• 한국임상보건과학회지
• /
• 제5권1호
• /
• pp.816-824
• /
• 2017

Purpose. This study was classified into normal and demented elderly through K-MMSE. The purpose of this study was to analyze gait characteristics of normal elderly and demented peoples using GAITRite walking system. Methods. The subjects of this study were selected as elderly people receiving home visit physical therapy. An independent t-test was conducted to verify the statistical significance of the time-space variables of the elderly with dementia. Results. Step time(p=0.041), cycle time(p=0.037), distance(p=0.024), and cadence(p=0.048) were significantly shorter in the normal elderly than in the demented elderly on flat place. The mean age was significantly longer in normal elderly than in elderly persons with dementia. Step time(p=0.022), cycle time(p=0.023), distance(p=0.019), and cadence(p=0.015) were significantly shorter in the mat walking. The mean age was significantly longer in normal elderly than in elderly patients with dementia. Stretch time, cycle time, distance, and hair support time were significantly shorter in the mat walking. The mean age of the elderly was significantly longer than that of the elderly with dementia. The spinal support time, which is a spatial variable, was significantly shorter in the normal elderly than in the demented elderly. Conclusions. It compares the various gait characteristics of the normal and demented elderly people, thereby increasing the walking ability of the elderly person more effectively. This study should be utilized as basic data for preventing fall-down.

• 대한물리의학회지
• /
• 제11권2호
• /
• pp.63-70
• /
• 2016

PURPOSE: The aim of this study was to conduct an Otago exercise program with stroke patients in a clinical setting and ascertain its effects on balance and walking ability. METHODS: The participating subjects were 45 people who had been diagnosed with stroke. They were assigned to two groups (Otago exercise; OE, n=22; balance exercise; BE, n=23), and the exercises were conducted for three sessions per week for eight weeks. The main balance outcomes were evaluated using the timed up and go test (TUG) and the four step square test (FSST), while walking ability was evaluated using the 10 m walk test (10MWT), direction change ability was measured using the figure 8 of walk test (F8WT), and the decrease of fear was evaluated using the modified falls efficacy scale (MFES). RESULTS: In the analysis results, the Otago exercise group showed significant increases in TUG, FSST, 10MWT, and F8WT within the both groups. There were significant differences in all variables between the OE group and the BE group at the post-intervention evaluation, but there was no significant difference between the groups with respect to the 10MWT. This study showed that conducting Otago exercise in stroke patients increased the main outcomes for TUG, FSST, F8WT scores, but not for 10MWT. CONCLUSION: The results of this study demonstrated that Otago exercise would be useful to improve balance and gait for stroke patients who want to improve their abilities and activities of daily living.

• 한국운동역학회지
• /
• 제26권3호
• /
• pp.293-301
• /
• 2016

Objective: The purpose of this study was to analyze the effects of freezing of gait and visual information on the static postural control ability in patients with Parkinson's Disease (PD) during the bipedal stance with feet together. Method: This study included a total of 36 patients with PD; the freezer group included 17 PD patients (age: $69.3{\pm}6.2yrs$, height: $159.6{\pm}9.0cm$, weight: $63.4{\pm}9.78kg$) and the nonfreezer group included 19 PD patients (age: $71.4{\pm}5.6yrs$, height: $155.8{\pm}7.1cm$, weight: $57.7{\pm}8.6kg$). Static postural control ability was analyzed using variables of center of pressure (COP) and dividing by mediolateral, anteroposterior, and integration factors during a bipedal stance with the eyes open and closed. Results: Freezers and nonfreezers showed increases in anteroposterior velocity, mediolateral velocity, averaged velocity, and mediolateral 95% edge frequency when visual information was blocked. Additionally, freezers had greater anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position than nonfreezers. Conclusion: Freezers and nonfreezers showed a reduction in static postural control ability when visual information was blocked. Additionally, the results of this study found a significant difference in static postural control ability between freezers and nonfreezers with PD. In particular, anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position might be used to distinguish between freezers and nonfreezers with PD.

• 한국운동역학회지
• /
• 제20권2호
• /
• pp.191-196
• /
• 2010

The purpose of this study was to investigate the effect of gait speed and walkway slope on the body acceleration, for the future validation of using an accelerometer in the estimation of energy consumption. Ten young healthy subjects with accelerometers on the upper thigh and ankle walked on a treadmill at 9 conditions(three speeds ${\times}$ three slopes) for 5 minutes. Acceleration signals of four directions, i.e. anterior-posterior(AP), medio-lateral(ML), superior-inferior(SI) and vector sum(VS) directions, of each sensor were measured, and root means squared(RMS) values of them were used as analysis variables. As statistical analysis, repeated measure two-way ANOVA was performed for RMS accelerations at each attachment sites, with slope and velocity as independent factors. At both the upper thigh and ankle, RMS acceleration of all directions were affected by gait velocities(p<.001) showing greater accelerations for higher velocities. Contrary to expectations, no slope effect existed in RMS accelerations at hip. Moreover, RMS acceleraion at ankle decreased with slope in SI and VS directions(p<.01). These results suggests that RMS acceleration cannot reflect the change in physical activity due to the change in walkway slope.

• Annals of Rehabilitation Medicine
• /
• 제39권6호
• /
• pp.897-904
• /
• 2015

Objective To investigate differences in plantar pressure distribution between a normal gait and unpredictable slip events to predict the initiation of the slipping process. Methods Eleven male participants were enrolled. Subjects walked onto a wooden tile, and two layers of oily vinyl sheet were placed on the expected spot of the 4th step to induce a slip. An insole pressure-measuring system was used to monitor plantar pressure distribution. This system measured plantar pressure in four regions (the toes, metatarsal head, arch, and heel) for three events: the step during normal gait; the recovered step, when the subject recovered from a slip; and the uncorrected, harmful slipped step. Four variables were analyzed: peak pressure (PP), contact time (CT), the pressure-time integral (PTI), and the instant of peak pressure (IPP). Results The plantar pressure pattern in the heel was unique, as compared with other parts of the sole. In the heel, PP, CT, and PTI values were high in slipped and recovered steps compared with normal steps. The IPP differed markedly among the three steps. The IPPs in the heel for the three events were, in descending order (from latest to earliest), slipped, recovered, and normal steps, whereas in the other regions the order was normal, recovered, and slipped steps. Finally, the metatarsal head-to-heel IPP ratios for the normal, recovered, and slipped steps were $6.1{\pm}2.9$, $3.1{\pm}3.0$, and $2.2{\pm}2.5$, respectively. Conclusion A distinctive plantar pressure pattern in the heel might be useful for early detection of a slip event to prevent slip-related injuries.

• 한국전문물리치료학회지
• /
• 제26권1호
• /
• pp.1-7
• /
• 2019

Background: The Microsoft Kinect which is a low-cost gaming device has been studied as a promise clinical gait analysis tool having satisfactory reliability and validity. However, its accuracy is only guaranteed when it is properly positioned in front of a subject. Objects: The purpose of this study was to identify the error when the Kinect was positioned at a $45^{\circ}$ angle to the longitudinal walking plane compare with those when the Kinect was positioned in front of a subject. Methods: Sixteen healthy adults performed two testing sessions consisting of walking toward and $45^{\circ}$ obliquely the Kinect. Spatiotemporal outcome measures related to stride length, stride time, step length, step time and walking speed were examined. To assess the error between Kinect and 3D motion analysis systems, mean absolute errors (MAE) were determined and compared. Results: MAE of stride length, stride time, step time and walking speed when the Kinect set in front of subjects were investigated as .36, .04, .20 and .32 respectively. MAE of those when the Kinect placed obliquely were investigated as .67, .09, .37, and .58 respectively. There were significant differences in spatiotemporal outcomes between the two conditions. Conclusion: Based on our study experience, positioning the Kinect directly in front of the person walking towards it provides the optimal spatiotemporal data. Therefore, we concluded that the Kinect should be placed carefully and adequately in clinical settings.

• 한국전문물리치료학회지
• /
• 제28권1호
• /
• pp.77-83
• /
• 2021

Background: Although symmetry of spatio-temporal parameter and center of pressure (COP) shift during walking is associated with knee adduction moment, research on clinical association with knee osteoarthritis (OA)-related knee pain and functional scores is lacking. Objects: The aims were 1) to compare symmetry of gait parameters and COP-shift in patients with unilateral knee OA and pain and matched controls, and 2) to investigate the relationship between symmetry of gait parameters and COP-shift, and clinical measures. Methods: Female subjects (n = 16) had with unilateral radiological knee OA and pain. Healthy controls (n = 15) were age-matched to OA group. Symmetry of foot rotation, step length, stance and swing phase, lateral symmetry of COP and anterior/posterior symmetry of COP during walking was assessed. To assess the clinical variables, pain intensity, pain duration and function using Knee Osteoarthritis Outcome Survey (KOOS) subscales were collected. We compared symmetry between groups using Mann-Whitney U-test or independent t-test. Relationships between clinical measures and symmetry index measured using Spearman's correlation test. Statistical significance was set at α = 0.05. Results: Knee OA group showed significantly greater values of only lateral symmetry of COP (p < 0.01) than healthy group. Values of lateral symmetry of COP had moderate or strong correlation significantly with the intensity of knee pain, pain duration, and scores of all KOOS subscales (p < 0.01). Conclusion: Patients with unilateral knee OA and pain showed more asymmetry of lateral COP-shift during walking compared with matched healthy controls. In addition, larger asymmetry of lateral COP-shift has the moderate or strong association with worse of knee pain, worse in KOOS scores and longer duration of knee pain. Asymmetry of lateral COP-shift during walking may be one of the characteristics of unilateral knee OA as the compensatory strategy response to unilateral OA of the knee.

• 한국전문물리치료학회지
• /
• 제28권3호
• /
• pp.215-226
• /
• 2021

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

• 한국정밀공학회지
• /
• 제29권2호
• /
• pp.239-244
• /
• 2012

The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

• 한국운동역학회지
• /
• 제26권1호
• /
• pp.127-133
• /
• 2016

Purpose: The purpose of this study was to analyze the effects of using external kinesio-tape wrapping for inner arch support on the lower extremity EMG for gait in stiletto heels. Methods: Subjects for this study were two female college students who had been wearing stiletto heels almost every day of the week for more than three years. The independent variable was the presence or absence of kinesio-tape wrap for inner arch support. Dependent variables were EMG readings for the four muscle groups: the medial and lateral gastrocnemius, the tibialis anterior, and the peroneus longus. EMG readings were taken using the NORAXON (USA). The Paired t-test within the subject repeated measure design for the presence and absence of inner arch support (p<0.05) was used via SPSS 18.0. Results: With kinesio-tape wrap for inner arch support, there was a statistically significant decrease in the muscle force mean values for the peroneus longus and the medial and lateral gastrocnemius, in the maximum muscle forces of the peroneus longus and the lateral gastrocnemius. Conclusion: External kinesio-tape wrapping for inner arch support in stiletto heels could have an effect to reduce peroneus longus, and medial/lateral gastrocnemius activities that could result in decreased fatigue and discomfort.