• 대한통합의학회지
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• 제3권4호
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• pp.69-78
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• 2015

Purpose: The purpose of this study was to identify whether inclined treadmill gait training with rhythmic auditory simulation (RAS) could improve on balance and gait in stroke patients. Method: Fifteen stroke patients who had agreed with the study were allocated to the group 1(n=5), group 2(n=5), or group 3(n=5). The group 1, group 2 and group 3 performed RAS with inclined treadmill gait training, inclined treadmill gait training and treadmill without incline gait training respectively for 3 weeks (30 minutes per session, 5 times in a week). The balance was assessed using Timed Up & Go (TUG) and Berg Balance Sale (BBS), and the gait was evaluated using 6 Minutes Walking Test (6MWT) and spatio-temporal walking variables as walking speed, cadence, Single Limb Support of affected side(SLS) and Symmetric Index(SI) before and after training. Result: Both the group 1 and group 2 showed significant improvement after training in all variables of balance and gait. The group 3 showed significant improvement in TUG values, 6MWT values, walking speed, cadence and SI. The changes in the group 1 were significantly greater in all dependent variables of balance and gait than those of the group 2 and group 3. The changes in the group 2 were significantly greater in TUG values, BBS scores, 6MWT values, walking speed, and cadence than those of the group 3. Conclusion: The result of this study show inclined treadmill gait training with RAS is more effective to improve balance and gait in stoke patients than inclined treadmill or general treadmill gait training without RAS.

• 대한물리치료과학회지
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• 제15권3호
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• pp.73-79
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• 2008

Background : Treadmill training has been proposed as a useful adjunct to conventional physical therapy to restore ability to walk after stroke. The purpose of this study to inform clinical practise by evaluating the research evidence for the effectiveness of treadmill training after stroke. Methods : We searched to the effectiveness of any form of intervention for effect of treadmill training by Dankook University electronic library databases of Medline, Embase, Cinahl, Amed and PEDro combined with a hand search of papers published in relevant peer-reviewed journals. Any type of study relevant to the topic published in English during time period from 1980 to 2007 was included. Results : The literature search identified 35 studies. The included studies enrolled a total of 374 subjects. 1. Treadmill retraining without partial body weight support might be more effective than no treatment at improving gait velocity, get up and go time, gait endurance and step length symmetry. 2. Treadmill retraining with partial body weight support might be more effective than no treatment in improving step length symmetry, gait velocity, gait endurance and balance. 3. Treadmill retraining might be more effective with partial body weight support than without it at improving gait velocity and motor improvement as measured by The Stroke Rehabilitation Assessment of Movement(STREAM). 4. Treadmill retraining without partial body weight support may be no different from physiotherapy and increase gait velocity to conventional gait therapy. 5. Treadmill retraining with partial body weight support may be no different from physiotherapy for gait velocity, motor recovery and balance. Conclusion The review suggests that although treadmill training of gait, especially with partial body weight support, might Improve gait parameters and functional mobility, unless treadmill training is directed at Improving gait speed it might be no more effective than conventional physical therapy at improving gait parameters.

• 대한임상전기생리학회지
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• 제10권1호
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• pp.23-28
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• 2012

Purpose : The objectives of this study were to examine changes in gait parameters related to the COP and gait velocity resulting from the use of ankle foot orthosis, and to provide information for the prescription of ankle foot orthosis and gait rehabilitation training. Methods : We sampled a control group of 14 normal children of the same age as the spastic diplegia (spastic diplegia used ankle foot orthosis) and measured their COP at barefoot gait and their gait parameters at three gait velocities. Change in the COP according to the use of ankle foot orthosis measured one-way ANOVA and Gait parameters according to gait velocity used repeated measures ANOVA. Results : As a result of analyzing change in the COP it became close to that of normal children, and changes in gait parameters such as step width, stride length and stride time also became close to those of normal children. Conclusion : In conclusion, when spastic diplegia used ankle foot orthosis, their balancing ability was improved as a result of decreased change in the COP, and their changes in gait parameters also became close to those of the control group. These results show that the use of ankle foot orthosis improves spastic diplegia gait functions.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.1-10
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• 2016

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

• Annals of Clinical Neurophysiology
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• 제5권2호
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• pp.197-201
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• 2003

Background: The aim of this study is to present the basic reference data of kinematic gait analysis of normal Korean adults with 3 dimensional electrogoniometer, $Domotion^{(R)}$. Method: The basic kinematic gait parameters of hip, knee and ankle joints on the sagittal plane were obtained from 10 healthy adults with 5 repetition for each. Three-dimensional gait analysis was performed with $Domotion^{(R)}$ electrogoniometer in 10 meters long flat floor. Each data collected was processed with IBM PC equipped with gait analysis program. Results: Mean maximal hip flexion was $23.05^{\circ}{\pm}4.62^{\circ}$and mean maximal hip extension was $6.46^{\circ}{\pm}1.30^{\circ}$. Knee flexion was observed with two peak values. The first peak knee flexion was $6.50^{\circ}{\pm}2.07^{\circ}$ at 20.4% of gait cycle and the second peak flexion was $50.34^{\circ}{\pm}2.23^{\circ}$ at 75.8% of gait cycle. Mean maximum ankle dorsiflexion was $5.57^{\circ}{\pm}1.19^{\circ}$ at 44% of gait cycle and mean maximum ankle plantar flexion was $15.51^{\circ}{\pm}1.73^{\circ}$ at 68.5% of gait cycle. Conclusion: We concluded three dimensional gait analysis with electrogoniometer $Domotion^{(R)}$ offers a valid and reliable kinematic data and the application of this tools for clinical gait evaluation will be helpful in management of pathological gait.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7285-7292
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• 2015

본 연구의 목적은 생체역학적 변인을 근거로 하여 후진보법의 전방향 보행(댄스보행)이 후방보행처럼 재활과 걷기운동으로써의 가능성을 규명하는 것이다. 실험대상자는 13명의 여성댄스 전문가로 자료수집을 위하여 12대의 적외선카메라와 2대의 지면반력기가 동조되어 사용되었다. 연구결과에 따르면 댄스보행의 보속, 활보장과 양 하지지지기시간은 후방보행보다 크고, 활보폭은 작았으며 관절각범위, 관절모멘트와 관절파워의 최대치 출현 빈도에서 댄스보행이 후방보행보다 더 많았다. 이러한 결과들은 댄스보행이 재활과 걷기운동에 후방보행에 버금가는 훌륭한 도구임을 판단하는데 충분하다.

• 대한물리의학회지
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• 제9권2호
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• pp.201-211
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• 2014

PURPOSE: The purpose of this study was to investigate the inter-rater absolute reliability and the concurrent validity of the Tinetti-gait scale that was translated into Korean for chronic stroke patients. METHODS: Fifty-two patients with post-stroke participated in this study. Inter-rater reliability was analyzed by Intraclass Correlation Coefficient ($ICC_{3,1}$) and Kappa coefficient, and absolute reliability was analyzed by the Standard Error of Measurement (SEM), and the Minimal Detectable Change (MDC). Concurrent validity was analyzed by correlating between the Tinetti-gait scale and physical functions. The physical functions were measured by using the Dynamic Gait Index(DGI), 10m walking test(10WT), One Leg Standing Test of affected/non-affected side(OLST), Sit to Stand test(STS), (Fugl Meyer assessment of Lower Extremity(FM-LE). RESULTS: The inter-rater reliability of the Tinetti-gait scale was high; $ICC_{(3,1)}=.91$ (95% CI=.85~.95) (very reliable), the range of Kappa coefficient were .73~.92 (substantial~good). The inter-rater agreement of the each item in Tinetti-gait scale ranged from .74 to .92 (95 % CI=.59~.95) (reliable~very reliable). The SEM and MDC were .56 and 1.55, respectively. In the results of concurrent validity, there were moderate positive correlation between Tinetti-gait scale and DGI (r=.78), 10WT (r=.74), OLST (r=.65~.73), FM-LE (r=67). And there was moderate negative correlation between Tinetti-gait scale and STS (r=-79) (p<.01). CONCLUSION: The Tinetti-gait scale(Korean version) was a reliable and valid tool to measure gait ability in patients with chronic stroke. Thus, it could be a useful tool for examining a gait ability of post-stroke patients. Further study should be conducted to investigate the usability to predict fall risk of post-stroke patients of the Tinetti-gait scale.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.205-210
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• 2018

Purpose: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. Methods: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: $0^{\circ}$ treadmill gait training (n=14), $5^{\circ}$ treadmill gait training (n=15), and $10^{\circ}$ treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. Results: This study showed that gait training on a treadmill at controlled inclinations of $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ positively influenced the stroke patients' standing balance. The $5^{\circ}$ and $10^{\circ}$ inclination gait training groups showed significantly more improvement than the $0^{\circ}$ inclination group. Conclusion: Gait training on a treadmill with inclinations of $0^{\circ}$, $5^{\circ}$, or $10^{\circ}$ can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, $5^{\circ}$ and $10^{\circ}$ inclination gait training offered more significant improvement than the $0^{\circ}$ inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2008년도 심포지엄 논문집 정보 및 제어부문
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• pp.73-74
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• 2008

In this study, we developed a robotic gait trainer which induces the active gait training based on predefined continuous proper lower extremity joint movements. AC servo motors and linear actuators were used to control hip and knee joints of patients and the weight support system was used to support the patient's weight during the gait training. We also implemented a Gill program to set the gait training pattern with several training parameters and to confirm states of patients and the system through the visual feedback. The effectiveness of the gait training system will be determined by the long-term clinical experiments in the future. We expect that the developed robotic gait training system could be applied very practically to recover gait abilities for persons with gait disorder.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.35-43
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• 2016

Background: The Functional Gait Assessment (FGA) was developed to measure of gait-related activities. The FGA was translated in Korean but only a few psychometric characteristics had been studied. Objects: The purpose of this study was to evaluate the validity and reliability of the Korean version of FGA scale using Rasch analysis. Methods: The study included 120 patients with stroke (age range=30~83 years; mean${\pm}$standard deviation=$58.3{\pm}11.1$). The FGA and Berg Balance Scale were performed, and were analysed for dimensionality of the scale, item difficulty, scale reliability and separation, and item-person map using Rasch analysis. Results: The 4 rating scale categories of FGA were satisfied with optimal rating scale criteria. The most items of the FGA showed sound item psychometric properties except 2 items ('gait with the horizontal head turns', and 'gait with narrow base of support'), and the 2 misfit items were excluded for all further analyses. The 8 items were arranged in order of difficulty. The most difficult item was 'gait with eyes closed', the middle difficult item was 'gait level surface', and the easiest item was 'gait with vertical head turns.' A person separation reliability was .93 and the person separation index was 3.57. Conclusion: This study suggests that the 8-item Korean FGA are valid measure of assess the gait-related balance performance, and to set the goal of rehabilitation plan in patient with stroke.