• 한국운동역학회지
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• 제31권1호
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• pp.30-36
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• 2021

Objective: The objective of the present study was to analyze the relationship between strength of the lower extremity's joints and their local dynamic stability (LDS) of gait in elderly women. Method: Forty-five elderly women participated in this study. Average age, height, mass, and preference walking speed were 73.5±3.7 years, 153.8±4.8 cm, 56.7±6.4 kg, and 1.2±0.1 m/s, respectively. They were tested torque peak of the knee and ankle joints with a Human Norm and while they were walking on a treadmill at their preference speed for a long while, kinematic data were obtained using six 3-D motion capture cameras. LDS of the lower extremity's joints were calculated in maximum Lyapunov Exponent (LyE). Correlation coefficients between torque of the joints and LyE were obtained using Spearman rank. Level of significance was set at p<.05. Results: Knee flexion torque and its LDS was negatively associated with adduction-abduction and flexion-extension movement (p<.05). In addition, ratio of the knee flexion torque to extension and LDS was negatively related to internal-external rotation. Conclusion: In conclusion, knee flexion strength should preferentially be strengthened to increase LDS of the lower extremity's joints for preventing from small perturbations during walking in elderly women.

• 전기학회논문지
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• 제65권2호
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• pp.349-353
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• 2016

The purpose of this study was to investigate possible age differences in the attenuation of acceleration in the upper body (from pelvis through shoulder to head) during fast walking. Thirty young and 29 elderly subjects participated in this study. Wireless acceleration sensors were attached on head, shoulder, and pelvis. Subjects performed two trials of fast walking on a treadmill, where the fast speed was defined as 1.5 times of the comfortable speed. Root-mean-squared (RMS) accelerations of each axis were compared with age group and sensor position as independent factors. In the AP direction, the pelvis acceleration was greater in the young and the shoulder-to-head attenuation was also greater in the young (p<0.001), so that the head acceleration was comparable between age groups (p=0.581). In the ML direction, the pelvis acceleration was greater in the young and also the pelvis-to-shoulder attenuation was greater in the young (p<0.001), so that the head acceleration was greater in the elderly group (p<0.001). Insufficient attenuation ML acceleration in the elderly resulting in the greater acceleration in the head may deteriorate the balance control which utilize feedback signals from the sensory organs in head, e.g., vestibular and visual systems.

• 시큐리티연구
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• 제24호
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• pp.33-51
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• 2010

본 연구의 목적은 민간경호원의 규칙적인 척추안정화 운동프로그램 적용 유 무에 따른 근기능 및 보행능력의 변화를 분석하는 것으로 다음과 같은 결론을 얻었다. 첫째, 척추안정화 운동프로그램과 관련된 근기능의 변화에 있어서 최대 요부신전근력 및 요부굴곡근력의 경우 운동그룹에서는 처치 전 후 요부신전근력과 요부굴곡근력 모두 증가되었고 비운동그룹에서도 처치 전 후 요부신전근력과 요부굴곡근력이 증가하는 것으로 나타났다. 그리고 처치전에는 두그룹간 차이가 없었으나, 처치후에는 운동그룹과 비운동그룹이 차이가 있는 것으로 나타났으며, 통계적으로도 유의한 차이가 나타났다. 둘째, 척추안정화 운동프로그램과 관련된 근기능의 변화에 있어서 요부 굴곡 신전근 비율의 경우 운동그룹과 비운동그룹 모두 처치 전에는 요부 신전근의 기능적 소실을 나타냈으나, 처치 후 운동그룹은 정상적으로 회복되었고, 비운동그룹은 요부 신전근의 기능적 소실을 나타내었으며, 통계적으로도 유의한 차이가 나타났다. 셋째, 척추안정화 운동프로그램과 관련된 근기능의 변화에 있어서 요부안정화근력의 변화에 있어서 총 8가지 방향으로 요부안정화근력을 분석하였으며, 운동그룹에서는 각도별로 요부 안정화근력이 증가하였고 비운동그룹에서는 각도별로 요부안정화근력이 감소하거나 변화가 없었으며, 통계적으로 유의한 차이가 나타났다. 넷째, 척추안정화 운동프로그램과 관련된 보행능력의 변화에 있어서 10m 보행검사를 이용하여 최대 보행시 속도와 보폭에 대하여 분석하였으며, 척추안정화 운동프로그램 적용 유 무에 따른 운동그룹에서 비운동그룹 보다 보행능력을 증가시키는 것으로 나타났으며, 통계적으로도 유의한 차이가 나타났다. 결론적으로 민간경호원에게 규칙적인 척추안정화 운동프로그램 적용은 요부신전근력, 요부 굴곡근력, 요부 굴곡 및 신전근 비율, 요부안정화근력, 보행능력 등에서 긍정적인 효과가 있는 것으로 나타났다. 이러한 결과는 척추안정화 운동프로그램이 민간경호원들의 요통의 완화 및 근력향상에 긍정적인 효과가 있으며, 환자들의 빠른 회복으로 보다 빠르게 사회로의 복귀를 도와줄 수 있을 것이다. 또한 경호원들을 대상으로 예방적인 또는 기능을 향상시키기 위한 운동처방 프로그램으로 활용가능하다고 생각한다.

• 한국산학기술학회논문지
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• 제17권12호
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• pp.363-370
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• 2016

본 연구의 목적은 속도가 다른 트레드밀 훈련이 다리 근두께에 어떠한 영향을 미치는지 알아보고자 하였다. 대상자는 대학생 남녀 36명을 평보군 (n=12)과 속보군 (n=12), 교차보행군 (n=12)으로 나누어 평보군은 평균 속도의 100%의 속도로 훈련을 실시하였고, 속보군은 평균 속도의 130%의 속도로 실시하였으며, 교차보행군은 130%의 속도와 100%의 속도를 각각 교차하면서 보행 훈련을 실시하였다. 훈련은 6주 동안 시행하였고, 주당 3회, 회당 60분간 시행하였다. 측정은 넙다리곧은근과 가쪽넓은근, 장딴지근, 앞정강근의 두께를 비교하기 위해 초음파영상장치를 이용하였다. 연구 결과 넙다리곧은근, 가쪽넓은근, 장딴지근에서 시간에 따라 유의한 증가가 있는 것으로 나타났고, 상호작용 또한 있는 것으로 나타났다. 그리고 앞정강근에서는 시간에 따라 유의한 증가가 있는 것으로 나타났다. 이상과 같은 결과로 보아 평속보다는 속도를 달리한 훈련을 실시하였을 때 다리 근육의 두께 변화에 영향을 미치는 것으로 생각되며, 추후 연구에서는 신경계나 근골격계 질환으로 인한 보행 장애를 가진 환자를 대상으로 재활 프로그램에 적용하는 연구가 지속적으로 이루어져야 할 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.571-577
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• 2015

Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.

• 국제물리치료학회지
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• 제3권1호
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• pp.370-377
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• 2012

This study examines the effects of different environments on the application of hemiplegia patients circuit balance training. Group 1 performed circuit balance training without any auditory intervention Group 2 performed training in noiseless environments and Group 3 performed training in white noise environments. First, among lower extremity muscular strength evaluation items, maximum activity time(MAT) was not significantly different(p>.05). Maximum muscle strength(MMS) increased significantly in Group 3(p<.01), there was no significant difference in MMS among the groups. Average muscle strength(AMS) indexes also significantly increased in Group 3(p<.01), there was no significant difference in AMS among the groups. Second, among balancing ability evaluation items, Berg's balance scale(BBS) scores significantly increased in all groups(p<.05), BBS scores were significantly difference among the groups. Based on the results, Group 1, 2 and Group 1, 3 showed significant increases (p<.05). Functional reach test(FRT) values significantly increased in Group 2, 3(p<.05), and there was no significant difference in FRT values among the groups. Timed up and go(TUG) test values significantly decreased in Group 2, 3(p<.05), and there was no significant difference in TUG test values among the groups. Third, among walking speed evaluation items, the time required to walk 10m significantly decreased in all groups(p<.05), and there was no significant difference in the values among the groups. Average walking speeds showed significant increases in Group 1, 3(p<.05), and there was no significant difference in the values among the groups. Based on the results of this study, noise environments should be improved by either considering auditory interventions and noiseless environments, or by ensuring that white noise environments facilitate the enhancement of balancing ability.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.8-17
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• 2014

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group ($n_1=14$) and the general neurodevelopment therapy (NDT) group ($n_2=16$). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.228-233
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• 2015

Purpose: Gait is the most basic element when evaluating the quality of life with activities of daily living under ordinary life circumstances. Symmetrical use of the lower extremities requires complicated coordination of all limbs. Thus, this study examined asymmetry of muscle activity quadriceps femoris and tibialis anterior as a baseline for training during over-ground walking and stair walking of stroke patients. Methods: Subjects were 14 stroke patients included as one experimental group. Gait speed used in this study was determined by the subject. Low extremity paretic and non-paretic EMG was compared using the surface EMG system. Results: The low extremity EMG difference was statistically significant during over-ground walking and stair walking (p<0.05). The result of low extremity EMG substituted symmetry ratio formula was compared to EMG symmetry ratio in both legs during over-ground walking and stair walking. The average symmetry ratio of quadriceps femoris during over-ground walking was 0.65, and average symmetry ratio of quadriceps femoris during stair walking was 0.47, with significant difference (p<0.05). Conclusion: EMG data was higher in stair walking than over-ground walking. However, in the comparison of symmetry ratio, asymmetric EMG of quadriceps femoris was significantly increased during stair walking. These findings suggested that application of stair walking for strengthening of both legs can be positive, but the key factor is maintaining asymmetrical posture of both legs. Therefore, physical therapists should make an effort to reduce asymmetry of quadriceps femoris power during stair walking by stroke patients.

• 한국운동역학회지
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• 제27권1호
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• pp.53-58
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• 2017

Objective: The purpose of this study was to compare the accuracy of stride time and stride length provided by a commercial APDM inertial sensor system (APDM) with the results of three dimensional motion capture system (3D motion) during treadmill walking. Method: Five healthy men participated in this experiment. All subjects walked on the treadmill for 3 minutes at their preferred walking speed. The 3D motion and the APDM were simultaneously used for extracting gait variables such as stride time and stride length. Mean difference and root mean squared (RMS) difference were used to compare the measured gait variables from the two measurement devices. The regression equation derived from the range of motion of the lower limb was also applied to correct the error of stride length. Results: The stride time extracted from the APDM was almost the same as that from the 3D motion (the mean difference and RMS difference were less than 0.0001 sec and 0.0085 sec, respectively). For stride length, mean difference and RMS difference were less than 0.1141 m and 0.1254 m, respectively. However, after correction of the stride length error using the derived regression equation, the mean difference and the RMS difference decreased to 0.0134 m and 0.0556 m or less, respectively. Conclusion: In this study, we confirmed the possibility of using the temporal variables provided from the APDM during treadmill walking. By applying the regression equation derived only from the range of motion provided by the APDM, the error of the spatial variable could be reduced. Although further studies are needed with additional subjects and various walking speeds, these results may provide the basic data necessary for using APDM in treadmill walking.

• 한국운동역학회지
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• 제26권1호
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• pp.135-142
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• 2016

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.