• Physical Therapy Korea
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• v.19 no.4
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• pp.16-23
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• 2012

This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.49-53
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• 2010

Purpose: The purpose of this study was to investigate the plantar pressure distribution between the affected and unaffected side in adult hemiplegia during gait with the use of a quad-cane. Methods: Thirty-four stroke patients from 34 to 83 years of age were enrolled in this study, and in random order, all patients were asked to walk at their most comfortable speed three times along a walkway with the use of quad-cane over a period of three days. Plantar pressure distribution was measured with regard to foot contact pattern and center of pressure (CoP) trajectories during the stance phase, progressing from heel-strike to toe-off. The F-scan system was used to compare the foot pressure of the affected and unaffected sides. Results: A significant reduction in the total contact area, the width of fore foot (FF) and hind foot (HF), and anterior/posterior (AP) CoP trajectory of the affected side was found. However, contact pressure of the hind foot on the affected side during walking increased when compared to that on the unaffected side. Conclusion: We demonstrated that plantar pressure distribution on the affected side of adult hemiplegia patients was generally poorer than that on the unaffected side when these patients walked with cane assistance. However, the use of a quad-cane was shown to increase contact pressure of the hind foot on the affected side because weight can be borne on the affected side during heel-strike with use of the cane.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.124-127
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• 2015

Purpose: The emphasis on gait rehabilitation after stroke depends on training support through the lower limbs, balance of body mass over the changing base of support. However, muscle weakness, lack of control of lower limb, and poor balance can interfere with training after stroke. For this case study report, a wearable robot orthosis was applied to stroke patients in order to verify its actual applicability on balance and gait ability in the clinical field. Methods: Two stroke patients participated in the training using the wearable robot orthosis. Wearable robot orthosis provides patient-initiated active assistance contraction during training. Training includes weight shift training, standing up and sitting down, ground walking, and stair up and down Training was applied a total of 20 times, five times a week for 4 weeks, for 30 minutes a day. Gait ability was determined by Stance phase symmetry profile, Swing phase symmetry profile, and velocity using the GAITRite system. Balance ability was measured using the Biodex balance system. Results: Subjects 1, 2 showed improved gait and balance ability with mean individual improvement of 72.4% for velocity, 19.4% for stance phase symmetry profile, 9.6% for swing phase symmetry profile, and 13.6% for balance ability. Conclusion: Training utilizing a wearable robot orthosis can be useful for improvement of the gait and balance ability of stroke patients.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.41 no.8
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• pp.771-782
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• 2017

This paper describes the development of a wearable robot to assist ankle power for the elderly. Previously developed wearable robots have generally used motors and gears to assist muscle power during walking. However, the combination of motor and reduction gear is heavy and has limitations on the simultaneous control of stiffness and torque due to the friction of the gear reducer unlike human muscles. Therefore, in this study, Mckibben pneumatic muscle, which is lighter, safer, and more powerful than an electric motor with gear, was used to assist ankle joint. Antagonistic actuation using a pair of pneumatic muscles assisted the power of the soleus muscles and tibialis anterior muscles used for the pitching motion of the ankle joint, and the model parameters of the antagonistic actuator were experimentally derived using a muscle test platform. To recognize the wearer's walking intention, foot load and ankle torque were calculated by measuring the pressure and the center of pressure of the foot using force and linear displacement sensors, and the stiffness and the torque of the pneumatic muscle joint were then controlled by the calculated ankle torque and foot load. Finally, the performance of the developed ankle power assistive robot was experimentally verified by measuring EMG signals during walking experiments on a treadmill.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Journal of Korea Society of Industrial Information Systems
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• v.28 no.4
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• pp.1-9
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• 2023

In this paper, we propose a method to recognize the braille blocks for embedded devices in real time through deep learning. First, a deep learning model for braille block recognition is trained on a high-performance computer, and the learning model is applied to a lightweight tool to apply to an embedded device. To recognize the walking information of the braille block, an algorithm is used to determine the path using the distance from the braille block in the image. After detecting braille blocks, bollards, and crosswalks through the YOLOv8 model in the video captured by the embedded device, the walking information is recognized through the braille block path discrimination algorithm. We apply the model lightweight tool to YOLOv8 to detect braille blocks in real time. The precision of YOLOv8 model weights is lowered from the existing 32 bits to 8 bits, and the model is optimized by applying the TensorRT optimization engine. As the result of comparing the lightweight model through the proposed method with the existing model, the path recognition accuracy is 99.05%, which is almost the same as the existing model, but the recognition speed is reduced by 59% compared to the existing model, processing about 15 frames per second.

• Journal of Korean Clinical Nursing Research
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• v.23 no.3
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• pp.350-360
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• 2017

Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.86-88
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• 1997

Regional sympathetic blockade is the most effective treatment for reflex sympathetic dystrophy (RSD). Radiofrequency thermocoagulation provides longer duration of pain relief than local anesthetics and less complication than chemical neurolytic agents for lumbar sympathectomy. Spinal cord stimulation (SCS) is thought to be an effective modality yieding good results in treating intractable neuropathic pain. Therefore RSD might be a good indication for SCS. We treated a patient with RSD who responded well to lumbar sympathetic blockade (LSB) with radiofrequency thermocoagulation and SCS. The patient had a left ankle sprain requiring a case for the lower leg for 2 weeks. The patient suffered increasing pain and swelling on the lower part of that leg. We thought to block the lumbar sympathetic chain utillzing radiofrequency thermocoagulation 2 days after LSB with local anesthetics. The results provided accepatable pain relief (VAS $8{\rightarrow}15$) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS $5{\rightarrow}13$) and patient could walk without assistance.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.332-342
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• 2002

Purpose: The purpose of this study was to assess the level of activities of daily living (ADL) in a group of community dwelling elderly. Methods: The subjects were 100 low-income elderly registered in a public health center. The data were analyzed using the SPSS/PC program. Results: The results were as follows: 1. The basic ADLs of the subjects were scored at 7 levels, and the mean score was 6.24 out of 7 points. The subjects did not necessarily require help from others, but might have needed more times or instrumental assists to perform ADLs. The lowest ADL score was reported on walking up to the stairs (5.05), for which the subjects did not need physical assistance, but needed a certain degree of supervision. The highest score was reported on self eating (6.74), followed by bowel management (6.60). 2. The mean IADL score of the subjects was 1.77 out of 4 points. indicating that the subjects were very independent in performing IADLs, without help from others. 3. In relation to general characteristics, the level of ADLs of the subjects was significantly different by age (F=6.65, P=.000), main activities (F=6.36, P=.001), perceived health status (P=4.66, P=.012), educational background (F=4.64, P=.03), marital status(F=4.62, P=.005), and major household income (F=4.15, P=.002). 4. The subjects' level of IADLs in relation to their general characteristics was significantly different by perceived health status (F=8.08, P=.001), major activities (F=7.33, P=.000), age (F=6.18, P=.000), family context (F=3.53, P=.018), religion (F=3.10, P=.019), marital status(F=2.62, P=.055), and major household income (F=2.31, P=.049).

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.539-542
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• 2005

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.