• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.91-99
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• 2022

Purpose : The goal of this study is to examine the effect of robot assisted gait training (RAGT) on the kinematic factors (temporospatial gait parameters, gait cycle ratio, and gait line length) of gait in stroke patients. Methods : The subjects of this study were 24 stroke patients selected by inclusion criteria. Participants were randomly allocated to two groups: robot assisted gait training (n=11) and general neurological physical therapy group (n=11). In the robot-assisted gait training group, robot-assisted gait training was mediated for 30 minutes a day in addition to general neurological physical therapy. The general neurological physical therapy group was mediated by general neurological physical therapy for 30 minutes a day in addition to general neurological physical therapy. The number of interventions was 5 times a week for 5 weeks. In order to compare the kinematic factors of walking between the two groups, gait analysis was performed before and after 5 weeks of training using the Zebris gait analysis system. Results : As a result of the gait analysis of the two groups, there were significant differences in temporospatial gait variables (step length, stride length, step width, step time, stride time), gait cycle ratio (swing phase, stance phase) and gait line length. However, there was no significant difference in the cadence (temporospatial gait parameters) in the robot assisted gait training group compared to general neurological physical therapy group. Conclusion : It is considered to be a useful treatment for stroke patients to promote the recovery of gait function in stroke patients. Based on the results of this study, continuous robot assisted gait training treatment is considered to have a positive effect on gait ability, the goal of stroke rehabilitation. In the future, additional studies should be conducted on many subjects of stroke patients, the kinematic factors of the legs according to the severity of stroke and treatment period, and the effect of gait training.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.459-466
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• 2016

This study examined the effects of robot-assisted therapy on the motor and functional recovery of the lower limbs in 53 subacute stroke patients. Robot-assisted therapy was performed using Lokomat? (Hocoma AG, Zurich, Switzerland) for thirty minutes per day, five times a week for four weeks. The outcome measures used were the Fugl-Meyer assessment, Motricity index(MI), Functional ambulation category(FAC), Berg balance scale(BBS) for gait function and balance ability, 10m walking test, K-Modified Barthel Index(K-MBI) for the activities of daily living and Mini mental state examination (MMSE), and Beck's depression inventory(BDI) for depression. All patients recruited underwent these evaluations before and after the four week robot-assisted therapy. For the evaluation, the somatosensory evoked potentials were used to assess the functional recovery. Robot-assisted therapy on the lower limb after subacute stroke showed improvement in motor strength, gait function, and the activities of daily living. All changes in terms of MI, FAC, BBS, and K-MBI exhibited a statistically significant difference after the four weeks robot-assisted therapy. The somatosensory evoked potential result showed a correlation with the MI and K-MBI. Robot-assisted therapy is believed to facilitate the motor and functional recovery of the lower limb in subacute stroke patients.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.71-76
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• 2016

Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.59-78
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• 2018

Objective : The purpose of this study was to investigate the effect of robot-assisted therapy on upper extremity function. Methods : This study used a single-subject experimental A-B-A' design. Three Parkinson's disease patients took part. Each subject received a robot-assisted therapy intervention (45 min/session, 5 sessions/week for 4 weeks). Upper extremity movement was evaluated with the Reo Assessment tool in Reogo. The Jebsen-Taylor hand motor function test, Fugle-Mayer Assessment score, Box and Block Test, and Nine-hole pegboard test were assessed pre- and post-intervention. Results : After intervention, all subjects underwent 3D motion analysis of reaching function. There was overall improvement in resistance, smoothness, direction accuracy, path efficiency, initiation time, and time to moving target with robot-assisted therapy. Robot-assisted therapy may have a positive effect on upper extremity movement in Parkinson's disease. Conclusion : Robot-assisted therapy is considered an alternative in clinical occupational therapy to improve upper extremity function in Parkinson's disease.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.65-73
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• 2022

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

• Proceedings of the Korean Society of Computer Information Conference
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• 2014.07a
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• pp.21-24
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• 2014

본 연구는 뇌손상(뇌졸중, 외상성 뇌손상, 뇌성마비 등)으로 인하여 손의 능동적 움직임이 결여되어 발생하는 관절의 구축, 근육의 단축, 근육의 탄력성 저하 등의 문제점을 분석하여 인체 역학적 모델에 따른 과학적 설계를 기반으로 환자의 손 기능 회복을 위하여 로봇 기술과 스마트폰의 융합을 통한 재활 로봇 보조 치료기를 설계하고 구현하였다. 제안된 시스템은 일반적인 근 경직을 치료하는 방법을 응용하여 IT 기술과 로봇기술을 융합하여 치료사들의 부담을 덜어 주고, 환자들에게 오랫동안 정확한 운동을 반복적으로 할 수 있도록 하는데 목적이 있다. 하나의 구동기로 2자유도의 움직임을 조절 할 수 있는 링크 매커니즘과 링크의 길이를 조절하여 신전(extension)과 과신전(Hyperextension)의 범위 조절이 가능하도록 로봇 플랫폼을 설계하였다. 또한 환자의 재활정도 및 상태에 적합한 운동속도, 운동반복횟수 등을 손쉽게 조작할 수 있는 등의 개인 맞춤형 재활훈련이 가능한 사용자 인터페이스를 설계 및 구현하였다.

• Physical Therapy Korea
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• v.28 no.3
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• pp.215-226
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• 2021

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

• Journal of Biomedical Engineering Research
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• v.45 no.2
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• pp.66-74
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• 2024

This study analyzed the occurrence of abnormal muscle coactivations based on the assistance of upper limb weight during reaching task in stroke patients. Nine chronic stroke survivors with hemiplegia performed reaching tasks using a programmable haptic robot. Electromyography (EMG) coactivation levels in the upper limb muscles were analyzed using a linear model describing the activation levels of two muscles when the patient's upper limb weight was assisted at 0%, 25%, and 50%. As the upper limb weight assistance of the haptic robot decreased, the magnitude of the EMG signal in both the deltoid and biceps muscles increased simultaneously on both the paretic and non-paretic sides. However, no difference was found between the paretic and non-paretic sides when comparing the slope of the linear model describing the activation relationship between the deltoid and biceps. The aforementioned results suggest that in some stroke survivors, the deltoids, triceps, and biceps on the paretic side may not be abnormally coupled when supporting the upper limbs against gravity. Furthermore, these results suggest that the combination of haptic robots and EMG analysis might be utilized for evaluating abnormal coactivations in stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.562-568
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• 2016

This study to investigated the therapeutic effect of robot-assisted rehabilitation (Lokomat) with virtual reality (VR) on Pusher syndrome (PS) after stroke. A total of 10 patients presented with PS after stroke were recruited. The participants were divided into two groups: Lokomat (n=5) and control groups (n=5). Lokomat and conventional physical therapy (CPT) were performed together in the experimental group, and the patients in the control group were treated with CPT only twice a day. One session of intervention was carried out for 30 minutes five times per week for 4 weeks. Scale for contraversive pushing (SCP), Berg balance scale (BBS), falling index (FI), and Timed up and go test (TUG) were measured before and after the intervention. The Lokomat group produced significantly better outcomes in SCP (p=0.046), BBS (p=0.046), FI (p=0.038), and TUG (p=0.038) compared with the control group after 4 weeks of intervention. In addition, there were significant correlations between SCP and BBS (p=0.024), FI (p=0.039), and TUG (p=0.030). In conclusion, Lokomat with VR more effectively aided recovery from PS after stroke, and restoration of PS symptoms was related with improvement of balance and gait function.