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A Comparative Study on Clinical Gait Abilities of Stroke Patients According to Indoor and Outdoor Environments

  • Hwang, Hyesun;Woo, Youngkeun;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.10 no.3
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    • pp.356-366
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    • 2021
  • Objective: This study aimed to compare gait ability through gait evaluations in indoor and outdoor environments according to the general characteristics and walking ability of stroke patients. Design: Crossed-sectional study. Methods: The subjects of this study were 57 hospitalized stroke patients.The study subjects were asked to select an indoor environment and an outdoor environment in random order, and the Timed Up and Go Test (TUG), 10-Meter Walk Test (10MWT), Figure-Eight Walk Test (F8WT) and the Functional Gait Assessment (FGA) were used to assess each environment. Results: The TUG, 10MWT, F8WT time and number of steps, and FGA showed a significant decrease in gait ability in the outdoor environment compared to the indoor environment (p<0.05). Although the TUG, 10MWT, and the time required for the F8WT were statistically higher in the outdoor compared to the indoor environment at points 2, 3, and 4, but not 5 of the functional ambulatory category (FAC), significant increases in the number of steps of the F8WT were found in the outdoor compared to the indoor environment for only points 2 and 3 of the FAC (p<0.05). In the FAC 3 and 4, there was a statistically significant decrease in the outdoor compared to the indoor environment only in the FGA (p<0.05). Conclusions: Therefore, it has been shown that the gait ability of stroke patients is reduced in the outdoor environment compared to the gait ability in the indoor environment.

A Comparative Study on Biomechanical Variables of Elderly Women and Elderly Women at Risk of Fall in Gait by Environmental Conditions (환경조건에 따른 보행 시 낙상 위험 여성 노인과 정상 여성 노인의 생체역학적 변인 비교 연구)

  • Kim, Tae-Whan;Kim, Dae-Hyun;Min, Seok-Ki;Cho, Eun-Hyung;Lee, Jin-Seok
    • Korean Journal of Applied Biomechanics
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    • v.31 no.3
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    • pp.189-198
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    • 2021
  • Objective: The aim of this study is to investigate the effect of biomechanical variables on gait according to indoor and outdoor environmental conditions in elderly women at risk of falling. Method: 26 elderly women aged 70 years or older, and consisted of 13 elderly people with a walking speed of less 1.0 m/s and 13 people in the fall risk group as normal groups. Depending on the purpose of the study, physical examination and psychological questionnaire were prepared, and then walking was performed in an indoor/outdoor environment, and the gait pattern, muscle activity, and plantar pressure results were compared and analyzed in the elderly females through a 2 group × 2 environment 2-way repeted ANOVA analysis. Results: The gait variable showed an interaction effect the cadence. The muscle variables showed interaction effects in the rectus femoris and tibialis anterior muscles, and the interaction effects of the plantar pressure variables were confirmed in the forefoot and midfoot of the contact area, and the midfoot of the mean pressure. Conclusion: These results indicate that both groups are exposed to falls risk when gait in an outdoor environment, but the fall risk group has a higher risk of falls in both the gait pattern, muscle activity, and plantar pressure variables. The results of this study are considered to be helpful as basic data and development of exercise programs to prevent falls.

Study on Effects of Auditory Feedback and Application of Functional Electrical Stimulation During Gait on Balance, Gait and Lower Extremity Function in Patients with Subacute Stroke (아급성기 뇌졸중 환자의 보행동안 청각적 피드백과 기능적 전기 자극 적용이 균형, 보행 및 하지 기능에 미치는 영향)

  • Min-Ju Nam;Yong-Bum Jung ;Chang-Geol Kim ;Myoung-Kwon Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.3
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    • pp.55-64
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    • 2023
  • PURPOSE: Examine the effects of auditory feedback and functional electrical stimulation on balance, walking ability, and lower extremity function of subacute stroke patients. METHODS: Twenty-seven subjects diagnosed with subacute stroke within six months were randomly divided into three groups: test group 1, which performed walking exercises with auditory feedback and functional electrical stimulation; test group 2, which performed walking exercises only with functional electrical stimulation; control group applied only functional electrical stimulation, with nine subjects each. RESULTS: There were significant pre- to post-intervention differences in BBS in the gait training group with auditory feedback and functional electrical stimulation treatment, and significant pre- to post-intervention differences in BBS, sit-to-stand time, and average step speed in the gait training group with functional electrical stimulation, but no statistically significant differences in between-group comparisons. CONCLUSION: Gait training with auditory feedback and functional electrical stimulation can improve the balance and gait performance in stroke patients. Therefore, in the future, gait training with auditory feedback and functional electrical stimulation therapy may be suggested as a gait rehabilitation training tool for stroke patients.

The Effect of Ankle Balance Taping on Gait and Balance in Stroke Patients

  • Kyoung-Won Kim;Ki Bum Jung;Dong-Ho Kim;Yongwoo Lee
    • Physical Therapy Rehabilitation Science
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    • v.12 no.2
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    • pp.123-129
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    • 2023
  • Objective: Kinesio tape has been applied to the ankle to improve balance and gait. Stroke patients show abnormal gait patterns due to foot drop. This study aimed to determine the effects of ankle balance taping which to support the ankle joint on balance and gait in patients with chronic stroke. Design: A randomized controlled trial. Methods: Twenty-four chronic stroke patients were selected and randomized into experimental group (n=12) and control group (n=12). The experimental group applied kinesio taping three times a week for three weeks, and the control group applied placebo taping for the same amount of time. To evaluate the effectiveness of the treatment, the subjects' walking ability, static balance, and dynamic balance were assessed before and after the experiment. Gait speed and spatiotemporal gait ability were measured to examine walking ability, postural sway velocity and velocity moment for static balance, and Timed-Up and Go test and Berg Balance Scale were conducted to check dynamic balance. Results: The experimental group showed a significant increase in walking ability, static balance, and dynamic balance in the within-group pre-post difference (p<0.05). In the between-group comparison, the experimental group had a significant difference in walking ability than the control group (p<0.05). Conclusions: Ankle balance taping can help improve gait, and this study can be used as a basis for future studies of ankle balance taping.

A Study on Stride-to-stride Variability by Treadmill Walking (트레드밀을 이용한 보행간 Variability 분석에 관한 연구)

  • Choi, Jin-Seung;Kang, Dong-Won;Tack, Gye-Rae
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.1-8
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    • 2007
  • The purpose of this study was to investigate the difference in the stride-to-stride variability between two treadmill conditions; traditional treadmill and special treadmill whose speed can be adjusted automatically by subject's walking speed. Eight male subjects (25.1 years, 172.7 cm, 66.6 kg) were participated in treadmill walking experiment. First, preferred walking speed (PWS) of each subject was determined. Second, each subject performed walking experiment with fixed PWS condition and with free PWS condition for 10 minutes. 3D motion capture system (Motion analysis Corp., USA) with 6 cameras was used to collect motion data with sampling frequency of 120Hz. Temporal and spatial variables for stride-to-stride variability were calculated. Coefficient of variance (CV) which quantifies the amount of variability and Detrended Fluctuation Analysis (DFA) which explains the structure (self-similarity) of the variability were used for analysis. Results showed that the amount of variability during free PWS condition was greater than that of fixed PWS condition. DFA results showed that there was a statistical difference between two treadmill conditions for the variables of step length, stance time, and double support time. From these results, it is possible that traditional treadmill study might give incorrect conclusion about gait variability study. Further study is necessary to clarify these matters by considering the number of subjects, experimental time, and gait variables for the study of stride-to-stride variability.

Development of Insole Sensor System and Gait Phase Detection Algorithm for Lower Extremity Exoskeleton (하지 외골격 로봇을 위한 인솔 센서시스템 및 보행 판단 알고리즘 개발)

  • Lim, Dong Hwan;Kim, Wan Soo;Ali, Mian Ashfaq;Han, Chang Soo
    • Journal of the Korean Society for Precision Engineering
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    • v.32 no.12
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    • pp.1065-1072
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    • 2015
  • This paper is about the development of an insole sensor system that can determine the model of an exoskeleton robot for lower limb that is a multi-degree of freedom system. First, the study analyzed the kinematic model of an exoskeleton robot for the lower limb that changes according to the gait phase detection of a human. Based on the ground reaction force (GRF), which is generated when walking, to proceed with insole sensor development, the sensing type, location, and the number of sensors were selected. The center of pressure (COP) of the human foot was understood first, prior to the development of algorithm. Using the COP, an algorithm was developed that is capable of detecting the gait phase with small number of sensors. An experiment at 3 km/h speed was conducted on the developed sensor system to evaluate the developed insole sensor system and the gait phase detection algorithm.

Comparison of Gait Pattern during the Support Phase after Perturbation According to Age (보행 시 지지면 급변에 따른 연령별 운동학적 반응 형태 비교)

  • Chun, Young-Jin;Shin, In-Sik
    • Korean Journal of Applied Biomechanics
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    • v.21 no.3
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    • pp.281-288
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    • 2011
  • The purpose of this study was to analyze the difference in reaction patterns during the support phase after perturbation in gait according to different age. A total of 12 subjects participated; 5 elderly and 7 adults(control), to investigate the differences between normal and perturbed gait. The step length didn't change during normal and perturbed gait but was longer in the control group. There was no difference in the step width. When the right foot was perturbed, the control group's left foot speed was faster than the elderly group's which was to maintain stability. The elderly flexed both right and left knees more than the control group. After the perturbation, the elderly group had a larger trunk anterior flexion. With the larger flexion of both legs of the elderly group it shows that the lack of knee flexion strength is a factor, that could cause falling and so a prevention program should focus on strengthening the quadriceps. With the excessive trunk flexion after the perturbation by the elderly group observed, it is suggested that while walking everyday a good routine of walking with an upright posture should be developed.

Effect of Gender Difference on the Functional Asymmetry during Preferred Walking Speed

  • Hyun, Seunghyun;Ryew, Checheong
    • International journal of advanced smart convergence
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    • v.9 no.2
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    • pp.49-57
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    • 2020
  • We have not identified on what gender difference during gait at a pace of one's preferred velocity effects on the function of bilateral lower limb. This study was undertaken to investigate a difference of gait strategy by gender during gait at a one's preferred velocity of participants of adult male and female (n=20). Cinematographic data for motion analysis, ground reaction force (GRF) variables, and muscle volume of lower limb were analyzed. Significant difference of variables on movement of center of mass whole body, joint angle and moment of lower limb, and ground reaction force were tested by 2-way ANOVA analysis (P<0.05). Male group showed more muscle volume than female, and both showed more volume in dominant leg than non-dominant. Main effect by bilateral leg during gait showed higher difference in right than left leg in change of vertical position of center of mass (maximal, minimal). Main effect by gender in vertical change of position and velocity of center of mass showed higher difference in male than female (maximal, minimal). Hip joint showed more flexed and extended angle in male than female, and also dorsiflexion of ankle and flexion moment of knee and hip joint showed higher in male than female group. Therefore, this result was assumed that dominant showed furthermore more contribution for propulsive function than non-dominant leg. Gender difference showed in strategy controlling of biomechanical characteristics, and perhaps influenced by muscle volume.

Characteristics of Pelvic Ranges According to Artificial Leg Length Discrepancy During Gait: Three-Dimensional Analysis in Healthy Individuals (보행 중 인위적 다리길이 차이에 따른 3차원적 골반 가동범위의 특성)

  • Kim, Yongwook
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.2
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    • pp.59-67
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    • 2019
  • Purpose : The purpose of this study was to analyze the dynamic range of motion (ROM) of pelvic and translation of center of mass (COM) when wearing different shoe insole lifts according to leg length discrepancy (LLD) during free speed gait. Methods : Thirty-five healthy adults were participated in this study. Kinematic data were collected using a Vicon motion capture system. Reflective and cluster 40 markers attached to participants lower extremities and were asked to walk in a 6 m gait way under three different shoe lift conditions (without any insole, 1 cm insole, and 2 cm insole). The pelvic ROM and COM translation in three planes were sorted using a Nexus software, and a Visual3D motion analysis software was used to coordinate all kinematic data. Results : There were significantly increased maximal pelvic elevation and total pelvic range in coronal plane when wearing a standard shoe with 2 cm insole lift during gait (p<.05). When wearing a standard shoe with 2 cm insole lift, the total range of the pelvic segment were significantly different in all three motion planes (p<.05). Conclusion : Although LLD of less than 2 cm develops abnormal movement pattern of the pelvis and may cause of musculoskeletal diseases such as low back pain, hip and knee joint osteoarthritis, therefore intensive various physical therapy interventions for LLD are needed.

The Effect of Side-Step Tasks Based Circular Training Program on Balance and Gait in Stroke Patients

  • Sang Jun Son;Joong-Hwi Kim
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.384-390
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of the side-step tasks based circular training program (STCT) on balance and gait characteristics in stroke patients. Design: A randomized controlled trial Methods: Twenty-four stroke patients were randomly divided into two groups of twelve patients each. One group was applied with the STCT whereas the other group was treated with conservative physiotherapy (CP). The ability of gait was measured in 10m walking test and stride length on both side using BTS G-WALK (BTS Bioengineering S.p.A, Italy) and the ability of balance was measured in Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Results: The STCT group was significant differences in the balance parameters of BBS and TUG (p<0.05) and showed significant differences in gait variables in 10m walking speed, stride length of affected and non-affected side after the experiment before and after the experiment (p<0.05). In addition, the STCT group showed a significant difference in BBS compared to the control group (p<0.05). Conclusions: The results of this study confirmed that the side-step tasks based circular training program (STCT) improves balance and walking ability in stroke patients. STCT is expected to be used as a useful intervention method for stroke rehabilitation.