Hong, Soung Kyun;Park, Su Ho;Shin, Sung Ri;Lee, Dong Geon;Lee, Seung Hoo;Jung, Sun Hye;Pyo, Seung Hyeon;Lee, Kyeong-Bong;Lee, Gyu Chang
Physical Therapy Rehabilitation Science
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제7권1호
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pp.23-28
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2018
Objective: The purpose of this study was to investigate the impact of wearing various types of shoes on gait ability in stroke survivors and in order to gain information in regards to shoes that could possibly replace ankle orthosis. Design: Cross-sectional study. Methods: Eight hemiplegic survivors diagnosed with stroke participated in the study. Gait was analyzed using the GAITRite Electronic Walkway (CIR System Inc., USA) when subjects walked with no showed, walked with non-ankle-covered shoes, and walked with ankle-covered shoes. This study collected gait variables, including velocity, cadence, step length, stride length, single support time, and double support time, respectively. Results: In the comparison of walking with no shoes, non-ankle-covered shoes, and ankle-covered shoes, there were significant differences in gait velocity, step length, stride length, and the less affected side single support time (p<0.05). However, there were no significant differences in cadence, affected side single support time, and double support time. Conclusions: Ankle-covered shoes had a positive impact on the gait of stroke survivors. However, it is necessary to conduct more studies comparing various types of shoes with ankle orthoses.
Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.
Objective To replace camera-based three-dimensional motion analyzers which are widely used to analyze body movements and gait but are also costly and require a large dedicated space, this study evaluates the validity and reliability of inertial measurement unit (IMU)-based systems by analyzing their spatio-temporal and kinematic measurement parameters. Methods The investigation was conducted in three separate hospitals with three healthy participants. IMUs were attached to the abdomen as well as the thigh, shank, and foot of both legs of each participant. Each participant then completed a 10-m gait course 10 times. During each gait cycle, the hips, knees, and ankle joints were observed from the sagittal, frontal, and transverse planes. The experiments were conducted with both a camera-based system and an IMU-based system. The measured gait analysis data were evaluated for validity and reliability using root mean square error (RMSE) and intraclass correlation coefficient (ICC) analyses. Results The differences between the RMSE values of the two systems determined through kinematic parameters ranged from a minimum of 1.83 to a maximum of 3.98 with a tolerance close to 1%. The results of this study also confirmed the reliability of the IMU-based system, and all of the variables showed a statistically high ICC. Conclusion These results confirmed that IMU-based systems can reliably replace camera-based systems for clinical body motion and gait analyses.
Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.
This paper aims at collecting the guantitative data of kenematic variables by analysing the gait patterns of the normal adult men and the handicapped. The gait motions were taped with 4 video cameras, the cinematographic analyses were performed by the DLT technique of three dimensional image treatment. The following results were obtained in the analysis of the variables: 1. The ratio of stance time and swing time did not show any significant difference in the groups of the normal men and the handicapped when both foot of the former and the right feet of the latter were compared. The stride peeriod time of these two groups were 1.12 and 1.11 second, respectively. 2. In the handicapped group, the step width was wider, the step length and stride length were shorter, and especially, the step length of the right foot was shorter, 3. The small vertical displacement of left toes of the handicapped group showed that the heal contact and the left midstance are almost simultaneous. 4. The two groups have almost the same horizontal displacement of the center of gravity and the same vertical rate of extension. In view of the velocity of the center of gravity the normal adults showed the constant speed of movement. However, the handicapped adults were reduced from the right midstance to the right toe-off. 5. The handicapped showed prominently low angle on the left toe-off in the ankle joint angle, they also had the tendency to walk in the patterns of extended knee in the knee joint angle. Both the handicapped and the normal had the hyperextension on the toe-off in the hip joint angle. In the back and front angle of body, both showed the slightly back-sided walking positions. 6. Both groups had the abduction of both feet in foot placement angle, but the handicapped did not show serious abduction of left midstance.
Purpose: The purpose of this study was to identify whether task-related circuit exercise program combined with sensorimotor training for 4 weeks could improve the balance and gait in stroke patients. Method: Fifteen stroke patients who had agreed with the study were randomly divided into 3 groups categorized as task-related circuit exercise program combined with sensorimotor training group (experimental group 1, n=5), task-related circuit exercise program group (experimental group 2, n=5), and control subjects performed conventional physical therapy (control group, n=5). The balance and gait were assessed by BT-4 force platform system, Berg Balance Scale, 10meter Walk Test and Smart Step at before training and after training. Wilcoxon signed rank test was used to analyze change before and after intervention in intra-group. Kruskal Wallis H test, Mann-Whitney U test and Bonfferoni correction were used to analyze changes of all variables in inter-groups. Result: The experimental group 1 showed significant improvements in postural sway area, BBS scores, walking velocity and plantar pressures of affected foot, whereas the experimental group 2 showed significant improvements in BBS scores, and the control group were no significantly different in all variables following training. The changes of postural sway area and BBS scores in the experimental group 1 were significantly greater than them of the control group. The changes of postural sway area in the experimental group 1 was significantly greater than that of the experimental group 2. Conclusion: The result of this study suggest the task-related circuit exercise program combined with sensorimotor training is an effective intervention to improve balance and gait in stoke patients.
Objective: This study aimed to predict balance and gait abilities with the Trunk Impairment scales (TIS) in persons with stroke. Design: Cross-sectional study. Methods: Sixty-eight participants with stoke were assessed with the TIS, Berg Balance scale (BBS), and Functional Gait Assessment (FGA) by a therapist. To describe of general characteristics, we used descriptive and frequency analyses, and the TIS was used as a predictive variable to determine the BBS. In the simple regression analysis, the TIS was used as a predictive variable for the BBS and FGA, and the TIS and BBS were used as predictive variables to determine the FGA in multiple regression analysis. Results: In the group with a BBS score of >45 for regression equation for predicting BBS score using TIS score, the coefficient of determination ($R^2$) was 0.234, and the $R^2$ was 0.500 in the group with a BBS score of ${\leq}45$. In the group with an FGA score >15 for regression equation for predicting FGA score using TIS score, the $R^2$ was 0.193, and regression equation for predicting FGA score using TIS score, the $R^2$ was 0.181 in the group of FGA score ${\leq}15$. In the group of FGA score >15 for regression equation for predicting FGA score using TIS and BBS score, the $R^2$ was 0.327. In the group of FGA score ${\leq}15$ for regression equation for predicting FGA score using TIS and BBS score, the $R^2$ was 0.316. Conclusions: The TIS scores are insufficient in predicting the FGA and BBS scores in those with higher balance ability, and the BBS and TIS could be used for predicting variables for FGA. However, TIS is a strong predictive variable for persons with stroke who have poor balance ability.
This paper investigates the load model for single footfall trace of human walking. A large amount of single person walking load tests were conducted using the three-dimensional gait analysis system. Based on the experimental data, Fourier series functions were adopted to model single footfall trace in three directions, i.e. along walking direction, direction perpendicular to the walking path and vertical direction. Function parameters such as trace duration time, number of Fourier series orders, dynamic load factors (DLFs) and phase angles were determined from the experimental records. Stochastic models were then suggested by treating walking rates, duration time and DLFs as independent random variables, whose probability density functions were obtained from experimental data. Simulation procedures using the stochastic models are presented with examples. The simulated single footfall traces are similar to the experimental records.
The purpose of this study was to investigate the difference in the stride-to-stride variability between two treadmill conditions; traditional treadmill and special treadmill whose speed can be adjusted automatically by subject's walking speed. Eight male subjects (25.1 years, 172.7 cm, 66.6 kg) were participated in treadmill walking experiment. First, preferred walking speed (PWS) of each subject was determined. Second, each subject performed walking experiment with fixed PWS condition and with free PWS condition for 10 minutes. 3D motion capture system (Motion analysis Corp., USA) with 6 cameras was used to collect motion data with sampling frequency of 120Hz. Temporal and spatial variables for stride-to-stride variability were calculated. Coefficient of variance (CV) which quantifies the amount of variability and Detrended Fluctuation Analysis (DFA) which explains the structure (self-similarity) of the variability were used for analysis. Results showed that the amount of variability during free PWS condition was greater than that of fixed PWS condition. DFA results showed that there was a statistical difference between two treadmill conditions for the variables of step length, stance time, and double support time. From these results, it is possible that traditional treadmill study might give incorrect conclusion about gait variability study. Further study is necessary to clarify these matters by considering the number of subjects, experimental time, and gait variables for the study of stride-to-stride variability.
Purpose: The aim of this study was to investigate the effect of goal-oriented side walking training on balance and gait in chronic stroke patients. Methods: This study involved 18 chronic stroke patients who were divided into an experimental group (n=9) and a control group (n=9). The experimental group performed goal-oriented side walking training, and the control group performed general side walking training. The walking variables assessed were walking speed, stride length, and 10-m walking time. The balance variables assessed were foot pressure, timed up and go test (TUG), and Berg balance scale (BBS). These variables were measured before and after the exercise. Wilcoxon's signed-rank test was used to compare the participants' performances before and after the intervention in both groups. The Mann-Whitney U test was conducted for between-group comparisons after the intervention. Statistical significance was set at ${\alpha}=0.05$ Results: Walking speed, stride length, 10-m walking time, TUG, and foot pressure were significantly improved in both groups after the exercise (p<0.05). The between-group comparison showed a significant improvement in the goal-oriented side walking group (p<0.05). However, there were no significant between-group differences in 10-m walking times (p>0.05) and BBS (p=0.05). Conclusion: The results revealed that goal-oriented side walking training was effective in improving the balancing and walking ability of chronic stroke patients.
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