, who have been diagnosed with hemiplegia over a year ago, were participated in this study. All subjects were asked to perform normal walking [N], wrist sandbag walking [W], wrist & trunk sandbag walking [WT], and both wrist sandbag walking [B] and both wrist & trunk sandbag walking [BT], respectively. Eight infrared cameras were used to collect the raw data. Gait parameters, arm swing, shoulder-pelvic kinematics, and lower extremity joint angle were calculated to examine the differences during walking. Results: As a result, there were no significant differences in the gait parameters, shoulder-pelvis, and lower extremities joint angles, but significant differences were found in the range of motion and the anteversion in arm swing. Conclusion: Wrist and trunk weight loading using sandbags affected the movement of the upper extremities only while it did not affect the movement of the lower extremities. It implies that it can reduce the risk of falling caused by a sudden movement change in lower extremities. In addition, the wrist and trunk weight loading using sandbags can induce changes in movement of the upper extremities independently and contribute to functional rehabilitation through resistance training.

Correlations of Fugl-Meyer Assessment Scale, Gait Speed, and Timed Up & Go Test in Patients With Stroke (뇌졸중 환자에서 Fugl-Meyer 평가척도와 보행속도, Timed Up & Go 검사와의 상관관계)

  • Lee, Young-Jung;Yi, Chung-Hwi;Kwon, Oh-Yun;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.11 no.1
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    • pp.1-17
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    • 2004
  • The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.

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Effects of Elastic Band Resistance Exercise on Improving the Balance Ability in the Elderly (탄력밴드저항운동이 노인의 균형 능력 향상에 미치는 영향)

  • Kim, Geon;Kim, Su-Hyon;Seo, Sam-Ki;Yoon, Hui-Jong;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.20 no.2
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    • pp.1-10
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    • 2008
  • Purpose: This study examines the effects of elastic band of resistance exercise for balance control of the elderly. Methods: Thirty of eighty participants in experiment subjects who demonstrated balance-impairment through the use of primary screening tests including the one leg standing test (OLST), functional reach test (FRT) and timed up and go (TUG) were selected as subjects. Fifteen subjects that underwent muscle-strengthening exercise using an elastic band were selected as the exercise group and fifteen subjects were selected as a control group. Subjects undertook a home-based exercise program three times per week for 9 weeks. Muscle strength, functional assessment and a balance test were quantitatively measured before and after the exercise regimen. Results: After muscle strengthening exercises, changes in maximal voluntary isometric contraction (MVIC) showed a significant increase in all of the lower extremity muscles of the exercise group subjects. There were statistically significant differences between the exercise and control groups for changes in the OLST, FRT and TUG, which are functional assessments of balance ability, and changes of the unit path length and circumference area, measurement items of quantitative analysis. In addition, from examining correlations between MVIC, balance ability, it was found that an increase of muscle strength in the hip joint group of muscles among the lower extremity muscles had greater improvement in correlation with balance ability in this elderly population. Conclusion: Resistance exercise using elastic bands had significant effects on muscle strengthening in elderly subjects, with a resultant increase of lower extremity muscle strength with significant improvement of balance ability.

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Comparison of the Changes in the Activation of the Quadriceps Muscle based on the Plantar Flexion Degree of the Ankle Joint in Healthy Young Females during the Stand-to-Sit movement

  • Sung-Min Son
    • The Journal of Korean Physical Therapy
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    • v.35 no.2
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    • pp.53-57
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    • 2023
  • Purpose: The purpose of this study was to compare the changes in the muscle activation of the quadriceps muscle (rectus femoris, vastus lateralis, vastus medialis) during the stand-to-sit (StandTS) movement according to the plantar flexion angle of the ankle joint. Methods: A total of 22 healthy young females participated in this study. During the StandTS under the three conditions (plantarflexion angle 0°, 20°, and 45° of the ankle), electromyography (EMG) data (% maximum voluntary iso¬metric contraction) of the rectus femoris, vastus lateralis, and vastus medialis were recorded using a wireless surface EMG system. Results: There was a significant difference in the muscle activation of rectus femoris, vastus lateralis, and vastus medialis according to the plantar flexion angle (0°, 20°, and 45°) of the ankle. The muscle activation of the quadriceps was the highest at a 45° angle of plantarflexion and the lowest at 0°. One-way repeated ANOVA was used to analyze the muscle activation data of the lower extremity muscles according to the angle of the ankle joint. Conclusion: Based on the results of our study, it was confirmed that the muscle activity of the quadriceps can be increased even in the StandTS movement, which involves the eccentric contraction of the quadriceps muscle. This suggests that maintaining a plantar flexion posture for a long time, say by wearing high-heeled shoes, can quickly cause muscle fatigue in the lower-limb muscles, which can cause a decrease in balance ability leading to falls.

The Effect of a Hip Joint Strengthening Exercise using PNF on Balance, Sit-to-Stand Movement, and Gait in a Tibia Fracture Patient with Skin Defects - A Single Case Study - (PNF을 이용한 엉덩관절 강화운동이 피부 결손을 동반한 개방성 정강뼈 골절 환자의 균형과 앉았다 일어서기, 보행에 미치는 영향 - 단일사례연구 -)

  • Jung, Du-Kyo;Chung, Yi-Jung
    • PNF and Movement
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    • v.16 no.3
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    • pp.317-332
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    • 2018
  • Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

Analysis on the Changes in Muscle Function of the Leg Joint in Athletics Athletes Through by Whole Body Vibration Exercise Training (전신진동(Whole body vibration)운동훈련을 통한 육상 투척선수의 하지관절 근육 기능변화에 관한 분석)

  • Lee, Youngsun;Yoon, Changsun;Han, KiHoon;Kim, Jinhyun;Hah, Chongku;Park, Joonsung;Kim, Jongbin
    • Journal of Convergence for Information Technology
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    • v.11 no.3
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    • pp.250-260
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    • 2021
  • The purpose of this study is to investigate muscle function and symmetry index during whole body vibration exercise using lower extremity training posture for throwing athletes. For throwing athletes in their 20s(6 males, 4 females, age: 24.60±0.92years, height: 177.90±7.40cm, weight: 92.90±22.97kg), lower extremity training postures with squat, carphrase, and lunge movements. Whole body vibration exercise training was performed using. Tensiomyography(TMG) variables Time Delay(Td), Time Contraction(Tc), Time Sustain(Ts) Time Relaxation(Tr), and Displacement Maximumal(Dm) in the lower extremity joint muscles(biceps femoris(BF), gastrocnemius lateral(GL), gastrocnemius medial(GM), rectus femoris(RF), tibialis anterior(TA), lateral vastus(LV), medial latissimus(ML)), were measured to compare and analyze muscle activity, muscle fatigue, and left-right symmetry. The results of the study are left RF, VL, right VM (p<.05) in Td, VM (p<.05) in Tc, GM in Ts (p<.05), left RF in Tr, and right TA (p<. 05) showed a change. Therefore, it has been proven that various whole-body vibration training is an effective exercise with changes in muscle contraction, and stability of the core is secured by symmetry of the left and right muscles. For this reason, the whole body vibration exercise will have a positive effect on rehabilitation training, and it is believed that it will be able to improve performance.

The Effectiveness of Backward Gait Training on the Treadmill in Children With Spastic Diplegic Cerebral Palsy: A Pilot Study (트레드밀에서 뒤로걷기 훈련이 경직성 양하지 뇌성마비 아동의 보행에 미치는 영향: 사전 연구)

  • Kim, Sung-Gyung;Ryu, Young-Uk;Kim, Won-Ho
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.81-90
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    • 2012
  • The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.

Free Tissue Transfer in the Treatment of Infected Diabetic Foot Ulcers (유리 조직 이식술을 이용한 당뇨병성 족부 궤양의 치료)

  • Song, June-Young;Kim, Ki-Soo;Kim, Hee-Dong;Park, In-Suk
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.154-162
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    • 2001
  • Diabetic foot ulcer is a serious complication which result from long-standing diabetes. Especially, severe infected diabetic foot ulcer results in unwanted lower extremity amputation. The diabetic patient is considered the relative contraindication for microsurgery because of the severe peripheral vascular disease. Recently, microvascular free tissue transfer technique applied to diabetic foot ulcer. It is well known that free tissue transfer provides immediate soft tissue coverage and control of infection. So it is possible that preservation of the lower extremity through free tissue transfer. A retrospective study of diabetic patients who had infected foot ulcer from 1999 to 2000 with foot defects reconstructed with free tissue transfer were reviewed. Thirteen patients were studied with mean follow-up of 12.7 months. There were two deaths during follow-up period. There were two failures after free flap surgery. All eleven survived patients were ambulatory. There was no recurrence of ulcer. No patient need amputation above the ankle joint. We have found that free tissue transfer for infected diabetic foot ulcer is very effective surgical technique. Careful patient selection and regular follow-up is important.

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Optimal Joint Trajectory Generation for Biped Walking of Humanoid Robot based on Reference ZMP Trajectory (목표 ZMP 궤적 기반 휴머노이드 로봇 이족보행의 최적 관절궤적 생성)

  • Choi, Nak-Yoon;Choi, Young-Lim;Kim, Jong-Wook
    • The Journal of Korea Robotics Society
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    • v.8 no.2
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    • pp.92-103
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    • 2013
  • Humanoid robot is the most intimate robot platform suitable for human interaction and services. Biped walking is its basic locomotion method, which is performed with combination of joint actuator's rotations in the lower extremity. The present work employs humanoid robot simulator and numerical optimization method to generate optimal joint trajectories for biped walking. The simulator is developed with Matlab based on the robot structure constructed with the Denavit-Hartenberg (DH) convention. Particle swarm optimization method minimizes the cost function for biped walking associated with performance index such as altitude trajectory of clearance foot and stability index concerning zero moment point (ZMP) trajectory. In this paper, instead of checking whether ZMP's position is inside the stable region or not, reference ZMP trajectory is approximately configured with feature points by which piece-wise linear trajectory can be drawn, and difference of reference ZMP and actual one at each sampling time is added to the cost function. The optimized joint trajectories realize three phases of stable gait including initial, periodic, and final steps. For validation of the proposed approach, a small-sized humanoid robot named DARwIn-OP is commanded to walk with the optimized joint trajectories, and the walking result is successful.