• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.498-504
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• 2014

Objectives: This study investigated the change of foot rotation angle of gait analysis parameters according to gait improvement in post-stroke hemiplegic patients. Methods: We measured the foot rotation angle of eight post-stroke hemiplegic patients at the time of dependent and independent gait. Results: The foot rotation angle of the paralyzed side reduced closer to normal average according to gait improvement, but the non-paralyzed side not significantly. Conclusions: Improvement of foot rotation is an important thing for independent gait of post-stroke hemiplegic patients so this treatment seems worthy of being considered in clinical trials.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.239-245
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• 2013

Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.448-454
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• 2014

Objectives: The aim of this study was to analyze the change of lateral shift of Center of Pressure (CoP) according to the gait improvement in post-stroke hemiplegic patients and to investigate relationship between the change of motor grade and lateral shift of CoP. Methods: We measured the lateral shift of CoP and motor grade of eight post-stroke hemiplegic patients at the beginning of dependent gait and independent gait. Results: We found that CoP tended to be shifted to the non-affected side when patients started to walk independently. Furthermore, there was no relationship between the change of motor grade and lateral shift of CoP. Conclusions: This result may suggest it is more important to control the non-affected side than the affected side, at least until the beginning independent gait.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.471-477
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• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.125-131
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• 2020

Purpose : Lower extremity orthoses have been used as conservative methods to recover gait of the stroke patients. The purpose of this study is to examine how newly designed pelvic belt orthosis can improve gait ability and dynamic balance of adults with Hemiparesis after stroke. Methods : 22 patients who had hemiparesis after stroke participated in this study. Two groups were randomly created by assigning 10 subjects to the experimental group and the rest of the 12 subjects to the control group. The control group was treated by conventional physical therapy and occupational therapy. Identical therapy protocols were used to treat the experimental group who were assigned to wear the pelvic belt orthosis during post measurement. This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The GAITRite system was used to measure spatial-temporal gain parameters and the balance system SD to measure dynamic balance. The data was analyzed using R version 3.3.1. Random forest, boosting algorithm, and MANOVA test were conducted to determine the effects of independent variables on dependent variables. Results : This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The independent variable "group" has the most important value, which is approximately 25.42 (%IncMSE) representing a value three times greater than the second important predictor "height." Conclusion : As a result of this research, the hypothesis is validated with conclusion that Pelvic Belt orthosis could be effectively used for improving gait ability and balance of the patients with post-stroke hemiparesis.

• The Journal of Korean Physical Therapy
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• v.14 no.1
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• pp.75-88
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• 2002

The purpose of this study was to investigate the influence of anterior, posterior, and lateral pelvic tilt exercise upon the gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of this study was 24 men and women patients with hemiplegia. The patients, the subject of this study, were classified into 12 patients of treatment group applying pelvic tilt exercise using visual feedback and 12 patients of control group applying general pelvic tilt exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis (Boening, 1977) was used to analyze their gait, and ink foot-print was applied as on of measurement methods. To find out meaningful difference between control group and treatment group, this study carried out independent sample t-test for each item by utilizing SPSS/Win 10.0, compared changes in control group's and treatment group's gait characteristics before and after exercise as percentage, and applied paired t-test to conduct before-after test in same group. Statistical significance level was ${\alpha}$ < 0.05. The results of this study were as follows. As a result of independent sample t-test for control group's and treatment group's gait characteristics after exercise, it was not statistically significant so there was no meaningful difference between two groups. However, it was statistically significant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that pelvic tilt exercise using visual feedback for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general pelvic tilt exercise. In the future, studies on the effect of pelvic tilt exercise using visual feedback shall be continued based on more quantitative methods.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.465-473
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• 2011

Purpose : This study was to evaluate gait velocity and muscle activity on 3 different gait conditions in elderly women. Methods : There were one group was 20's generation(n=12), and the other group was over 60's generation (n=12). The velocity of gait was analysed for using the Footscan system, EMG(MP150) for muscle activity. Subjects were measured 3 gait condition(normal, obstacle-10cm, dual obstacle-10cm. Measured values were used by the independent t-test for analysing between groups, and repeated measurement of ANOVA for analysing within group. Results : The results were as follow: velocity and acticities of lower 4 muscles were significantly differences in experimental group. In control group, there were not significantly differences. Contrast-groups were significantly differences of velocity(obstacle, dual obstacle), muscle activities(soleus-dual obstacle, hamstring-all). Conclusion : These results indicate that elderly people are reduced gait ability in dual task, and obstacle gait. So Elderly women need to training obstacle/dual gait for preventing falling.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.399-404
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• 2013

Purpose: To investigate the effects of initiation side on gait symmetry in the chronic stroke patients. Methods: Twenty one patients with independent gait after stroke were divided into the paretic-leg gait initiation group (PLI) and the nonparetic-leg gait initiation group (NPLI). The symmetry ratio (SR) was calculated from of the spatiotemoral and kinematic parameter which measured by 3D motion analysis. Results: In the spatiotemporal variables, SR-step length and SR-velocity was significantly different between groups (p<0.05). In the kinematic variables, SR-TOAA and SR-SwPAA of the hip joint was significantly different between groups (p<0.05). Conclusion: We suggest that the initiating leg may influence on the gait symmetry of stroke patient These results will be a helpful reference in hemiplegic gait training or intervention.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.4
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• pp.249-255
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• 2009

Purpose：To investigate of gait component in Parkinson's Disease patient. Methods：participated Parkinson's Disease patient(n=12) and Normal adult(n=13). gait measure used by GaitRite. Results：SPSS for win version 12 was used for statistic analysis and independent t-test used to find between two groups. In the comparison of temporal parameter of gait between groups, the swing phase was significant decreased in Parkinson's groups, in the stance phase was significant increased in Normal groups, in the single support was significant decreased in Parkinson's groups and in the double support was significant increased in Parkinson's groups(p<.05). In the asymmetrical ratio of singele support was significant increased in Parkinson's groups(p<.05), and the swing phase and stance phase was significant increased in Parkinson's groups(p<.05). Conclusion：In the Parkinson's Disease patient gait showed temporal and spatial component variable changes comparison normal adult. therefore, it was seems to very important considerable at gait tranning in clinical intervention.