• Physical Therapy Korea
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• v.8 no.4
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• pp.45-61
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• 2001

본 연구는 보행주기 동안 정상인과 당뇨병성 족부궤양 환자의 족관절 운동역학적 변수와 족관절 근육들의 근활성도에 차이가 있는지 알아보기 위하여 실시하였다. 본 연구의 대상자는 당뇨병성 족부궤양이 있는 환자 9명(남자: 6명, 여자: 3명)과 성, 연령, 체중으로 짝짓기(matching)시킨 대조군 9명이었다. 3차원 동작분석기, 힘판, 표면 근전도를 이용하여, 보행주기 동안 족관절의 관절가동범위, 모멘트(moment), 일률(power), 그리고 내측가자미근, 전경골근, 비복근의 근수축 개시시간(onset time)과 종료시간(cessation time)을 측정하였다. 정상군과 비교하여 당뇨병성 족부궤양군의 보행속도는 느렸고, 입각기 기간이 길었으며, 족관절의 가동범위가 적었고, 족관절 최대 족저굴곡 모멘트와 일률이 정상군에서보다 유의하게 낮았다. 보행주기에서 당뇨병성 족부궤양군에서 내측 가자미근과 비복근의 근수축 개시시간은 유의하게 빨랐으며, 전경골근과 비복근의 근수축 종료시간은 유의하게 지연되었다. 당뇨병성 족부궤양 환자군의 족관절 근육에서 동시수축(co-contraction)이 증가되고, 보행속도가 느리며, 입각기 기간이 증가하였다. 이러한 보행특성의 차이는 족부 감각손실에 따른 보행의 안정성을 유지하기 위한 보행전략 때문으로 판단된다. 앞으로 이러한 비정상적인 보행특성이 당뇨병성 족부궤양에서 발생하는 비정상적인 족저부 압력분포과 족부궤양 발생과 어떤 관계가 있는지 알아보는 연구가 필요할 것이다.

• Physical Therapy Korea
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• v.7 no.1
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• pp.55-63
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• 2000

Physical therapists have been using balance and weight shifting training to induce improvements in standing and walking. This study compared the effects of kinetic feedback frequency and concurrent kinetic feedback on the performance and learning of a weight shifting skill in young, nondisabled adults. Sixteen young adults without known impairment of the neuromusculoskeletal system volunteered for the study. Subjects in each of three kinetic feedback groups performed a weight shifting task in an attempt to minimize error between their effort and a center of pressure (COP) template for a 12 second period. Feedback was provided: 1) concurrently (concurrent feedback), 2) after each trial (100% feedback), 3) after every other trial (50% feedback). Immediate and delayed (24 hour) retention tests were performed without feedback. During acquisition phase, the concurrent feedback group exhibited less error than either of the post response feedback group. For the immediate retention test, the 50% feedback group exhibited less error than did the 100% feedback and concurrent feedback. During the delayed retention, 50% feedback group displayed less error than did the other groups. But no significant differences were found between groups. These results suggest that practice with concurrent feedback is beneficial for the immediate performance, but not for the learning of this weight shifting skill. Lower frequency of feedback resulted in more permanent changes in the subject's ability to complete the task.

• Physical Therapy Korea
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• v.23 no.4
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• pp.27-37
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• 2016

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.

• Physical Therapy Korea
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• v.21 no.2
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• pp.37-47
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• 2014

Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.643-651
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• 2001

Osteoarthritis(OA) is a widespread, slowly developing disease with a high prevalence rate increasing with age. The most common big joints involved in OA is the knee, where the disease particulary strikes, causing difficulties in rising from a chair. climbing stairs, kneeling. standing, and walking. The primary complaints of these patients include pain, stiffness. instability, and loss of function. The purpose of this study was to assess the impact of self-reported symptoms and limited flexion, and limited extension on functional impairment in patients with knee osteoarthritis. In the data collection, a total of 206 who had visited the physiotherapy unit at six different departments of orthopedics were interviewed in K City from June to September, 2000. The results of the study summarized are as fellows: 1. There was a significant difference among different degree group of limited flexion(p<0.05). A group difference was demonstrated between <5 ${\sim}$ 15 and 16 > (F=16.21, p<0.05). In the relationship between the degree of limited flexion and the level of functional impairment, the h igher the range of limited flexion, the lower the level of functional impairment. 2. In the relationship between the degree of limited extension and the level of functional impairment, a group difference was revealed between the non-limitation group and the <10 and 11 < However, no significant difference was noted between 11 ${\sim}$ 20 and 21 >(F= 13.37, p<0.05). In conclusion, finding above suggest that functional impairment is closely correlated with limited tlexion and extenion

• Physical Therapy Korea
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• v.9 no.3
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• pp.47-65
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• 2002

This study examined the correlations among the Berg Balance Scale, which is a clinical tool used to evaluate balance ability, spatiotemporal parameters of gait, and falling; determined the parameters most closely related to falling; and identified a discriminatory parameter and its predictability. Thirty-four subjects aged 72 to 92 years participated in this study. Following a questionnaire survey about falling, the Berg Balance Scale and spatiotemporal parameters of gait were measured. The results revealed that the incidence of falls increased with aging and an accompanying reduction in the flexion range of motion of the hip joint. The gait characteristics of elderly people who fell easily included a slower walking speed, shorter stride, and longer stance time than other elderly. When the cutoff score was set at 45, the Berg Balance Scale was able to identify correctly those individuals who truly have experience of falling than when the cutoff score was set at 39. But when the cutoff score was set at 39, the scale's specificity identifying correctly those individuals who truly have not experience of falling was higher than at the cutoff score of 45. Therefore, the Berg Balance Scale is an appropriate screening method in a clinical setting for the early detection of elderly people at risk of falling. In conclusion, elderly people with a Berg Balance Scale score. below 45 are the most likely to fall owing to their decreased balance ability.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.738-742
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• 2014

This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.

• Journal of Biomedical Engineering Research
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• v.41 no.3
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• pp.121-127
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• 2020

The purpose of this paper is to review the validation on the application of low frequency IMU(Inertial Measurement Unit) sensors by replacing high frequency motion analysis systems. Using an infrared-based 3D motion analysis system and IMU sensors (22 Hz) simultaneously, the gait cycle and knee flexion angle were measured. And the accuracy of each gait parameter was compared according to the statistical analysis method. The Bland-Altman plot analysis method was used to verify whether proper accuracy can be obtained when extracting gait parameters with low frequency sensors. As a result of the study, the use of the new gait assessment system was able to identify adequate accuracy in the measurement of cadence and stance phase. In addition, if the number of gait cycles is increased and the results of body anthropometric measurements are reflected in the gait analysis algorithm, is expected to improve accuracy in step length, walking speed, and range of motion measurements. The suggested gait assessment system is expected to make gait analysis more convenient. Furthermore, it will provide patients more accurate assessment and customized rehabilitation program through the quantitative data driven results.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.75-87
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• 2018

PURPOSE: The purpose of this study was to describe and analyze the components of physical therapy interventions to enhance postural control and mobility in children with spastic diplegia. METHODS: Thirsty-eight physical therapists working in rehabilitation settings volunteered to record the components of physical therapy interventions used during 894 treatment sessions for 179 children with spastic diplegia presenting with difficulties in postural control and mobility. Descriptive statistics were used to analyze the general characteristics of the therapists, the patients, and the frequency of the interventions. A one-way analysis of variance (ANOVA) and chi-square test were used to describe the components of the interventions and the goals of treatment. RESULTS: In clinical practice, physical therapists primarily used methods including "Hands-on: facilitation" (n=1990, 36.47%) and "Hands-off: practice" (n=1355, 24.83 %). Only 13.96% (n=762) of the interventions allowed patients to be independent or active outside of the treatment sessions. Interventions reflecting the therapeutic aims were performed for sitting (17.53%), standing (18.25%), and walking (27.39%). CONCLUSION: Physical therapists mostly used "therapistled" interventions to treat impaired postural control and mobility in children with spastic diplegia. Interventions to facilitate independent activity or practice outside the treatment sessions are infrequently used. These types of interventions were used regardless of the aims of treatment.

• The Journal of Korean Physical Therapy
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• v.23 no.6
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• pp.15-22
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• 2011

Purpose: This research investigated falls due to obstacles that occur among elderly people by assessing changes in the values of plantar foot force, peak force, and plantar foot pressure in elderly subjects while they were stepping over obstacles of different heights. Methods: The subjects were 20 elderly people aged 70-80 years; Pressure was measured on flat ground(0 cm), and after installing obstacles of 8 cm and 12 cm using the F-scan system, which is a resistance-type pressure sensor. A one-way analysis of variance was performed to compare pressure on each part of the foot according to various heights after collecting data using the Tekscan program. The least significant difference test was used for the post-hoc analysis, A p-value <0.05 was considered significant. Results: The force value for the toe area (parts 1, and 2) and contact pressure increased significantly with the 12 cm obstacle (p<0.05). The peak force value and the peak contact pressure for part 1 increased significantly with the 12 cm obstacle (p<0.05). Conclusion: Larger changes appeared in the functions and structure of the foot while subjects walked over obstacles of different heights compared to flatland walking. This result suggests that people have safety strategies to prevent falls, and that there is a need for a more realistic approach through practice to overcome obstacles of various heights to prevent falls.