• Journal of the Korean Society of Physical Medicine
• /
• v.13 no.1
• /
• pp.137-146
• /
• 2018

PURPOSE: This study examine the effect of community ambulation training on gait, depression and self - efficacy of stroke patients in order to develop more effective training methods of community rehabilitation. METHODS: In the experimental group, community ambulation training combined with indoor and outdoor walking was performed for 30 minutes three times a week for six weeks. In the control group, general indoor walking training was performed. The physical factors were assessed by a 10-meter walking test, six-minute walking test and community gait test. Psychological factors were assessed by the Korean version of the Epidemiology Center Depression Scale and Activity-Specific Balance Confidence Scale. RESULTS: In the 10-meter walking test, the normal walking speed was significantly improved after the intervention in both the experimental group and the control group (p<.05). However, the fast walking speed was significantly improved only in the experimental group (p <.05). ln the community gait test, the experimental group showed significant improvement (p<.05), but the control group did not. Depression and self-efficacy were significantly improved in the experimental group (p<.05) but not in the control group. CONCLUSION: Community ambulation training may improve the gait ability of stroke patients and reduce their depression and improve self-efficacy.

• The Journal of Dong Guk Oriental Medicine
• /
• v.5
• /
• pp.79-95
• /
• 1996

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.

• Korean Journal of Applied Biomechanics
• /
• v.17 no.3
• /
• pp.181-188
• /
• 2007

The purpose of this study was to investigate the biomechanical effects of wearing different type of insole shoes on gait characteristics in patients with knee osteoarthritis. Seven patients with knee osteoarthritis (Grade 3 & 4 by Kellgren & Lawrence) were participated in the study. They wore two different type of shoes (with Gel-type Insole: GIS, with Normal insole: NIS) during gait. Three dimensional cinematography and Ground Reaction Force(GRF) data were used to get the maximal value of horizontal distance between the center of pressure in GRF and knee joint center, GRF in mediolateral direction, peak value of GRF in frontal plane, vertical compressive force and adduction moment in knee joint. The results were as follows: The maximal value of horizontal distance between the center of pressure in GRF and knee joint center was smaller in GIS than NIS. The peak value of GRF in mediolateral direction was found in 30% of gait cycle, five subjects wearing GIS showed lower value of peak GRF in mediolateral direction than wearing NIS. The peak value of GRF in frontal plane and vertical compressive force in knee joint did not show any difference between GIS and NIS. The adduction moment in GIS decreased in the late stance of gait and the mean value of the adduction moment in GIS smaller than that in NIS. GIS may help to move quickly knee joint center to the center of pressure in GRF, therefore it may prevent increasing the adduction moment in knee joint.

• Journal of Biomedical Engineering Research
• /
• v.32 no.2
• /
• pp.165-176
• /
• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.11 no.1
• /
• pp.81-89
• /
• 2017

In this paper, we propose a gait pattern recognition method for intelligent prosthesis that enables walking in various environments of femoral amputees. The proposed gait mode changing method is a single sensor based algorithm which can discriminate gait surface and gait phase using only strain gauges sensor, and it is designed to simplify the algorithm based on multiple sensors of existing intelligent prosthesis and to reduce cost of prosthesis system. For the recognition algorithm, we analyzed characteristics of the ground reaction force generated during gait of normal person and defined gait step segmentation and gait detection condition, A gait analyzer was constructed for the gait experiment in the environment similar to the femoral amputee. The validity of the paper was verified through the defined detection conditions and fabricated instruments. The accuracy of the algorithm based on the single sensor was 95%. Based on the proposed single sensor-based algorithm, it is considered that the intelligent prosthesis system can be made inexpensive, and the user can directly grasp the state of the walking surface and shift the walking mode. It is confirmed that it is possible to change the automatic walking mode to switch the walking mode that is suitable for the walking mode.

• The Journal of the Korean bone and joint tumor society
• /
• v.3 no.1
• /
• pp.18-25
• /
• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• Journal of Korean Academy of Nursing
• /
• v.30 no.5
• /
• pp.1318-1332
• /
• 2000

The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.

• Journal of Korean Physical Therapy Science
• /
• v.8 no.2
• /
• pp.961-965
• /
• 2001

The aim of this study is to present the basic reference data of age and specipic gait parameters for Korean Adult. The basic gait parameters were extracted from 20 Adult, 10 men and 10 women, 21 to 24 years of age using VICON 512 Motion Analyzer. The temporal gait parameters and kinematic parameters of Korean Adult similar to other western reference data. The results were as follows: 1) The mean Cadence of the male to the female were 113.5 steps/min to 117.6 steps/min. 2) The mean Walking Speed of the male to the female were 1.30 m/s, to 1.27 m/s. 3) The mean Stride Length of the male to the female were 1.35 m, to 1.30 m. 4) The mean maximal angles of pint on the pelvic tilt motion for different male to the female were $9.80^{\circ}$ to $7.75^{\circ}$. (p<0.05) 5) The mean maximal angles of pint on the hip flexion motion for different male to the female were $22.62^{\circ}$ to $27.65^{\circ}$. (p<0.05) 6) The mean maximal angles of pint on the knee flexion motion for different male to the female were $55.78^{\circ}$ to $55.49^{\circ}$. (p>0.05) 7) The mean maximal angles of pint on the ankle dorsiflexion motion for different male to the female were $12.47^{\circ}$ to $13.39^{\circ}$. (p>0.05).

• Journal of Korean Physical Therapy Science
• /
• v.12 no.4
• /
• pp.33-41
• /
• 2005

The purpose of this report was to describe the gait pattern and parameters of the complicated bilateral amputee with right transtibial and left tarsometatarsal amputation. Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed at pre and post-test. Treadmill Training with 15 degree, incline was practiced for 8weeks, 3times per week. In linear parameters, the Velocity, Stride length and Single limb support were increased than pre-test. but Cadence and Double limb support were less post-test than pre-test. In kinematics, the maximal pelvic tilt angle showed right side $21.87^{\circ}$, left side $20.67^{\circ}$ at pre-swing phase, and decreased as compared with pre-test. Especially, the inimal hip flexion angle showed right side $-6.83^{\circ}$, left side $1.52^{\circ}$ at pre-swing phase and increased as compared with pre-test. The maximal knee flexion angle disclosed right side $2.66^{\circ}$, left side $21.71^{\circ}$ at stance phase, and decreased as compared with pre-test. In kinetics, the hip extension moment on initial contact stage was right side 0.938NM/Kg, left side 0.09NM/Kg, which was impaired compared with normal person.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.9 no.1
• /
• pp.37-43
• /
• 2015

In this paper, an efficient system using 3-axis accelerometer is proposed to diagnose the gait imbalance. The proposed hardware system consists of two 3-axis accelerometers to measure 3 directional acceleration of ankles and an embedded system to transfer the data. The acquired data were normalized and then compared to analyze the symmetry between normal and abnormal gait with ROCC (ratio of correlation coefficient). 10 healthy subjects were participated and each subject repeated the experiment 5 times. To make unbalanced ambulation, the height of the heel of one foot was changed during experiments. From the results, it is verified that ROCC index grew apart from the reference according to growing imbalance and the proposed system could be available for estimation of gait imbalance.