• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.134-139
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• 2017

Objective: Dual-task interference is defined as decrements in performance observed when people attempt to perform two tasks concurrently, such as a verbal task and walking. The purpose of this study was to investigate the changes of gait ability according to the dual task interference in chronic stroke survivors. Design: Cross-sectional study. Methods: Ten chronic stroke survivors (9 male, 1 female; mean age, 55.30 years; mini mental state examination, 19.60; onset duration, 56.90 months) recruited from the local community participated in this study. Gait ability (velocity, paretic side step, and stride time and length) under the single- and dual-task conditions at a self-selected comfortable walking speed was measured using the motion analysis system. In the dual task conditions, subjects performed three types of cognitive tasks (controlled oral word association test, auditory clock test, and counting backwards) while walking on the track. Results: For velocity, step and stride length, there was a significant decrease in the dual-task walking condition compared to the single walking condition (p<0.05). In particular, higher reduction of walking ability was observed when applying the counting backward task. Conclusions: Our results revealed that the addition of cognitive tasks while walking may lead to decrements of gait ability in stroke survivors. In particular, the difficulty level was the highest for the calculating task. We believe that these results provide basic information for improvements in gait ability and may be useful in gait training to prevent falls after a stroke incident.

• Physical Therapy Korea
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• v.19 no.3
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.10a
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• pp.24-24
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• 2003

For the elderly, achieving a close-to-normal ambulation is important for activities of daily life. Recent researches of SE(Silver Engineering) restoring physical ability would help the elderly by developing the advanced gait assisting devices and orthoses. For the applications using the advanced technologies, the gait characteristics of the elderly must be understood. However, a few studies were performed to investigate the physiological or pathological gaits. The purpose of this study is to provide the gait analysis data and also to investigate relationships between alignment of the lower limb, foot progression angle and knee joint moments in the healthy elderly. By participating a total of 20 healthy elderly persons in this study, the following facts were found: 1) Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04m, Step length was 0.56m; 2) The maximum knee flexion angle through swing phase showed left 46.82$^{\circ}$, right 40.19$^{\circ}$ and the maximum knee extension angle showed left -1.32$^{\circ}$, right 2.01$^{\circ}$. Knee varus showed left 26.90$^{\circ}$, right 30.93$^{\circ}$; 3) The maximum knee flexion moment showed left 0.363 Nm/kg, right 0.464 Nm/kg, The maximum knee extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximum knee adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg. The maximum internal rotational moment showed left 0.13 Nm/kg, right 0.140 Nm/kg; 4) The subjects who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase; and 5) The subjects who had large foot progression angle had statistically lower in knee adduction moment in late stance phase.

• Journal of the Korea Convergence Society
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• v.11 no.1
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• pp.57-63
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• 2020

The purpose of this study was to investigate the effects of sling exercise convergence with passive vibration on balance and gait in stroke patients. One time 35 minutes three times a week for six weeks. The sling exercise experimental group and the control group were divided into eight members. Balance and gait were measured. There was a significant difference between the eyes open standing and the eyes closed standing in the comparison between the experimental group and the control group. The experimental and control groups showed significant differences in the groups of eyes open standing and eyes closed standing, limits of stability and gait speed before and after intervention. Vibration sling exercise may help to improve the balance and gait of stroke patients. In the future, many patients, various frequencies, and effective exercise periods are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.57-66
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• 2020

Purpose : This study aimed to identify whether resistance exercise using elastic bands for six weeks can improve muscle strength, muscle tone, balance, and gait in patients with stroke. Methods : In total, 35 patients with stroke were randomly divided into three groups: resistance exercise using elastic band training combined with less affected side training group, more affected side training group, and both sides training group. Muscle strength, muscle tone, balance, and gait were assessed using a hand-held dynamometer, the modified Ashworth scale, the Berg Balance scale (BBS), and wireless 3-axis accelerometer, before and after training. Results : All three groups showed a significant increase in muscle strength of the lower extremity after training, and there was a significant difference among the groups. There was no change in muscle tone in all three groups. BBS scores increased significantly in all three groups after training, but these scores were not significantly different. The gait speed increased significantly in all three groups after the training, but the difference was not significant. The cadence increased significantly in Group 2 after training; however, there was no significant difference between Groups 1 and 3. There were no significant differences between the groups before and after the training. Step length increased significantly in Groups 2 and 3 after the training, but it was not significantly different in Group 1. After training, Groups 2 and 3 were significantly greater than Group 1 in the change in step length. Conclusion : The results show that resistance exercise using elastic bands can improve strength, balance, and gait in patients with chronic stroke. Especially, more affected side training was more effective in improving muscle strength than less affected side training. More affected side and both sides training are thought to be more effective than less affected side training to improve step length.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.1-8
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• 2011

Purpose : The purpose of this study was to find out the effect of closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius on gait in stroke. Methods : 30 hemiplegic patients voluntarily participated in this study. Subjects were divided into experimental group(n=15) and control group(n=15). Experimental group was given closed kinetic chain exercise with FES of the gluteus medius and control group was given only closed kinetic chain exercise for 4 weeks. All subjects were measured 10m-walking speed, cadence, functional walking category(FAC) and modified motor assessment scale(MMAS) before and after intervention. Results : In experimental group, gait velocity, cadence, FAC and MMAS showed significant difference between pre and post test(p<.05). In control group, gait velocity, cadence and FAC showed significant difference between pre and post test(p<.05). Before intervention, gait velocity, cadence, FAC and MMAS were not significant difference between experimental group and control group(p>.05), but after intervention, gait velocity, FAC and MMAS were significant difference(p<.05). Conclusion : This study show that closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius is beneficial intervention for increase the wlking ability in stroke.

• Physical Therapy Korea
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• v.21 no.3
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• pp.80-88
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• 2014

Previous studies have reported that decreased cognitive ability has been consistently associated with significant declines in performance of one or both tasks under a dual-task walking condition. This study examined the relationship between specific cognitive abilities and the dual-task costs (DTCs) of spatio-temporal gait parameters in stroke patients. The spatio-temporal gait parameters were measured among 30 stroke patients while walking with and without a cognitive task (Stroop Word-Color Task) at the study participant's preferred walking speed. Cognitive abilities were measured using Computerized Neuropsychological Testing. Pearson's correlation coefficients (r) were calculated to quantify the associations between the neuropsychological measures and the DTCs in the spatio-temporal gait parameters. Moderate to strong correlations were found between the Auditory Continuous Performance test (ACPT) and the DTCs of the Single Support Time of Non-paretic (r=.37), the Trail Making A (TMA) test and the DTCs of Velocity (r=.71), TMA test and the DTCs of the Step Length of Paretic (r=.37), TMA test and the DTCs of the Step Length Non-paretic (r=.36), the Trail Making B (TMB) test and the DTCs of Velocity (r=.70), the Stroop Word-Color test and the DTCs of Velocity (r=-.40), Visual-span Backward (V-span B) test and the DTCs of Velocity (r=-.41), V-span B test and the DTCs of the Double Support Time of Non-paretic (r=.38), Digit-span Forward test and the DTCs of the Step Time of Non-paretic (r=-.39), and Digit-span Backward test and the DTCs of the Single Support Time of Paretic (r=.36). Especially TMA test and TMB test were found to be more strongly correlated to the DTCs of gait velocity than the other correlations. Understanding these cognitive features will provide guidance for identifying dual- task walking ability.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.155-164
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• 2020

Objective: This study aimed to compare muscle structure, balance, and gait parameters between healthy adults and persons with stroke and to analyze the correlation among these variables. Design: Cross-sectional study. Methods: Twenty persons with stroke (11 male, 9 female) and twenty healthy participants (9 male, 11 female) were included. Ultrasound images of the triceps surae and the tibialis anterior were acquired in sitting resting, sitting co-contraction, and standing resting positions and also during the functional reach test (FRT) and single leg anterior reaching test (SLART). Muscle thickness and fascicle length were measured. Spatiotemporal parameters of gait were measured using a pressure walkway. Gait speed, cadence, step length, stride length, stance time, and swing time were measured. Results: Changes in percent fascicle length were significantly greater in the gastrocnemius and soleus (SOL) muscles of healthy adults in the sitting co-contraction position (p<0.05). The percent fascicle length of the SOL in FRT and SLART were significantly greater in healthy adults (p<0.05). The mid-stance phase of stroke patients was shorter than healthy adults (p<0.05). A negative correlation was observed between percent fascicle length of the SOL in the sitting co-contraction position and the proportion of the mid-stance phase (p<0.05). Conclusions: The function of the triceps surae is affected in persons with stroke when compared with healthy adults. This can lead to difficulty in performing tasks that involve forward transfer of weight. If the triceps surae is not sufficiently secured, the possibility of compensation in the stance phase increases during gait.

• Korean Journal of Applied Biomechanics
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• v.17 no.1
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• pp.111-119
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• 2007

The purpose of this study was to investigate muscle activity and gait pattern in lower limb depending on the outsole of heel rockers. Fifteen healthy men volunteered for this experiment. Each subject performed totally three trails with two pairs of different heel rocker shoes and a pair of normal running shoes at speed of 1.33m/s for 1 minute during walking on a treadmill. Kinematic data gathered in 100Hz was recorded and analyzed by using the 3D motion capture system to measure the trunk tilt and joint angle of the right lower limb. And the lower extremity muscle activities were simultaneously recorded in 1000Hz and assessed by using EMG. The statistical analysis was the one-way ANOVA with the repeated measures to compare among the three kinds of shoes. The level of statistical significance for all tests was 0.05. Joint angle of lower limb was showed statistically significant different in MST(hip joint), LHS(ankle joint), and RTO(knee and ankle joint). Muscle activity of rectus femoris and biceps femoris was statistically increased in both heel rocker shoes during gait cycle on treadmill. The maximum peak time of tibialis anterior in the negative heel rocker showed the delay of approximately 23.8%time than normal shoes. Gait pattern variability of the negative heel rocker was increased in the first half of the stance phase and the variability of the positive heel rocker was increased in the terminal stance phase. In Conclusion, stability was decreased in between joints of lower limb on positive heel rocker than negative heel rocker. This study found that there were different joint angle, muscle activity, gait pattern and coordinate system of the lower limb in each kind of shoes. These unstability affected the lower extremity and the whole body. A further study has to be continued with study of rehabilitation and exercise for a long-term.

• The Journal of Korean Physical Therapy
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• v.33 no.4
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• pp.202-209
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• 2021

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects' knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group. Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion: This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.