• 한국운동역학회지
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• 제28권1호
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• pp.19-27
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• 2018

Objective: This study aimed to analyze the effects of freezing of gait on spatiotemporal variables, ground reaction forces (GRFs), and joint moments during the sit-to-walk task at the preferred and maximum speeds in patients with Parkinson's disease (PD). Method: The subjects were classified by a neurologist into 12 freezers, 12 non-freezers, and 12 controls. Sit-to-walk parameters were measured during three repetitions of the task in a random order at the preferred and maximum possible speeds. Results: In the sit-to-walk task at the preferred speed, the freezers and non-freezers exhibited a higher peak anterior-posterior GRF (p<0.001) in the sit-to-stand phase and lower step velocity (p<0.001), step length (p<0.001), and peak anterior-posterior GRF (p<0.001) in the first-step phase than the controls. The freezers had higher peak anterior-posterior GRF (p<0.001) and peak moment of the hip joint (p=0.008) in the sit-to-stand phase than the non-freezers. In the sit-to-walk phase at the maximum speed, the freezers and non-freezers had lower peak moment of the hip joint (p=0.008) in the sit-to-stand phase than the controls. The freezers and non-freezers displayed lower step velocity (p<0.001) and peak anterior-posterior GRF (p<0.001) in the first-step phase than the controls. The freezers showed higher peak moments of the hip joint in the sit-to-stand phase than the non-freezers (p=0.008). Conclusion: The PD patients had reduced control ability in sit-to-stand motions for efficient performance of the sit-to-walk task and reduced performance in the sit-to-walk task. Furthermore, the freezers displayed reduced control ability in the sit-to-stand task. Finally, the PD patients exhibited a lower ability to control dynamic stability with changes in speed than the controls.

• 한국산학기술학회논문지
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• 제14권1호
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• pp.344-350
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• 2013

본 연구의 목적은 파킨슨병 환자의 청각 신호에 따른 보행 시, 상지 스윙의 비대칭과 진폭에 미치는 영향을 알아보기 위함이다. 연구의 대상자는 초기 파킨슨병으로 진단받은 14명의 환자로, 청각 신호(빠른 속도, 일반적인 속도, 느린 속도)를 무작위 순서로 제공하여 보행을 실시하였다. 청각 신호 속도는 전자 메트로놈을 이용하여 대상자의 자연스러운 보행 속도보다 ${\pm}20%$ 속도를 적용하였다. 각각의 속도에 따른 청각 신호를 적용한 보행을 실시하는 동안, 동작분석기를 사용하여 보행 시 상지 스윙의 운동학적 변수를 비교 분석하였다. 정상 속도의 보행 시 파킨슨병 환자의 양측 상지 스윙 진폭의 비교에서는 더 많은 영향을 받은 쪽(MAS)의 상지 스윙 진폭에서 유의한 감소가 나타났다(p<.05). 청각 신호 속도에 따른 보행 시의 비교에서는 빠른 속도의 청각 신호를 적용한 보행 시 상지 스윙의 유의한 증가가 나타났다(p<.05). 본 연구의 결과를 통해 파킨슨 환자의 보행 시 양측 상지 스윙의 비대칭을 확인할 수 있었으며 또한 보행 시 빠른 청각 신호를 적용하는 경우, 파킨슨병 환자의 상지 스윙을 증가시켜 자연스러운 보행양상을 유도할 수 있으므로 중재 시 필요에 따라 적절한 속도의 청각 신호를 적용하여 보행훈련에 적용할 수 있을 것으로 생각된다.

• 한국운동역학회지
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• 제18권2호
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• pp.49-58
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• 2008

본 연구의 목적은 트레드밀 보행 시, gait dynamics 측면에서 보행의 속도 변화와 인지과제 수행 시 보행 변인의 가변성(variability)을 알아보고자 하는 것이다. 실험은 인지과제의 동시수행 유/무에 따른 5가지 속도(선호속도의 80%, 90%, 100%, 110% and 120%)에 의한 보행 실험으로 구성되었다. 인지과제의 종류는 학습기능이 없는 인지과제(2-back task)를 수행하였다. 인지과제는 피험자의 트레드밀 보행 시, 3m 앞에 놓여진 스크린에 주어지고 무선마우스를 통해 응답하는 형태로 구성되었다. 실험의 모든 과정은 3차원 동작분석기를 통해 동작데이터를 획득하였다. 이를 통해, 5가지 보행 시간 변인과 3가지 공간 변인을 추출하였다. gait dynamics 측면의 분석을 위해, 가변성의 크기를 살펴볼 수 있는 방법인 분산계수(coefficient of variance)와 변동량의 구조적 자기 유사성을 추론할 수 있는 detrended fluctuation analysis (DFA)를 사용하였다. 그 결과 보행 속도 변화에 따라 보행 변인의 평균값과 분산계수에서 통계적 유의한 차이가 발생하였고, 인지과제의 수행 유/무에 따라서는 DFA에서 통계적인 차이가 발생하였다. 이는 인지과제의 수행에 의해 보행의 발생과 조절 능력에 영향을 끼쳤다고 추론할 수 있다. 본 연구 결과를 명백히 하기 위해 더 많은 수의 피험자 실험과 추가 실험이 필요할 것이다.

• 한국응용과학기술학회지
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• 제38권3호
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• pp.762-770
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• 2021

본 연구의 목적은 신체 전신 운동인 맵시 운동 프로그램을 중년여성들에게 8주간 적용하여 보행 시 수직 지면반력 크기, 발생시간, 압력 중심 요인들에 미치는 영향을 분석하는데 있었다. 본 연구의 피험자로 운동군 13명(연령, 41±4.4 세; 신장, 162.5±5.8 cm; 체중, 57.8±6.7 kg; 신체질량지수, 21.9±2.4 kg/m²), 대조군 12명(연령, 41.1±5.6 세; 신장, 160.9±5.5 cm; 체중, 576.2±8.1 kg; 신체질량 지수, 21.7±2.9 kg/m²) 총 25명이 참여하였다. 운동군은 7영역 23종 77동작의 맵시운동 프로그램을 8주간 주 3회 실시하였다. 보행 시 지면반력 요인들의 검증을 위하여 Two-way repeated measures ANOVA를 실시하였으며, 사후검증은 bonferroni adjustment로 분석하였다(a=.05). 맵시 운동 프로그램의 운동군은 보행 시 FMWA와 FPO 시점까지의 소요 시간, FMWA와 FPO에서 발생한 수직 지면반발력 그리고 AP 방향 COP의 RMS 요인들에서 대조군에 비해 상대적으로 큰 수치를 나타내었다. 그러므로 8주간의 맵시운동 프로그램은 보행을 수행하는 중년여성들의 가속과 감속 운동 기능을 향상시킨 것으로 나타났다.

• 한국운동역학회지
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• 제22권3호
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• pp.261-268
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• 2012

The purpose of this study was to qualitatively analyze pressure intensity and the center of pressure(COP) trajectory according to shoe type. Subjects were ten first-year female university students. The EMED-AT 25/D(Novel, Germany) was used to measure pressure intensity and COP trajectory. The COP Excursion Index(CPEI) was used for within subject test design. Independent variables were bare feet and six types of shoes. Dependent variables were center of pressure trajectory and pressure intensity. Barefeet and five toed shoes had a similar pressure intensity and COP trajectory. COP trajectory for all other shoe types showed a medial wobble at the heel. Pressure intensity for all other shoe types was related to the structure of the shoes. In conclusion, different shoe types can not only affect gait, but they can also influence foot deformities, pain, and dysfunction.

• 대한물리의학회지
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• 제14권1호
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• pp.53-61
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• 2019

PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.

• 한국운동역학회지
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• 제30권4호
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• pp.321-335
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• 2020

Objective: The purpose of this study was to investigate the effect of neck traction and foot type on plantar pressure distribution during walking. Method: Total of 24 data were collected from women working with a computer for more than 6 hours every day. Three groups by foot type were divided: Pes Planus, normal foot, and Pes Cavus. Depending on the foot type and cervical traction, plantar pressure variables were measured; CA, MF, PP, and CT. Each variable was divided into 12 masks. MANOVA was performed for the difference of plantar pressure variables by foot type, and a paired t-test was performed for the cervical traction within groups. Results: The total CA decreased in the Pes Planus (p<.001) and Pes Cavus (p<.05) groups. MF increased in the big toe (p<.01) and 2nd toe (p<.05) of the normal foot, and MF-3rd metatarsal decreased (p<.01). The MF-2nd toe (p<.01) and 3rd toe (p<.05) of Pes Cavus decreased. The PP decreased in 2nd toe (p<.05), 3rd toe (p<.01), and 4th toe (p<.05) of the Pes Cavus. In normal foot, the PP-3rd metatarsal (p<.05) and PP-4th metatarsal (p<.01) reduced. In Pes Planus, PP decreased in the hindfoot (p<.05). In Pes Cavus group wearing a neck-tractor, the CT-hindfoot increased (p<.05). Conclusion: There was a significant change in the plantar pressure change by foot type after neck traction. When walking with a neck-tractor, the heel impact was alleviated in the Pes Planus, and the Pes Cavus showed the smooth and effective propulsion in the push-off. Overall, weight acceptance was effectively performed when walking with neck-traction. It was also found that the neck-tractor corrects the alignment of the neck, thereby creating a more stable gait pattern.

• 대한물리치료과학회지
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• 제18권2호
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• pp.17-28
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• 2011

Purpose: The aim of this study was to ascertain the effects of the lower extremity muscle strengthening exercise on balance and ambulation of children with cerebral palsy. Methods: 10 subjects who participated in this research undertook the 12-week the lower extremity muscle strengthening exercise program, which consisted of a series of mat exercises and sling exercises. The statistical significances were examined by using Wilcoxon signed-rank test, a non-parametric test, for evaluating the improvement of balance and ambulation of the subjects. In order to evaluate the correlation among the variables, Pearson's correlation coefficients were also calculated. In all statistical analyses the significance level was selected as ${\alpha}$=0.05. Results: Berg balance scale(BBS) was significantly increased after the intervention(p<.05). Percentage weight bearing(PWB) was decreased after the intervention, but there was no significant difference. Time up and go test(TUG) value was significantly decreased(p<.05). Gait velocities was increased after the intervention, but there was no significance. Stride length, step lengths of the affected side and the sound side were significantly increased after the intervention(p<.05). In the correlation analyses of the measures before the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). In the correlation analyses of the measures after the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). BBS revealed significant positive correlations to stride length, step lengths of the sound side and the affected side(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). Conclusion: Based upon the outcomes as above, it is likely that the muscle strength exercises have substantial effects on balance and ambulation of children with cerebral palsy. Thus various lower extremity muscle strengthening exercise programs are required to be studied and developed in order to contribute to functional improvements of children with cerebral palsy.

• PNF and Movement
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• 제16권2호
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• pp.249-257
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• 2018

Purpose: This study aimed to explore the effects of additional trunk exercises on an unstable surface on the balance and walking ability of individuals with chronic stroke. Methods: Sixteen patients with chronic stroke participated in this study. The participants were randomly assigned to two groups: experimental group (n=8) and control group (n=8). All the participants underwent a typical physical therapy program for 30 min a day. Moreover, the experimental group participated in a 30 min trunk exercise program on an unstable surface, whereas the control group participated in a 30 min trunk exercise program on a stable surface. Both groups performed the exercises five times a week for three weeks. The Berg Balance Scale (BBS) was used to measure changes in balance. The gait variables were measured using the GAITRite system (CIR System Inc., Clifton, NJ, USA) to examine changes in walking ability. Results: Both groups showed a significant intragroup improvement in balance, gait speed, cadence, stride length, and double support period (p<0.05). In the intergroup comparisons after the intervention, the experimental group showed significant improvements over the control group in balance, gait speed, cadence, stride length, and double support period (p<0.05). Conclusion: This study applied additional trunk exercises on an unstable surface to chronic stroke patients, and the results showed a significant improvement in the patients' balance and walking abilities. Therefore, trunk exercise on an unstable surface may be applicable as an intervention method to improve the balance and walking ability of chronic stroke patients.

• 한국전문물리치료학회지
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• 제11권3호
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• pp.59-70
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• 2004

The purpose of this study was to propose a task-related circuits program for stroke patients and to test the difference in functional improvements between patients undergoing conventional physical therapy and those participating in a task-related circuits exercise program. The subjects were 10 stroke in-patients of the Korea National Rehabilitation Center in Seoul. We measured the following variables: Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Tone Assessment Scale (TAS), speed of gait, rate of step, physiological costs index, age, weight, height, site of lesion, onset day and whether the subject participated in an exercise program. Collected data were statistically analyzed by SPSS 10.0/PC using descriptive statistics, Mann-Whitney U test, Wilcoxon rank sum test and Spearman's correlation. The results of the experiment were as follows: (1) In the pre-test and post-test for function, there was not a statistical significance between the group partaking in a task-related circuits program and the group of conventional physical therapy (p>.05). (2) In the MAS, BBS and speed of gait test, the group undergoing conventional physical therapy showed a statistical significance (p<.05). (3) In the MAS, BBS, speed of gait, PCI, TAS (passive, associated reaction, TAS total score), the group of task-related circuits program showed a statistical significance (p<.05). As a result, the group participating in a task-related circuits program had a more functional improvement than the group participating in conventional physical therapy. Therefore, an intervention recommended for a stroke patient would be a task-related circuits program consisting of a longer session of each task for a more improved functional recovery.