• 대한물리치료과학회지
• /
• 제4권1호
• /
• pp.243-253
• /
• 1997

The purpose of this study was to determine the effect of systolic blood pressure, heart rate and myocardial oxygen consumption on 3-point nonweight bearing ambulation with axillary wooden crutch according to age. The subjects were fifty healty volunteers(22 male, 28 female), ages from 20 to 69(mean age of 43.8 years) with no history of cardiovascular or respiratory disease, diabetes mellitus, arthritis and orthopedic disorder within the past three years. This study was carried out from May 10 to August 10, 1996. The data were analyzed by percentage, mean and standard deviation and ANOVA. The results were as follows : 1. In systolic blood pressure(SBP), there was no significantly change between before walk and after 20 m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). 2. In heat rate(HR), there was no significantly change between before walk and after 20 m, 40 m in crutch walking with age, however, there did differ significantly after 60 m in crutch walking(p<0.05). 3. In myocardial oxygen consumption($MVO_{2}$), there was no significantly change between before walk and after 20m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). These result showed that cardiovascular system had a great effect on the olderly when 3-point nonweight bearing ambulation with axillary wooden crutch. Therefore, when train for axillary crutch in the olderly, we needed suitably basis of walking distance.

• 대한물리의학회지
• /
• 제15권1호
• /
• pp.77-84
• /
• 2020

PURPOSE: This study compared the activities of the trunk muscles during crutch walking to determine which of the crutch length measurements is most beneficial. METHODS: Twenty young women volunteered to participate in this study. After adjusting crutch length, the participants performed a three-point walking with nondominant leg limited in weight bearing. This study used six crutch length measurements: (1) Height-40.6cm, (2) Height'.77, (3) Olecranon-to-finger length, (4) Axillary-toheel length, (5) Arm-span length-40.6cm, and (6) Arm-span length'.77. The EMG activities of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES), muscles on the weight bearing side were monitored using wireless surface EMG. RESULTS: The EMG activities of the RA and ES appeared to be significantly different among the crutch length measurements (p<.05). The post-hoc test showed that the 'Arm-span length-40.6cm' was significantly greater in the RA activity when compared to the 'Height'.77' and 'Axillary-to-heel length' measurements, and in the ES activity when compared to 'Height'.77' measurements. Furthermore, IO/RA and MF/ES ratios showed significant differences among the crutch length measurements (p<.05). In the post-hoc test, significant difference was observed between 'Olecranon-to-finger length' and 'Arm-span length-40.6cm' for the IO/RA ratio, and between 'Height'.77' and 'Olecranon-to-finger length' and between 'Height'.77' and 'Arm-span length-40.6cm' measurement for the MF/ES ratio. CONCLUSION: These findings suggest that the 'Height'.77' measurement is relatively advantageous to optimize the activities of trunk muscles during the crutch walking, and allow simple measurements of the crutch length.

• 대한의용생체공학회:의공학회지
• /
• 제11권1호
• /
• pp.179-186
• /
• 1990

A numerical analysis of crutch walking cycle has been performed to determine the transmissibility of a single-degree-of-freedom crutch system when a non-harmonic periodic forcing function is acting on the spring-damping-mass system. The results indicate that the damping factor which can reduce the forces transmitted to the human body plays an important role. In crutch walking, the stride angle of dynamic crutches must be limited for the comfortable walking.

• 로봇학회논문지
• /
• 제9권3호
• /
• pp.133-139
• /
• 2014

This paper proposes a wearable and motorized crutch control system for the patients using the conventional crutches. The conventional crutches have a few disadvantages such as the inconvenience caused by the direct contact between the ground and the armpit of the patients, and unstable gait patterns. In order to resolve these problems, the motorized crutch is designed as a wearable type on an injured lower limb. In other words, the crutch makes the lower limb to be moved forward while supporting the body weight, protecting the lower limb with frames, and rotating a roller equipped on the bottom of the frames. Also the crutch is controlled using the electromyography and two force sensing resistor (FSR) sensors. The electromyography is used to extract the walking intention from the patient and the FSR sensors to classify the stance and swing phases while walking. As a result, the developed crutch makes the patients walk enabling both hands to be free, as if normal people do.

• 디자인융복합연구
• /
• 제17권3호
• /
• pp.55-70
• /
• 2018

이 연구는 하지장애인의 보행보조를 위한 목발 디자인의 가이드라인을 개발하고 그것을 적용한 사례에 관한 장기 프로젝트의 후반부에 해당한다. 다학제적 융합연구를 통하여 목발보행에 관한 객관적인 결과를 도출하고 이를 토대로 현실적인 대안을 제시하고자 한 이 연구의 구체적인 목표는 목발을 이용한 보행 특성에 부합하고 산업 측면에서 활용성이 높은 양산형 목발의 디자인 개발과 프로토타입 제작에 있다. 연구의 결과로 개발된 혁신적인 목발인 토고(TOGO)는 (1)목발 팁과 겨드랑이 받침대의 형태 및 구조 개선을 통해 목발이 지면과의 접촉으로 발생하는 충격의 전달 최소화, (2) 보행 중 사용자의 신체에 합리적으로 대응하는 인체공학적 구조, (3)알루미늄 압출 성형에 의한 프레임 제작과 구조 개선으로 목발을 사용하지 않을 경우 휴대성·이동성을 위한 쉽고 빠른 목발의 길이 조절, (4)보행 중 안전상 위험요소 최소화 및 (5)사용자가 자존감을 지킬 수 있게 충분히 매력적인 형태 등이 특징이다. 연구 성과로 도출된 새로운 목발은 특허 출원이 완료되었으며, 현재 대량생산 환경에서 발생할 수 있는 잠재적인 문제 검토에 이어 양산을 위한 기업 탐색과 실용화 방안을 모색하고 있다.

• 대한족부족관절학회지
• /
• 제8권1호
• /
• pp.111-113
• /
• 2004

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

• 제어로봇시스템학회논문지
• /
• 제21권5호
• /
• pp.393-400
• /
• 2015

This paper describes the development of a chest-wearable robot that can efficiently perform self walking rehabilitation without a helper. The features of the developed robot are divided into three parts. First, as a mechanical characteristic, the conventional elbow crutch is attached at the forearm. However, the proposed robot is attached to the patient's chest, enabling them to feel free to use their hands and eliminate the burden of the arms. Second, as a characteristic of the driving algorithm, pressure sensors attached to the chest automatically perceive the patient's walking intention and move the robot-leg thereafter. Also, for safety, it stops operating when an obstacle is found in front of the patient by using ultrasonic sensors and generates a beeping sound. Finally, by using the scotch yoke mechanism, supporting legs are moved up and down using a rotary servo motor without excessive torque that is generated by large ground reaction forces. We showed that the developed robot can effectively perform self walking rehabilitation through walking experiments, and its performance was verified using Electromyograph (EMG) sensors.

• 대한기계학회논문집A
• /
• 제41권9호
• /
• pp.825-837
• /
• 2017

본 논문에서는 하지 보행 장애를 가진 환자가 사용하는 크러치에 로봇 기술이 적용된 새로운 타입의 착용식 족형 보행 재활 로봇에 대해 서술하였다. 개발된 로봇의 주된 특징은 크게 세 가지로 나뉜다. 첫 번째, 착용 방식의 특징으로서, 팔꿈치에 착용하여 환자를 보조하는 엘보 크러치와 달리 환자의 가슴부에 족형 로봇을 착용함으로써 보행 시 넓은 가슴 면적으로부터 하중을 분산시키고 팔에 작용하는 집중 하중을 제거하였으며, 팔과 손의 움직임을 자유롭게 하였다. 두 번째, 사용자의 보행 의지를 파악하는 방법으로서, 족형 로봇의 발에 부착된 3축 힘센서를 이용하여 지면 반발력의 크기와 방향으로부터 사용자의 보행의도를 추정하는 알고리즘을 제안하였고 이에 따라 가슴 착용형 로봇을 보행시켰다. 마지막으로, 계단 보행을 위한 근력 강화 방법으로서, 둔턱을 오르내리는 근력 훈련이 가능하도록 바닥 높낮이에 따라 상하 운동 궤적이 변화할 수 있는 둔턱 보행 기능을 구현하였다. 최종적으로 개발된 로봇이 보행 의도를 인지하고 로봇 다리로부터 보행 보조를 효과적으로 수행할 수 있다는 것을 실험을 통하여 확인하였고, 하지 근전도 측정을 통하여 보행 시 로봇이 하지 근력을 보조하는 성능을 정량적으로 검증하였다.

• 대한골관절종양학회지
• /
• 제1권2호
• /
• pp.133-144
• /
• 1995

고관절 제거후 재건을 위한 방법으로서의 안장형 인공 고관절 치환술은 동종골 이식술후 고관절 전치환술, 열처리한 자가골 재삽입 후 고관절 전치환술, 좌골 대퇴골간 유합술, 가동 관절로 그대로 두는 방법 등에 비해서 수술 시간의 단축에 의한 감염율 및 기타 이환율의 감소, 술후 조기 보행 가능, 좌식 생활을 하는 한국인의 생활에 편리한 이점이 있다. 이 방법은 Modular system으로 다리 정렬 상태를 잘 보존시킬 수 있으며 필요하다면 추후 골 재건술도 할 수 있는 장점이 있다. 저자들은 비구를 침범한 악성 골 종양을 제거 고관절의 재건을 위해 3예에서 안장형 인공 고관절 치환술을 시행하였다. 이중 1예에서 가역성 서혜부 탈장이 관찰되었으나 12개월, 19개월(사망), 27개월의 추시 관찰 결과 자가 보행, 계단 오르내리기가 가능하고, 쪼그려 앉기와 방바닥에 앉을 수 있으며, 통증없이 일상적인 생활을 할 수 있었다. 따라서, 비구를 침범한 골 종양 제거후의 고관절 재건술의 좋은 방법으로 판단되어 이에 문헌 고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
• /
• 제32권4호
• /
• pp.539-542
• /
• 2005

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.