Objective: The purpose of this study was to determine the effects of Augmented Reality-based Postural Control (ARPC) training on balance and gait function in patients with stroke. Design: Single-blind randomized controlled trial. Methods: Twenty participants who experienced a stroke were enrolled in the study and randomly assigned to the ARPC (n=10) or control group (n=10). Subjects in both groups received conventional physical therapy for 60 min per session, 5 days per week, for 4 weeks. In addition, subjects in the ARPC group received ARPC training for 30 min per day, 3 days per week, for 4 weeks. The participants watched established normal postural control patterns on a head-mounted display and repeated the movements in ARPC training. Outcome measurements were assessed using the Berg Balance Scale (BBS) and 10-Meter Walk Test (10MWT) before and after 4 weeks of training. Results: Of the 20 randomized participants, only 18 completed the 4-week training program. The ARPC group showed significant improvement in the BBS and 10MWT after training (p<0.05). Meanwhile, the control group did not exhibit improvement in either variable. In addition, the ARPC group showed significantly greater improvement than the control group in the 10MWT (p<0.05), whereas no significant difference was observed between the groups for the BBS. Conclusions: The results of this study confirmed the benefits of ARPC training on dynamic balance and functional gait ability. Additionally, this study may provide evidence supporting the use of an ARPC training program for improving balance and gait ability in patients after a chronic stroke.
Purpose: The purpose of this study was to determine the changes in foot contact area and pressure when walking with a functional insole that emphasizes the Hallux point as compared to a general insole. Methods: In this study, an experiment was conducted to investigate changes in plantar pressure and contact area for a functional insole that emphasized the Hallux point as compared to a general insole. A lower extremity robot was used for walking reproduction. First, the gait sequence according to the two insoles was determined through a randomized controlled trial comparison. According to the sequence procedure, the insole was attached to the shoe and then worn on the right side of the lower extremity robot for gait reproduction at a normal gait speed of 20 steps per minute. After programming the robot to walk, the experiment was carried out. The result value was determined by averaging the pressure and area data of the fore and rear foot measures after walking at 20 steps per minute. Results: The functional insole that emphasized the hallux point significantly increased the forefoot and rearfoot contact area (p < 0.05) and significantly decreased the forefoot and rearfoot contact pressure (p < 0.05) compared to the general insole. Conclusion: A functional insole that emphasizes the hallux point does not collapse the medial longitudinal arch during gait, increasing foot stability and reducing fatigue. Thus, this functional insole needs to be widely used clinically.
The purposes of this study were to evaluate the effect of normalization by dimensionless number of Hof(1996) and to analysis the gait pattern for 20s Korean males and females. Subjects are selected in accordance with classification system of Korean standard body figure and age. Experimental equipment is the Motion capture system. Subjects who are walked at a self-selected normal walking speed were photographed using the Motion capture system and analyzed using 3D motion analysis method with OrthoTrak, Cortex, Matlab and SPSS for a statistical test. When used to normalize data, there are no differences of statistical significances between gender in all spatiotemporal variables. I concluded that gait research for mutual comparison requires a normalization by dimensionless number to eliminate the effects of the body size and to accurate statistical analysis.
Purpose: The purpose of this study was to investigate the kinematic characteristics and muscle activities during the following two conditions: transition from half-kneel to standing on the affected leg and non-affected leg. Methods: Twenty-one hemiplegic patients participated in the study. A motion analysis system was used to record the range of motion and angle velocity of the hip, knee and ankle from the half-kneel to the standing position. Electromyography was used to record the activity of 4 muscles. Results: The statistical analysis showed that the minimum ROM of the hip joint was less on the affected leg during transition from half-kneel to standing. However, the minimum ROM of the knee and ankle joints was less on the non-affected leg during transition from half-kneel to standing. The angle velocity of the knee and ankle joints was less during transition from half kneeling to standing on the non-affected leg. Muscle activity of the rectus femoris and tibialis anterior was less while moving from half-kneel to the standing position on the affected leg. Conclusion: These results show that greater active ROM of the knee and ankle was required on the affected leg for transition from half-kneel to the standing position than for normal gait. Muscle activity of the rectus femoris and tibialis anterior is normally required for movement from the half-kneel to the standing position during normal gait. Further studies are needed to investigate the antigravity movement in healthy subjects and hemiplegic patients in order to completely understand the normal and abnormal movement from the half-kneel to the standing position.
Objective: The purpose of this study was to investigate the effect of neck traction and foot type on plantar pressure distribution during walking. Method: Total of 24 data were collected from women working with a computer for more than 6 hours every day. Three groups by foot type were divided: Pes Planus, normal foot, and Pes Cavus. Depending on the foot type and cervical traction, plantar pressure variables were measured; CA, MF, PP, and CT. Each variable was divided into 12 masks. MANOVA was performed for the difference of plantar pressure variables by foot type, and a paired t-test was performed for the cervical traction within groups. Results: The total CA decreased in the Pes Planus (p<.001) and Pes Cavus (p<.05) groups. MF increased in the big toe (p<.01) and 2nd toe (p<.05) of the normal foot, and MF-3rd metatarsal decreased (p<.01). The MF-2nd toe (p<.01) and 3rd toe (p<.05) of Pes Cavus decreased. The PP decreased in 2nd toe (p<.05), 3rd toe (p<.01), and 4th toe (p<.05) of the Pes Cavus. In normal foot, the PP-3rd metatarsal (p<.05) and PP-4th metatarsal (p<.01) reduced. In Pes Planus, PP decreased in the hindfoot (p<.05). In Pes Cavus group wearing a neck-tractor, the CT-hindfoot increased (p<.05). Conclusion: There was a significant change in the plantar pressure change by foot type after neck traction. When walking with a neck-tractor, the heel impact was alleviated in the Pes Planus, and the Pes Cavus showed the smooth and effective propulsion in the push-off. Overall, weight acceptance was effectively performed when walking with neck-traction. It was also found that the neck-tractor corrects the alignment of the neck, thereby creating a more stable gait pattern.
The purpose of this study was to privide basic data for footwear development according to walking mechanics by comparing gait cycle difference between barefoot walking and walking shoes. The walking period was measured in 30 normal adult women with no foot deformity and abnormality. The first subject walked in sneakers and measured the cycle. And then, the subjects walked barefoot and the period was measured to obtain data. The data were taken form corresponding paired T-test. The results were as follows: In barefoot walking, the stance phase left side(p <.001), right side(p <.005), the loading response left side(p <.009), right side(p <.002) ), the pre-swing left side(p <.002), right side (p <.011), the double stance phase(p <.004) were increased and the mid-stance left side (p <.016), right side(p. 001), the swing phase left side(p<.001) was decreased. This suggests that barefoot walking increases the input of various senses of the foot, which makes stable walking possible. It is necessary to improve shoes based on the walking cycle in the future.
Purpose: This study is to identify the effect of Ankle Joint Taping applied to patients with chronic hemiplegia on their gait velocity and joint angles. Methods: We randomly extracted a clinical sample from 30 patients with hemiplegia resulting from stroke and classified them into two groups of a control group including 15 patients offered a regular therapeutic exercise and a test group including 15 patients offered taping. We also conducted the comparative analysis and pretest of the affected ankle joint angles by the normal characteristics of all subjects, Time to up and go test (TUG), 3D movement analyzer before the intervention. We applied taping to a test group for eight hours a day, five days a week during two weeks and conducted the comparative analysis of the gait velocity and the affected ankle joint angles by a comparison between and within two groups of before and after the intervention by conducting a posttest after the intervention. The result is as followings. Results: It indicated that there was a significantly decreased time with the increased gait velocity that a test according to a result of comparing the gait velocity within two groups (p<0.05). It indicated that there was a significantly increased angle in a comparison within two groups of test that inversion angle of a control group according to a result of comparing the ankle joint angles by 3D movement analyzer within groups (p<0.05). Conclusion: We found that TUG will help patients walk independently because it met a test group's need in the change of the gait velocity between two groups by recording less than 14 seconds which is the standard of using assistive aids and also found that ankle joint taping will help the joints prevent their function change considering that a control group showed an increased inversion angle in the change of the ankle joint within two groups.
Seo, Hye-Jung;Seo, Mu-Jung;Shin, Hyun-Hee;Oh, Tae-Young
Journal of the Korean Society of Physical Medicine
/
v.7
no.3
/
pp.293-302
/
2012
Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.
Jang, Sae Heon;Jae, Young Myo;Choi, Jin Hyuk;Bae, Jung Hoon;Seong, Sang Yoon;Cho, Se Hoon;Kim, Young Hoon
Korean Journal of Psychosomatic Medicine
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v.23
no.1
/
pp.66-69
/
2015
In addition to classical triad such as gait disturbance, urinary incontinence and dementia, parkinsonian extrapyramidal motor signs and neuropsychiatric symptoms can be observed in patients with normal pressure hydrocephalus (NPH). In our case, a 46 year old female patient showed extrapyramidal symptoms such as bradykinesia, rigidity and neuropsychiatric symptoms such as agitation, anxiety, restlessness and regressed behavior beside two(gait disturbance & urinary incontinence) symptoms of three classical triad. It was difficult to diagnose this patient as NPH from the beginning because of her relatively young age and previous psychiatric mediation history for controlling advanced anxiety and affective disorder. Antiparkinsonian agents and discontinuation of psychiatric medications did not work for this patient. Patient's brain computed tomographic finding showed enlarged ventricles. We suspected NPH and did empirical drainage of 30mL CSF. Finally, patient's pyramidal and neuropsychiatric symptoms as well as two of three classical triad of NPH were improved dramatically within several days. It is important to consider NPH as one of the differential diagnosis in patient with parkinsonian symptoms and various neuropsychiatric symptoms who did not respond to usual clinical management especially in case of ventricular enlargement in neuroimaging because of its treatable property by CSF shunt operation.
Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.
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