• Title/Summary/Keyword: Ambulation training

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The Effects The Type of Canes-Handle Affects in Recovering-Balance of Hemiplegic patients (지팡이 손잡이 형태가 편마비 환자의 균형 회복에 미치는 영향)

  • Lee, Sang-Yeol;Lee, Myoung-Hee;Park, Min-Chull;Han, Jin-Tae;Kweon, Oh-Hyun;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.20 no.4
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    • pp.7-13
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    • 2008
  • Purpose: We compared T-type and I-type canes on postural balance in 28 hemiplegic patients. Methods: Subjects were allocated randomly into two groups: a T-shape cane group (n=14) and an I-shape cane group (n=14). Before the test, subjects were trained by a physical therapist to walk with a cane for 6 weeks. The Main Outcome Measures were measured as maximal sway velocity, sway path, sway area, and partial weight bearing using a Balance Performance Monitor (BPM) and ambulation velocity using a 'Timed up and go test'. We also measured the maximal ambulation velocity. Results: The distribution of weight bearing on the affected side without the cane was 35% in the I-shape cane group and 36% in the T-shape cane group. After training, weight bearing on the affected side increased by 45% in the I-shape cane group and 40% in the T-shape cane group. With the cane held in the hand, weight bearing on the affected side in the T-shape cane group decreased by 3%. Conclusion: The I-shaped cane increased static standing balance, including hemiplegic side weight bearing. Therefore, I-shape canes can improve the balance of hemiplegic patients.

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Effects of Performing Dual Task on Temporospatial Gait Variables in Subjects With Subacute Stroke (아급성기 뇌졸중 환자의 이중 과제 수행이 보행의 시·공간적 변수에 미치는 영향)

  • Jang, Young-Min
    • PNF and Movement
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    • v.15 no.3
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    • pp.361-371
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    • 2017
  • Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

Study on Efficacy of Gait Training for Hemiplegia Patients Using Lower-Limb Wearable Robot (착용형 하지 로봇을 이용한 편마비 보행 재활 훈련 효과에 관한 연구)

  • Ji, Younghoon;Yun, Deokwon;Jang, Hyeyoun;Lee, Dongbock;Khan, Abdul Manan;Kim, Sol;Kim, Mijung;Han, Jungsoo;Han, Changsoo
    • Journal of the Korean Society for Precision Engineering
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    • v.32 no.10
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    • pp.879-883
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    • 2015
  • Conventional gait rehabilitation requires at least three therapists in a traditional rehabilitation training program. Several robots have been developed to reduce human burden and increase rehabilitation efficacy. In this study, we present a lower-limb wearable robot (WA-H) for gait rehabilitation of hemiplegia patients, and propose a protocol of 12 weeks gait rehabilitation training program using WA-H. To identify the efficacy of the robot and protocols, we conducted a clinical study with two actual hemiplegia patients and observed a chronological change of ambulation ability through four assessments. We discovered the progression of results by 6 minute walking test, TUGT (Timed Up and Go Test), SPPB (Short Physical Performance Battery), BBS (Berg Balance Test), and Fugl-Meyer score. The torques generated in the normal side and paralyzed side of the patient became similar, indicating rehabilitation. The result also showed the walking of the paralysis patient improved and imbalance motion had considerable improved performance.

Voluntary Motor Control Change after Gait Training in Patients with Spinal Cord Injury (척수신경손상 환자의 보행훈련 전.후의 능동적 근육제어의 변화)

  • 임현균;이동철;이영신;셔우드아더
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.133-140
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    • 2003
  • In this study, muscle activity was measured using surface EMG (sEMG) during a voluntary maneuver (ankle dorsiflexion) in the supine position was compared pre and post gait training. Nine patients with incomplete spinal cord injury participated in a supported treadmill ambulation training (STAT), twenty minutes a day, five days a week for three months. Two tests, a gait speed test and a voluntary maneuver test, were made the same day, or at least the same week, pre and post gait training. Ten healthy subjects' data recorded using the same voluntary maneuvers were used for the reference. sEMG measured from ten lower limb muscles was used to observe the two features of amplitude and motor control distribution pattern, named response vector. The result showed that the average gait speed of patients increased significantly (p〈0.1) from 0.47$\pm$0.35 m/s to 0.68$\pm$0.52 m/s. In sEMG analysis, six out of nine patients showed a tendency to increase the right tibialis anterior activity during right ankle dorsiflexion from 109.7$\pm$148.5 $mutextrm{V}$ to 145.9$\pm$180.7 $mutextrm{V}$ but it was not significant (p〈0.055). In addition, only two patients showed increase of correlation coefficient and total muscle activity in the left fide during left dorsiflexion. Patients' muscle activity changes after gait training varied individually and generally depended on their muscle control abilities of the pre-STAT status. Response vector being introduced for quantitative analysis showed good Possibility to anticipate. evaluate, and/or guide patients with SCI, before and after gait training.

The Effect of Speed-dependent with Body Weight Supported Treadmill Training on the Ambulation of Stroke (속도-의존적 체중지지 트레드밀 보행이 뇌졸중 환자의 보행에 미치는 영향)

  • Kim, Jwa-Jun;Rho, Min-He;Goo, Bong-Oh;Ahn, So-Youn
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.339-350
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    • 2005
  • This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.

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Effects of the ADL Activity Group Exercise Program on Independent Life of CNS Patients (일상생활 동작 집단학습 운동프로그램이 편마비 환자의 독립적 생활에 미치는 영향)

  • Park, Hyun-Sik;Kim, Taek-Yean;Park, Jong-Hang
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.1
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    • pp.66-76
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    • 2008
  • Purpose : The purpose of the study was to determine Effects of the ADL Group Study Program Training on Functional Independence and Quality of Life for the CNS Patients. Methods : Thirty patients with stroke were assigned to experimental and control group. During eight weeks, both group participated in the conventional physical therapy and only the experimental group added in the ADL Group Study program. Experimental group performed two a week for 8 weeks and both group were scored Mini-Mental State Examination-Korean version before the training. The data were analyzed with frequency, independent t-test, paired t-test using SPSS PC(ver.12.0). Results : The result of this study is as fallows : First, after eight weeks, the experimental group the significant improvement in Korean Activity Daily Living scale, washing(p<0.01), bathing, ambulation, toilet using(p<0.05) and decorating, the short distance transfer(p<0.05) in Korean Independent Daily Living scale, vitality(p<0.05) in Quality of Life score. Conclusion : These finding suggest that the ADL Group Study Program Training can be used to improve functional independent and quality of life for the CNS patients. Also, the result of this study can provide a reference for the successful therapeutic program in CNS patients.

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Virtual Sensor Verification Using Neural Network Theory of the Quadruped Robot (보행로봇의 신경망 이론을 이용한 가상센서 검증)

  • Ko, Kwang-Jin;Kim, Wan-Soo;Yu, Seung-Nam;Han, Chang-Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.33 no.11
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    • pp.1326-1331
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    • 2009
  • The sensor data measured by the legged robot are used to recognize the physical environment or information that controls the robot's posture. Therefore, a robot's ambulation can be advanced with the use of such sensing information. For the precise control of a robot, highly accurate sensor data are required, but most sensors are expensive and are exposed to excessive load operation in the field. The seriousness of these problems will be seen if the prototype's practicality and mass productivity, which are closely related to the unit cost of production and maintenance, will be considered. In this paper, the use of a virtual sensor technology was suggested to address the aforementioned problems, and various ways of applying the theory to a walking robot obtained through training with an actual sensor, and of various hardware information, were presented. Finally, the possibility of the replacement of the ground reaction force sensor of legged robot was verified.

Effects of Virtual Reality-based Exercise on Static Balance and Gait Abilities in Chronic Stroke (가상현실을 이용한 재활 운동이 뇌졸중 환자의 정적 균형 및 보행에 미치는 효과)

  • Shin, Won-Seob;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.33-40
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    • 2009
  • Purpose: This study examined the effects of a virtual reality-based exercise program on the functional recovery of balance and gait in chronic stroke subjects. Methods: A total of 42 chronic stroke patients were enrolled in this study. The participants were allocated randomly to 2 groups: a VR (n=22) and control group (n=20). Both groups received treadmill training for 3 sessions (10 minutes each), 30 minutes per week over a 6 week period. The VR group practiced additional virtual reality programs consisting of 3 programs for 10 minutes each. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. Results: The virtual reality-based exercise group showed significant increases in gait velocity, cadence and stride length compared to the control group (p<0.05). However, there were no significant differences in static balance. Conclusion: These results support the perceived benefits of exercise programs that incorporate virtual reality to augment the balance and ambulation of stroke patients. Therefore, virtual reality is feasible and suitable for stroke patients

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The Effect of the Dementia Elderly Persons on the Cognitive Function, ADL and Balance-Performing Ability the Group Therapeutic Exercise Program (집단운동치료 프로그램이 치매노인의 인지기능과 일상생활동작 및 균형 수행능력에 미치는 영향)

  • Kim, Chan-Mun;Kim, Jin-Hee
    • Journal of Korean Physical Therapy Science
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    • v.19 no.4
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    • pp.27-34
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    • 2012
  • The aim of study was to assess the effectiveness of dementia elderly persons on the cognitive function, Activities of Daily Living(ADL) and balance-performing ability the group therapeutic exercise programs. Fifteen community-dwelling subjects participated in this study. An 4-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-korean(MMSE-K), Modified Barthel Index(MBI), Berg Balance Scale(BBS), and Timed Up & Go (TUG) test were measured during before and after exercise points The results of this study were as follows : 1) After eight weeks, the MMSE-K and MBI total scores were significantly increased to more after than before(p<.05, p<.01). 2) in the MBI contents, personal hygiene, dressing, ambulation and chair, bed transfers scores were significant increased to after. 3) after BBS, TUG scores were statistically significant higher than the before scores(p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise program can be used to improve the cognitive function, ADL and balance-performing ability in dementia elderly persons.

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A Case Study of Functional Electrical Stimulation(FES) for Paraplegic Patients (척수손상인의 기능적 전기자극을 이용한 보행)

  • Lee, Jae-Ho;Kim, Tack-Hoon
    • Physical Therapy Korea
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    • v.3 no.3
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    • pp.32-43
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    • 1996
  • The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

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