• 제목/요약/키워드: hemiplegic gait

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팔걸이 형태에 따른 편마비 환자의 보행 변수 및 비마비측 견갑대의 근활성도 변화 (The Variations in Gait Parameters and the Muscle Activities on the Non-Affected Side of the Shoulder Girdle According to Arm Sling Type in Patients with Hemiplegia)

  • 이옥경;안덕현;유원규;오재섭;윤지연
    • 한국전문물리치료학회지
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    • 제17권3호
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    • pp.77-86
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    • 2010
  • The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

체중현수 트래드밀 훈련이 뇌졸중노인의 보행과 근활성에 미치는 영향 (The Efficacy of Treadmill Training with Body Weight Support on Ambulation and Muscle Activity with Elderly Chronic Stroke)

  • 김성학
    • 대한물리치료과학회지
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    • 제11권2호
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    • pp.27-37
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    • 2004
  • The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).

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감각귀환형 기능적 전기자극 시스템(SEFES)을 위한 발압력 분포 계측시스템의 개발 (Development of Measurement Systems of Foot Pressure Distribution for Sensory-Feedback type FES System(SEFES))

  • 김주명;김양영;양경모;고수복;정동명
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1994년도 춘계학술대회
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    • pp.88-91
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    • 1994
  • We develope a assistant system of foot pressure distribution for improvement gait Pattern, adapted working speed, and minimitation of muscle fatigue of the sensory feedback type FES system(SEFES). This measurement system consist of mat type pressure sensor with piezo electric films. The pressure data signal multiflexed input scanning method processed A/D conversion after two step amplify and integrate. Matrix sensor interface to PC for pseudo color display by level of Pressure distribution data. This measurement system clinically evaluated in hemiplegic patients. It has produced acceptable results with optimal location of the food sensor's pressure point and avoid the muscle fatigue.

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뇌졸중 후유증으로 인한 족하수(Foot drop)의 예방과 치료에 첩대 요법을 병행한 환자 치험 2례 (The 2 Case Report with Hemiplegic gait and foot drop after Cardiovascular Accident improved by Taping therapy)

  • 최인호;황진우;유상민;정재중;이용현;송윤경;임형호
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.49-60
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    • 2006
  • This study report foot drop patients, who improved by taping therapy. We applied therapy and check ROM, walking ability, MMT. It is considered that this therapy is meaningful for Foot drop.

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시지각 운동 과제 프로그램이 편마비 환자의 자세 균형 및 독립적 보행에 미치는 효과 (The Effects of Visuo-perceptual Task Exercise on Postural Balance and Independent Gait Pattern in Hemiplegic Patients)

  • 이동엽;송창호
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2009년도 춘계학술발표논문집
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    • pp.119-122
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    • 2009
  • 본 연구는 뇌졸중으로 인한 편마비 환자 20명을 대상으로 총 8주간 시지각 운동 과제를 적용하여 자세 균형, 보행 양상에 미치는 효과를 검증하고자 시행하였다. 실험군(n=10)과 대조군(n=10) 모두 보존적인 물리치료를 실시하였고 실험군에는 시지각 운동 과제 프로그램을 더하여 실시하였다. 본 연구의 결과는 실험군의 되먹임 측정을 통한 자세 균형 검사에서 편평한 지면 위에서 눈을 뜨고 감은 상태의 안정성 지수는 유의한 감소를 보였으며, pillow 위에서 눈을 뜨고 감은 상태의 안정성 지수도 유의하게 감소하였다. 체중분포지수는 편평한 지면에서 눈을 뜨고, 감은 상태와 pillow 위에서 눈을 뜨고 감은 상태 모두에서 유의하게 감소하였다. 실험군에서 10m 보행 속도는 대조군과 달리 유의하게 증가하였다. 본 연구에서의 시지각적 운동과제 프로그램은 편마비 환자의 신체기능과 관련된 자세균형 및 보행을 증진시키는 효과가 있었고 이에 보다 효과적인 운동방법으로 제시할 수 있다.

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고유수용성 신경근 촉진법에 의한 편마비 환자의 보행 및 계단 오르기 변화 (Change of walking and stair up in hemiplegia by Proprioceptive Neuromuscular Facilitation techniques)

  • 김대경
    • The Journal of Korean Physical Therapy
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    • 제11권3호
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    • pp.57-64
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    • 1999
  • The purpose of this study is to evaluate the effects of the lower extremities patterns in proprioceptive neuromuscular facilitation to the gait and stair up of the hemiplegic stroke patient. the patient was taken lower extremities patterns in porprioceptive neuromuscular facilitation with 5 times per week for 8 weeks. The results were as followings ; 1. The walking times was decreased from 78 seconds to 39 seconds at 20m, 2. The stride length was increased from 48.3cm to 93.3cm. 3. The step length was increassed from 25.2cm to 47.2cm. 4. The stair up was increased from 3.2cm to 15.5cm.

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편마비환자의 균형기능 향상에 관한 문헌적 고찰 (Improvements in Balance of Patients with Hemiplegia A Literature Review)

  • 강권영;송병호
    • 대한물리치료과학회지
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    • 제15권2호
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    • pp.87-95
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    • 2008
  • Background: Hemiplegic patients usually have difficulty maintaining balance. Balance training is a major component of there habilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of PLS(Posterior Leaf Spring), FES(Functional Electrical stimulation), treadmill training, and neurodevelopmental treatment on the improvement of balance in patients with hemiplegia. Methods: We looked into published studies from Dankook University’s electronic library databases of RISS4U, KMbase, NCBI, and MEDLIS concerning the effectiveness of any form of intervention leading to improvement of balance. All types of studies relevant to the topic that were published in English during the time period of 1986 to 2005 were included. Results: 1. There were significant differences in standing balance, dynamic activity balance, and gait speed between barefoot subjects and subjects who wore SPAFO and HPAFO(p<.05). 2. The changes in ROM and FRT related to sex, age, height, and weight part of the diagnosis, as well as experience relapse, was of meaningless value. Changes in ROM related to the duration of pain and experiences of falling down were also meaningless. However, FRT showed significant static differences(p<.05). 3. The body-weight-support treadmill training scoring of standing balance, step length, and a timed 10m walking test showed definite improvement. 4. The proprioceptive control approach improved dynamic balance in patients with hemiplegia. Conclusion: Consequently, further study is needed to verify methods when physical therapists are researching balance ability in hemiplegic patient.

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슬관절 움직임 제한 보조기를 이용한 슬관절 과신전 제한이 편마비 환자의 균형과 보행에 미치는 영향 (Effects of Limited Hyperextension at Knee Joint Using Limited Motion Knee Brace on Balance, Walking in Patients with Hemiplegia)

  • 이은혁;민경옥;이강성
    • 한국콘텐츠학회논문지
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    • 제10권3호
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    • pp.258-265
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    • 2010
  • 본 연구는 편마비 환자 중 슬관절 과신전으로 인해 균형 및 보행 장애를 보이는 환자들에게 슬관절 움직임 제한 보조기로 과신전을 제한시킨 연구군과, 치료사의 손으로 과신전을 제한시킨 대조군으로 나누어 전통적인 물리치료를 실시해 치료 전, 후와 두 간을 비교하여, 슬관절 움직임 제한 보조기가 슬관절 과신전이 있는 편마비 환자의 균형과 보행에 미치는 영향을 알아보고자 하였다. 연구 대상은 서울 참병원에서 편마비로 인하여 편마비라고 진단 받고 입원 및 통원 치료를 하는 환자 중 슬관절 과신전을 보이는 20명을 대상으로 무작위로 연구군과 대조군으로 나누어 연구 전, 후를 BBS (Berg Balance Scale), TUG (Time Up & Go Test), 보행 능력 평가를 이용하여 측정 비교 하였다. BBS를 이용해 균형능력을 측정한 결과 연구군, 대조군 모두에서 실험 전, 후에 유의한 차이를 보였다(p<0.05). 또한 TUG를 이용한 균형능력 측정 결과에서도 연구군, 대조군 모두에서 실험 전, 후에 유의한 차이를 보였다(p<0.05). 보행 능력 검사를 이용해 보행능력 평가를 한 결과 연구군, 대조군 모두에서 실험 전, 후에 유의한 차이를 보였다 (p<0.05). 균형 및 보행능력을 주 단위로 측정한 결과 연구군과 대조군 모두에서 유의한 증가를 보였고 (p<0.05), 두군 간에는 균형능력에서만 유의한 차이가 있었다(p<0.05). 하지만 그래프상으로 봤을 때 연구군에서 균형과 보행능력의 더 많은 증가를 보였다. 본 연구 결과 슬관절 움직임 제한 보조기를 사용한 슬관절 과신전 제한 후 치료는 편마비 환자의 보행능력 증진에는 유의한 효과가 없었지만, 균형능력 증진에 유의한 효과가 있었다.

Effects of White Noises on Gait Ability of Hemiplegic Patients during Circuit Balance Training

  • Jang, Na-Young;Kim, Gi-Do;Kim, Bo-Kyoung;Kim, Eun-Hee;Koo, Ja-Pung;Shin, Hee-Joon;Choi, Seok-Joo;Choi, Wan-Suk
    • 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.

Comparison on postural control between abdominal draw-in maneuver and abdominal expansion maneuver in persons with stroke

  • Choi, Ho-Suk;Shim, Yu-Jin;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • 제5권3호
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    • pp.113-119
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    • 2016
  • Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.