• Title/Summary/Keyword: walking rehabilitation

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Effects of Fast Treadmill Training on Spinal Alignment and Muscles Thickness

  • Kim, Won-Gi;Kim, Yong-Seong;Kim, Yong-Beom;Jeong, Ho-Jin;Kim, Jae-Woon;Cho, Woon-Su
    • The Journal of Korean Physical Therapy
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    • v.29 no.4
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    • pp.175-180
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    • 2017
  • Purpose: This study examined the effects of fast walking training on a treadmill on the spinal alignment and muscle thickness of normal adults. Methods: A total of 36 college students in their twenties participated in the study for eight weeks, and they were divided into the normal walking, fast walking, and speed change groups. All the groups were measured in a pre-test before training. The subjects performed exercise three times per week for six weeks. A post-test was conducted six weeks after training began, and a follow-up test was done two weeks after the training ended.Trunk and pelvic tilts were measured in Formetric 4D for the spinal alignment of the subjects. The muscle thickness was examined in the trunk with an ultrasound test. Repeated-measures ANOVA was conducted to test the main effects and interactions among the measurement variables according to time and group. Results: Significant differences were observed in the pelvic tilt according to time. There were significant differences in the external oblique, internal oblique, transverse abdominal muscle according to time. The post-test results showed significant differences in the left external oblique, internal oblique muscles between before training, six weeks into training, and two weeks after the completion of training. There were significant interactions in the left oblique muscles according to the time and group. Conclusion: These findings have some value for patient rehabilitation and clinical applications and interventions through walking training.

The Spatio-temporal Analysis of Gait Characteristics during Ramp Ascent and Descent at Different Inclinations (정상인의 경사로 보행 시 경사각에 따른 시공간적 보행 특성 분석)

  • Han, Jin-Tae;Cho, Jeoung-Sun;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.18 no.1
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    • pp.95-106
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    • 2006
  • Purpose: The aim of this study was to investigate the kinematics of young adults during ramp climbing at different inclinations. Methods: Twenty-three subjects ascended and descended four steps at four different inclinations(level, $8^{\circ},\;16^{\circ},\;24^{\circ}$). Temporal-spatial parameters were measured by GaitRite system(standard mat). Groups difference was analysed with on-way ANOVA and Student-Newman-Keuls test. Results: The different kinematics of ramp ascent and descent were analysed and compared to level walking patterns. In ascending ramps, step length and stride length decreased with $24^{\circ}$ inclination (p<.000). Stance duration increased with $24^{\circ}$, but swing duration decreased with $24^{\circ}$ inclination (p<.000). Step time and velocity decreased with $16^{\circ}C,\;24^{\circ}$ inclination (p<.000). Cadence decreased with all inclination($8^{\circ},\;16^{\circ},\;24^{\circ}$)(p<.000). In descending ramps, step length and stride length, velocity decreased with all inclination($8^{\circ},\;16^{\circ},\;-24^{\circ}$)(p<.000). Stance duration increased with all inclination($8^{\circ},\;-16^{\circ},\;-24^{\circ}$) and swing duration decreased with all inclination($-8^{\circ},\;-16^{\circ},\;-24^{\circ}$)(p<.000). But Step time was not differentiated with different inclinations. Cadence decreased with only. $8^{\circ}$ inclination(p<.05). Conclusion: These results suggest that there is a certain inclination angle or angular range where subjects do switch between level walking and ramp walking gait pattern. This shows their motor control strategy between level and ramp walking. Further studies are necessary to confirm and detect the ascent and descent ramp gait patterns.

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The Effect of Genu Valgum on the Body Mass Index, Moment of Lower Limb Joints, Ground Reaction Force (신체질량지수, 하지관절의 모멘트, 지면반발력이 무릎외반슬에 미치는 영향)

  • Lee, Yong-Seon
    • Korean Journal of Applied Biomechanics
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    • v.25 no.3
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    • pp.257-263
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    • 2015
  • Objective : The purpose of this study was to investigate the effect of genu valgum on the body mass index, movement of lower limb joints, and ground reaction force. Methods : Gait patterns of 30 college students with genu valgum were analyzed and the static Q angle of the femur was measured for selecting genu valgum of the subjects. To analyze the kinetic changes during walking, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. Results : As a result of measuring a relationship between genu valgum and Q-angle, as the Q-angle increases, it showed a genu valgum also increased. Body Mass Index showed a significant difference between the groups was higher in the genu valgum group.(p<.001). The analysis result showed that genu valgum had a significant effect on the internal rotation moment in the hip joint(p<.05). Also, genu valgum had a significant effect on the internal rotation moment of the knee joint(p<.05). The comparative analysis of the Medial-Lateral ground reaction force in the genu valgum group showed a tendency to increase the medial ground reaction force(p<.05). The vertical ground reaction forces of the middle of the stance phase(Fz0) showed a significant increase in genu valgum group(p<.05), in particular the results showed a decrease in the early stance phase(p<.001). Conclusion : In conclusion, the change in body mass is considered to be made by proactive regular exercise for improvement of the genu valgum. In addition, the prevention of the deformation caused by secondary of the genu valgum in this study may be used as an indicator of the position alignment rehabilitation for structural and functional improvements. Applying a therapeutic exercise program for the next lap will require changes in posture alignment.

Relationships Between Cognitive Function and Gait-Related Dual-Task Interference After Stroke

  • Kim, Jeong-Soo;Jeon, Hye-Seon;Jeong, Yeon-Gyu
    • 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.

The Effect of Presynaptic Inhibition Using the Transcutaneous Electrical Stimulation for Global Synkinesis on the Post-Stroke Hemiplegic Patients (경피전기자극을 이용한 연접 전 억제가 만성 뇌졸중 환자의 global synkinesis에 미치는 영향)

  • Park, Young-Hyun;Kim, Su-Hyun;Choi, Hyun;Oh, Seok;Choi, Ji-Ho;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.7-13
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    • 2010
  • Purpose : This study was performed as follows in order to investigate the effect of presynaptic inhibition mechanism using the transcutaneous electrical stimulation (TES) for global synkinesis (GS) on the post-stroke hemiplegic patients. Methods : The subjects consist of 38 post stroke hemiplegic patients; experiments were performed on thirty patients excluding eight. The experiment was performed on sham group, sensory level stimulation group, and motor level stimulation group for 20 minutes a day 5 times a week for 6 weeks total. We compared the differences in GS levels and walking ability. The measurements were carried out pre, immediated, post 10th, and 20th, for a total of four measurements. Results : The GS level using sEMG found significant differences between groups at the post 10th and post 20th in dorsiflexion, and post 20th in plantarflexion (p<0.05, p<0.01). The motor level group indicated more significant differences when the number of electrical stimulations increased. TUG and 10 m walking test indicated a significant difference at immediated, post 10th, and post 20th. The motor level group showed more significant decreasing tendency than the sensory level group. Conclusion: From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.

Effects of Rotation Direction during Curved Walking on Gait Parameters in Stroke Patients (뇌졸중 환자의 회전 보행 시 회전 방향이 보행 특성에 미치는 영향)

  • Jung, Kyeoung-Man;Joo, Min-Cheol;Jung, Yu-Jin
    • Quality Improvement in Health Care
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    • v.23 no.2
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    • pp.11-20
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    • 2017
  • Purpose: The purpose of this study was to determine the effects of rotation direction during curved walking on gait parameters in stroke patients. Methods: A group of thirty subjects with stroke (Berg Balance Scale score${\geq}41$ were fifteen, Berg Balance Scale score${\leq}40$ were fifteen) were enrolled in this study. Testing indications included two directions for rotation in each subject. These indications were for rotation toward the affected and unaffected side in stroke patients. The gait speed, affected side single support duration, affected side double support duration were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 40 points of Berg Balance Scale score. Results: There was significant increase affected side single support duration was turned the affected side in stroke patients that presented a Berg Balance Scale score${\geq}41$ (p<.05). There were significant increase gait speed, affected side single support duration, and significant decrease affected side double support duration while subjects were turned the affected side in stroke patients that presented a Berg Balance Scale score${\leq}40$ (p<.05). Conclusion: This result may be effective to rotate in the paralyzed direction to improve the ability of the paralyzed lower limb to gain weight during gait training for stroke patients with a Berg Balance Scale score<40. Therefore, walking training program for hemiplegic patient needs to be suggested in the direction of turning for suitable balance ability.

Effects of excessive Pronation of the Foot on Knee joint Strength and Gait (발의 과도한 회내 상태가 슬관절 근력과 보행에 미치는 영향)

  • Jung, Sang-mo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.77-85
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    • 2021
  • BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

Analysis of the Correlation Between Executive Function and Obstacle Gait Evaluation for the Elderly (노인의 실행기능 평가와 보행 평가사이의 상관관계 분석)

  • Lee, Seung-Min;Lee, Han-Suk
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.3
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    • pp.51-58
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    • 2022
  • PURPOSE: This study aimed to evaluate the correlation between executive function and gait evaluations for the elderly, and validate the obstacle gait evaluation as a cognitive impairment test tool. METHODS: This study was a cross-sectional design. 79 people aged 65 years or older were selected as subjects. The Korean version of the Mini-Mental State Examination (MMSE-KC) to evaluate overall cognitive function and the Trail Making Test (TMT) A, B to measure executive function were performed. The 4-meter walking speed test and the walking speed test while crossing over an obstacle were carried out to evaluate gait. The Spearman's correlation was used to measure the correlation between cognition and gait speed. RESULTS: There was no significant correlation between the 4 m gait speed and executive function( TMT-A (p = .056), TMT-B (p = .115)). However, there was a significant correlation between the 4 m gait speed and MMSE-KC (r = .277, p < .05). There was also a significant correlation between walking speed while crossing over an obstacle and all tests (MMSE-KC (r = .382, p < .01). TMT-A (r = -.327, p < .01), TMT-B (r = -.283, p < .05)). CONCLUSION: It was found that the gait speed while crossing over an obstacle was correlated with all cognitive function tests. Therefore, we suggest the use of the gait speed test while crossing over an obstacle rather than the simple gait test to diagnose cognitive decline.

Changes of Vastus Medialis Oblique and Vastus Lateralis Muscle Activities During Walking by Different Taping Method (테이핑 방법에 따른 보행 중 안쪽넓은근과 가쪽넓은근의 근활성도 변화)

  • Min-Hyung Rhee;Jong-Soon Kim
    • PNF and Movement
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    • v.21 no.2
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    • pp.231-241
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    • 2023
  • Purpose: Weakness of the vastus medialis oblique muscle (VMO), or the imbalance between VMO and vastus lateralis muscle (VL) activity, is one of the most important factors in knee joint problems. Rigid taping techniques, such as patellar inhibition taping and VL inhibition taping, are frequently used in clinical practice to treat knee joint problems. The purpose of this study was to compare the acute effect of three different types of taping (patellar inhibition taping (PIT), distal VL inhibition taping (DVLIT), and proximal VL inhibition taping (PVLIT)) on electromyography (EMG) activity of VMO, VL, and VMO:VL ratio during walking. Methods: Thirty-eight normal healthy subjects (38 males; mean age = 31.00 years) voluntarily participated in this study. EMG was applied to investigate muscle activation during walking. Repeated measures of ANOVA and one-way ANOVA compared the three different conditions (PIT, DVLIT, and PVLIT) for each variable. Results: VMO and VL activation were significantly increased after PTIT application, and VMO and VL activation were significantly decreased after DVLIT and PVLIT application. The VMO:VL ratio increased after the three types of taping application, but there were no significant differences among the three types of taping. Conclusion: Based on the results of this study, PTIT is more effective than DVLIT and PVLIT in increasing the muscle activation of the VMO and VL during walking. Also, DVLIT is more effective for increasing the VMO:VL ratio and has beneficial effects on the imbalance between VMO and VL activity.

Spatiotemporal characteristics of stroke patients gait (뇌졸중 환자에서 보행의 시공간적 특징)

  • Lee, Sangkwan;Choi, Sanho;Oh, Jaegun;Lee, Ilsuk;Park, Kee-eon;Hong, Haejin;Sung, Kang-keyng
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.1-7
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    • 2013
  • The following study reviewed the walking patterns of stroke patients with hemiplegia, which is called hemiplegic gait of stroke patients. Focusing is given to the changes in the distance and temporal factors of walking, which is called spatiotemporal characteristics, throughout the walking cycle. First, we introduced the definitions of essential terms related to gait and its measure. Second, we reviewed the spatiotemporal characteristics of hemiplegic gait. A main issue was that hemiplegic gait showed significant deviations from normal healthy gait. Although hemiplegia is primarily associated with unilateral motor disorder, changes in almost all spatiotemporal parameters used to assess walking were evident on both the involved and uninvolved sides of the body. Last, we reviewed the changes of spatiotemporal parameters of hemiplegic gait according to the prognosis or status of stroke patients, which may help to give a specific intervention for rehabilitation of stroke.

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