• The Journal of Korean Physical Therapy
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• 제20권1호
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• 대한통합의학회지
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• 제11권3호
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• pp.147-157
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• 2023

Purpose : Stroke patients exhibit considerable variations in gait patterns. Stroke patients generally show abnormal muscle tone and gait. This study was performed to evaluate the effects of treadmill gait training combined with muscle tone control technique (TM) on gait ability in patient with chronic stroke. Methods : A single-blind, randomized controlled trial was conducted with 36 patient with chronic stroke. They were randomly allocated 2 groups; treadmill gait training combined with muscle tone control technique group (TM group; n=18) and conservative treatment group (CG group; n=18). The TM group received 15 minutes muscle tone control technique and 15 minute treadmill gait training. In the conservative treatment group received 30 minutes conservative physical therapy. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome gait ability were measured by gait measurement system (Optogait, Microgate, Italy) and 10 m walking test (10MWT). An independent t-test was used to statistically analyze the pre-test and pos-ttest gait ability results. Results : Both groups demonstrated significant improvement of outcome in gait ability during intervention period. TM group showed significant differences in gait ability as compared to the CG groups (p<.05). TM group showed significant differences in 10MWT as compared to the CG groups (p<.05). Our results showed that TM was more effective on gait ability in patients with chronic stroke. Conclusion : Our findings of this study confirmed that the treadmill gait training combined with muscle tone control technique provided significant improvements on gait ability in patient with chronic stroke. Therefore treadmill gait training combined with muscle tone control technique may positive influenced gait ability. This study will be able to be used as an intervention data for recovering gait ability in patients with chronic stroke.

• 대한한방내과학회지
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• 제37권5호
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• pp.763-769
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• 2016

Objective: To confirm the immediate gait improvement in a post-stroke gait disturbance patient equipped with a weighted vest. Methods: We selected a patient who was able to walk without another’s help or with tools. The selected patient had an unstable gait because she had only started an independent gait within the past week, so we thought that a weighted vest could be very helpful for her. We first collected gait parameters using a treadmill gait analysis system while the patient walked on the treadmill without the weighted vest. After a 10-minute break, gait parameters were collected again while the patient walked on the treadmill while wearing the weighted vest. The gait parameters we collected included step length (cm), stance phase (%), swing phase (%), SW/ST, and gait line length (mm). For objective evaluation of gait improvement, we calculated the ratio of gait parameters of the right and left limbs. Results: The gait of the post-stroke patient was more symmetrical when wearing the weighted vest than without the weighted vest. Without the weighted vest, her step length ratio was 0.78, stance phase ratio was 0.88, swing phase ratio was 1.50, SW/ST ratio was 1.70, and gait line length ratio was 0.91. With the weighted vest, her step length ratio was 0.88, stance phase ratio was 0.90, swing phase ratio was 1.38, SW/ST ratio was 1.54, and gait line length ratio was 0.98. No side effects were observed due to the weighted vest.

• 대한물리의학회지
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• 제5권4호
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• pp.577-585
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• 2010

Purpose : This study was to evaluate gait velocity and stance time on 5 conditions in elderly women and elderly women with LBP. The subjects were 70's generation. Methods : The subjects are 20 divided into 2 groups. They measured gait velocity, stance-time. The 5 conditions were normal gait, 10cm obstacle gait, 25cm obstacle gait, dual 10cm obstacle gait, dual 25cm obstacle gait. The experimental period was between 2008/12 and 2009/2. Statistical analysis was used Repeated measurement for difference between conditions, independent t-test for difference in two groups. Subjects were countdown from 50 during dual task gait. Results : The results were as follow: there were significantly difference 10cm obstacle velocity, dual 10cm obstacle velocity in two group. The others were not significantly differences. Velocity and stance-time were significantly difference in control group. In dual 25cm obstacle gait, velocity was difference of normal gait. Stance-time was difference in 25cm obstacle gait, and dual 25cm obstacle gait. In Experimental group, velocity and stance-time were not significantly difference. But measured value of velocity was gradually decreased and stance time was increased. Conclusion : These results indicate that elderly people with LBP women are reduced gait ability in dual task, and obstacle condition. So they need to prevent falling in dual task, and obstacle gait and to train obstacle/dual tak gait.

• 대한의용생체공학회:의공학회지
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• 제28권2호
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• pp.218-228
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• 2007

Modem concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. In this study, we developed an active gait training system for patients with gait disorder. This system provides joint movements to patients who cannot carry out an independent gait. It provides a normal stance-swing ratio of 60:40 using an eccentric configuration of two gears. Joint motions of the knee and the ankle were evaluated with using the 3D motion analysis system and compared with the results from the multi-body dynamics simulation. In addition, clinical investigations were also performed for low stroke patients during the 6-week gait training. Results from the dynamics simulation showed that joint movements of the knee and the ankle were affected by the gear size, the step length and the length of the foot plate, except the radius of curvature of the foot guide plate. Also, the 6-week gait training revealed relevant improvements of the gait ability in all low subjects. Functional ambulation category levels of subjects after training were 2 in three patients and 1 in a patient. The developed active gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke.

• 한국전문물리치료학회지
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• 제13권3호
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• pp.18-23
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• 2006

The limited walking ability after a stroke restricts a patient's independent mobility at home and in the community. It also brings about significant social handicaps. Therefore, it is necessary to improve walking ability in community-dwelling persons with stroke. The purpose of this study was to evaluate the effectiveness of gait training and muscle strengthening exercise of lower extremities in persons with chronic stroke. Nineteen community-dwelling individuals with stroke participated in this program. The exercise program lasted for seven weeks, with a 1-hour program twice per week, and it consisted of balance training, gait training, and strengthening of lower extremities. The outcome of the program was assessed by the gait speed, Wisconsin Gait Scale (WGS), Berg Balance Scale (BBS), and Stroke Impact Scale (SIS). Significant effects were found for the WGS, BBS, and mobility and hand function domain of the SIS (p<.05). It was found that short-term gait training exercise could improve quality of gait, balance, and mobility. Therefore, a more effective exercise program is required for community-based persons with stroke.

• 대한인간공학회지
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• 제32권6호
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• pp.489-494
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• 2013

Objective: This study compared the effects of streamlined shoes on dynamic gait and foot plantar pressure in healthy young adults. Background: With the importance of ankle and lower extremity mechanism, streamlined shoes are contributing to a static gait factors. However, the study of dynamic gait factor is still insufficient. Method: Sixty subjects were randomly allocated to two groups: experimental group(n=30) and control(n=30), respectively. The experimental group performed streamlined shoes, whereas the control group applied usual shoes. Main outcome measurements were assessed contact time, step length and foot plantar pressure using gait analysis with the treadmill. Independent t-test was used to compare the both groups. Results: Compared with control group, contact time of forefoot, midfoot and hindfoot decreased significantly in experimental group(p<.05), Step length increased significantly in experimental group(p<.05). Foot plantar pressure of midfoot and hindfoot increased significantly in experimental group(p<.05), whereas that of forefoot did not show significantly in experimental group(p>.05). Conclusion: Our findings suggest that streamlined shoes was more effective than usual shoes in dynamic gait change including contact time and step length and foot plantar pressure in healthy young adults. Application: The results of streamlined shoes might help to control for the gait of industrial workers.

• The Journal of Korean Physical Therapy
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• 제34권6호
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• pp.326-331
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• 2022

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

• 대한한방내과학회지
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• 제36권4호
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• pp.478-485
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• 2015

Objectives: The purpose of this study was to analyze the change of area and average velocity of the center of pressure (COP) according to gait improvement in post-stroke hemiplegic patients.Methods: We measured the area and the average velocity of COP displacement of ten post-stroke hemiplegic patients while they stood quietly on a force plate at the time of dependent and independent gait . We also measured the area and the average velocity of COP displacement of normal persons to verify differences between them and post-stroke hemiplegic patients.Results: The area of COP displacement decreased significantly, and the average velocity of COP displacement tended to decrease, but not significantly. There were significant differences in the area and the average velocity of COP displacement between post-stroke hemiplegic patients and normal persons.Conclusions: The results of this study show that postural control ability improves as gait improves.

• 한국전문물리치료학회지
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• 제11권1호
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• pp.1-17
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• 2004

The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.