The purpose of the study was to determine if there was a difference in the Functional Ambulation Performance score of senior adults with or without a history of falls during walking at a preferred velocity. Twelve subjects with a history of falling (mean age=73.8) and eight subjects with no history of falling (mean age=70.4) participated in the study. Temporal and spatial parameters of gait were analyzed using the computerized GAITRite system. The GAITRite system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance score. The Functional Ambulation Performance score is a Quantitative means of assessing gait based on specific temporal and spatial parameters. Statistical analysis of the two groups demonstrated a significant decrease in Functional Ambulation Performance score for those with a history of falls. They had lower values for step/extremity ratios, mean normalized velocity, and greater values for step times, percent in double support. These results indicate that the GAITRite system can be useful in detecting footfall patterns and selected time and distance measurements of persons with a history of falls and the Functional Ambulation Performance score can be used as indicators of gait performance for senior adults with a history of falls.
Objective : The goals of surgical intervention for metastatic spinal cord compression (MSCC) are prolonging survival and improving quality of life. Non-ambulatory paraplegic patients, either at presentation or after treatment, have a much shorter life expectancy than ambulatory patients. We therefore analyzed prognostic factors for survival and postoperative ambulation in patients surgically treated for MSCC. Methods : We assessed 103 patients with surgically treated MSCC who presented with lower extremity weakness between January 2001 and December 2008. Factors prognostic for overall survival (OS) and postoperative ambulation, including surgical method, age, sex, primary tumor site, metastatic spinal site, surgical levels, Tokuhashi score, and treatment with chemo- or radiation therapy, were analyzed retrospectively. Results : Median OS was significantly longer in the postoperatively ambulatory group [11.0 months; 95% confidence interval (CI), 9.29-12.71 months] than in the non-ambulatory group (5.0 months; 95% CI, 1.80-8.20 months) ($p$=0.035). When we compared median OS in patients with high (9-11) and low (0-8) Tokuhashi scores, they were significantly longer in the former (15.0 months; 95% CI, 9.29-20.71 months vs. 9.0 months; 95% CI, 7.48-10.52 months; $p$=0.003). Multivariate logistic regression analysis showed that preoperative ambulation with or without aid [odds ratio (OR) 5.35; 95% CI 1.57-18.17; $p$=0.007] and hip flexion power greater than grade III (OR 6.23; 95% CI, 1.29-7.35; $p$=0.038) were prognostic of postoperative ambulation. Conclusion : We found that postoperative ambulation and preoperative high Tokuhashi score were significantly associated with longer patient survival. In addition, preoperative hip flexion power greater than grade III was critical for postoperative ambulation.
Since the current tendencies show us the increasing number of cerebral palsy children and the standard longevity, we need to find out more research about the following various problems. Therefore I have tried to figure out the difference of oxygen saturation and heart rate between before ambulation and after. Objects chosen are 17 C.P children on the process of treatment those who were able to walk and 8 normal children in Ah-San hospital, Gang-Nung. They haven't had either any operation or suffered heart disease and I measured their oxygen saturation and heart rate by using pulse-oximeter and are analyzed by SPSS (10.07 version). Results are the followings; 1. There was no difference of oxygen saturation and heart rate between pre-ambulation and post-ambulation of normal and spastic hemiplegia children. 2. There showed the significant statistic difference of oxygen saturation, heart rate between pre-ambulates and post-ambulation of normal and spastic diplegia(p<.05). 3. There was no difference of oxygen saturation, heart rate in C.P between(p>.05), but shows the significant statistic difference in heart rate(p<.05). As I compared the oxygen saturation and heart rate of spastic and normal children on between pre-ambulation and post-ambulation, theres is significant statistic difference on both items (p<.05). However there was no difference of oxygen saturation among hemiplegia, normal and diplegia children while the pulse rate showed the significant difference(p<.05). According to this clinical research, CP children's oxygen saturation and heart rate had no change between pre and post compared to normal children. But there was difference in diplegia. This is why we need to invest time to study these kinds of research about various analysis and comparison of oxygen saturation and heart rate, and furthermore making use of pulse-oxymetry in physical therapy room for the children involved would be beneficial to calculate in accuracy without any discomfort for the patient as well.
Purpose : The purpose of this study was to describe the Inter-expert cooperation strategy for community ambulation in stroke patient. Methods : The data was collected by stroke patient. We applied the Inter-expert cooperation strategy for community ambulation to stroke patient. Parameters of result were collected for using the 10m walk test, 6 minute walk test and ICF assessment sheet. Results : Significant differences were observed the stroke patient for 10m walk test, 6 minute walk test and ICF assessment sheet. stroke patient improved all test. Conclusions : Inter-expert cooperation strategy applied community ambulation is very useful and effective. It is effective in clinical practice.
Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.
Journal of the Korea Academia-Industrial cooperation Society
/
v.14
no.6
/
pp.2788-2794
/
2013
The study was conducted to determine the effect of community ambulation training and treadmill training on the gait ability and stroke impact scale in patients with hemiplegia due to stroke. Twenty-two patients with hemiplegia due to stroke were assigned to the community ambulation training group(n=11) or treadmill training group(n=11). Both groups were executed conventional treatment for 5 times per week for 6 weeks 30 minutes per session. Each group performed additional exercise for 30 minutes. Post treatment, compared to the treadmill training group, community ambulation training group showed significantly increased velocity, cadence, stroke impact scale(p<.05). These results support the perceived benefits of community ambulation training to augment on the gait ability and stroke impact scale of stroke patients. Therefore, community ambulation training is feasible and suitable for stroke patients.
The purpose of this study is to estimate how much the motility of affected and unaffected lower limb respectively would have effects on their ambulation through comparing the difference between their affected and unaffected lower limb and studying the correlation between such difference and their ambulation. In addition, the study also intends to find out remedial measures suitable for improving their ambulation with relevant physical treatment. To do this, a quantitative electromyogram(QEMG) test was done to both quadriceps and hamstring of affected and unaffected lower limb so as to yield IP values. Based on such IP values, RMS(root mean square) values as the total sum of IP values were found with QEMG analysis system (made by Medelec Co.) and then the ambulation depending on the difference in muscular strength were analyzed by ink-foot print method as well as the corresponding statistics were processed by T-test through SPSS. The effect of differences in muscular strength of quadriceps in affected and unaffected limb of hemiplegic patients on their ambulation was also different in each element of ambulation. However, there was not any statistically significant difference (p>.05). The differences in muscular strength of hamstring in unaffected limbs of hemiplegic patients only affect stride length. It was statistically significant. The effect of difference in muscular strength of the hamstring in affected limb of hemiplegic patients on their ambulation was very different between strong and weak group in terms of walking velocity, step per minute, stride and step length, showing statistically significant difference(p<.05). Although there was a difference in the step length of the affected limb, it was not statistically significant(p>.05). For the unaffected hamstring, there were significant differences of stride length between in unaffected limb and in affected limb. For the affected hamstring, there were also significant differences in walking velocity, step per minute, stride and step length. Besides, it was found that the difference of the muscular strength between strong and weak group was at the highest. Thus, the effect of difference in muscular strength on ambulatory factors such as walking velocity, step per minute, stride and step length did not show any statistical significance but differences in affected and unaffected quadriceps. However, it was found that both the difference of stride in unaffected hamstring and the difference of all ambulatory factors except from step length with affected limb had effects on ambulation depending upon muscular strength.
The purpose of this study was to introduce rotation-plasty procedure and prosthetic ambulation training. The recent development of chemotherapy and diagnostic facility have permitted the orthopaedic surgeons to try limb saving procedures rather than amputations for the treatment of the malignant bone tumors. If the tumors around the knee joint were treated by mid-thigh amputation or hip disarticulation, it would impose the client with a great handicap for rehabilitation. Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used a malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has the great functional advantage of converting the above-knee amputation to the below-knee amputation. The inverted foot was also good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight. This 15 years old girl case was had rotation-plasty due to osteosarcoma of the distal femur with 3rd postoperative chemotherapy, and admitted to Yonsei rehabilitation hospital for prosthetic ambulation training. Then, the case had excellent functional results of prosthetic ambulation training with rotaion-plasty after 3 months.
The purpose of this study is to introduce prosthetic discipline and ambulation training after hemipelvectomy due to osteosarcoma. Over the past years, when the malignant bone tumors occurs in the extremities amputation is not enough to prevent a part recurrence and distal transformation resulting in fatal prognosis. On the other hand, these procedures could bring about a difficulty in rehabilitation in curing patient who have had hemipelvectomy. However the recent development of chemotherapy and diagnostic facility have permitted the orthopedic surgeons to many try amputations for the treatment of the malignant bone tumors. Unfortunately, there has not been many researches on hemipelvectomy. Since there is no studies found on hemipelvectomy either. Therefore, we introduce successful procedures for rehabilitation through the ambulation training for patients who have had amputation. One of our patients, who is an eighteen years old male, has had hemipelvectomy on the eighteenth of June in 1997 after his anticancer treatment over 12 times. He has had physical therapy of prosthetic ambulation training at the department of rehabilitation medicine Yonsei University Medical Center from the fifteenth of October to December '2nd in 1997.
Purpose: This study was to compare the effects of early ambulation to usual care of late ambulation in patients with transarterial chemoembolization on back pain, discomfort, and puncture site complications. Methods: A nonequivalent control pretest-posttest design was used. Total 40 patients were recruited from a gastrointestinal unit of an urban general hospital in Seoul, South Korea. The experimental group began to ambulate after 4 hours of bed rest with a compression bandage after receiving transarterial chemoembolization. The control group stayed in bed with a compression bandage overnight. Results: Back pain was not significantly different between the two group. The experimental group reported significantly lower discomfort than the control group. There was no incidence of bleeding complications on puncture site between two groups. Conclusion: The results of this study showed that early ambulation with four hours of bed rest after femoral sheet removal did not cause bleeding complications compared to the usual care and even decreased patients' level of discomfort due to bed rest. Repetitive research on the effect of short bed rest is warranted for its clinical utilization.
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