• 한국전문물리치료학회지
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• 제27권2호
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• pp.126-132
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• 2020

Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a co-contraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing.

• 한국운동역학회지
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• 제29권2호
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• pp.79-88
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• 2019

Objective: The aim of this study was to determine the peak torques of the knee and ankle joint and local stability of the lower extremity's joints, and muscle activation patterns of the lower extremity's muscles between fallers and non-fallers in the elderly women during walking. Method: Four elderly women (age: $74.5{\pm}5.2yrs.$; height: $152.1{\pm}5.6cm$; mass: $55.3{\pm}5.4kg$; preference walking speed: $1.19{\pm}0.06m/s$) who experienced falls within six months since experiment had been conducted (falls group) and thirty-six subjects ($74.2{\pm}3.09yrs.$; height: $153.6{\pm}4.9cm$; mass: $56.7{\pm}6.4kg$; preference walking speed: $1.24{\pm}0.10m/s$) who had no experience in falls (non-falls group) within this periods participated in this study. They were measured torque peaks of the knee and ankle joint using a Human Norm and while they were walking on a treadmill at their natural pace, kinematic variables and EMG signals were collected with using a 3-D motion capture system and a wireless EMG system, respectively. Lyapunov Exponent (LyE) was determined to observe the dynamic local stability of the lower extremity's joints, and muscles activation and their co-contraction index were also analysed from EMG signals. Hypotheses between falls and non-falls group were tested using paired t-test and Mann-Whitey. Level of significance was set at p<.05. Results: Local dynamic stability in the adduction-abduction movement of the knee joint was significantly lower in falling group than non-falling group (p<.05). Conclusion: In conclusion, muscles which act on the abduction-adduction movement of the knee joint need to be strengthened to prevent from potential falls during walking. However, a small number of samples for fallers make it difficult to generalize the results of this study.

• 한국체육학회지인문사회과학편
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• 제57권3호
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• pp.345-356
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• 2018

이 연구의 목적은 여성 노인들을 대상으로 낙상자와 비낙상자 간 보행 시 하지의 국부적 안정성과 근 활동 양상을 후향성 접근을 통해 규명하고자 했다. 이를 위해 보행 시 낙상 경험이 있는 20명과 낙상 경험이 없는 20명이 선정되었다. 트레이드밀 보행 시 3차원 운동 캡쳐 시스템과 무선 근전도 장비를 이용해 운동학적 좌표와 근전도 신호를 수집했다. 운동좌표를 이용해 무릎과 발목 관절의 3차원 각 변위를 산출했으며, 이들의 국부적 안정성을 Lyapunov 지수를 통해 계산했다. 근 활성도는 근전도 신호를 이용해 대퇴직근과 대퇴이두근, 전경골근과 비복근을 살펴봤으며, 또한 이들의 동시 수축 지수를 정량화했다. 연구 결과 무릎 관절의 내·외전 움직임의 국부적 불안정성은 비낙상자 집단이 낙상자 집단보다 컸으며(p<.05), 전경골근의 근활성도는 낙상자 집단이 비낙상자 집단보다 적게 나타났다(p<.05). 또한 비복근과 전경골근의 동시 수축 지수는 낙상자 집단이 비낙상자 집단보다 컸다(p<.05). 그 밖에 낙상자 집단에서 비복근과 전경골근의 동시 수축 지수와 발목 관절의 굴신 움직임에 대한 국부적 안정성과는 유의한 상관관계를 보였다(p<.05). 따라서 보행 시 낙상을 예방하기 위해서는 무릎 관절의 내·외전 움직임에 관여하는 근들을 강화하고, 발목 관절의 굴신에 작용하는 비복근과 전경골근을 균형적으로 강화할 필요가 있다고 판단된다.

• 한국운동역학회지
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• 제25권3호
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• pp.323-333
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• 2015

Objective : The purpose of this study was to investigate the changes of gait patterns and muscle activations with increased loads during stair walking. Also, it can be used as descriptive data about continuous stair walking in a real life setting. Method : Twelve sedentary young male adults(Age: $27.0{\pm}1.8yrs$, Weight: $65.8{\pm}9.9kg$) without any lower extremity injuries participated in this study. Participants performed stair walking up 7 floors and their ascending and descending motion on each floor was analyzed. A wireless electromyography(EMG) were attached on the Rectus Femoris(RF), Biceps Femoris(BF), Gastrocnemius(GN), Tibialis Anterior(TA) muscle to calculate integrated EMG(iEMG), median frequency(MDF) and co-contraction index(CI). Chest and left heel accelerometer signal were recorded by wireless accelerometer and those were used to calculate approximate entropy(ApEn) for analyzing gait pattern. All analyses were performed with SPSS 21.0 and for repeated measured ANOVA and Post-hoc was LSD. Results : During ascending stairs, there were a statistically significant difference in Walking time between 1-2nd and other floors(p=.000), GN iEMG between 2-3th and 6-7th(p=.043) floor, TA MDF between 1-2nd and 5-6th(p=.030), 6-7th(p=.015) floor and TA/GN CI between 2-3th and 6-7th(p=.038) floor and ApEn between 1-2nd and 6-7th(x: p=.003, y: p=.005, z: p=.006) floor. During descending stairs, there were a statistically significant difference in TA iEMG between the 6-5th and 3-2nd(p=.026) floor, and for the ApEn between the 1-2nd and 6-7th(x: p=.037, y: p=.000, z: p=.000) floor. Conclusion : Subjects showed more regular pattern and muscle activation response caused by regularity during ascending stairs. Regularity during the first part of stair-descending could be a sign of adaptation; however, complexity during the second part could be a strategy to decrease the impact.