• Physical Therapy Korea
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• v.21 no.1
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• pp.13-19
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• 2014

The purpose of this study was to determine the effect of gait initiation training on gait and center of pressure (CoP) during gait initiation in stroke patients. Twenty-three subjects were randomly assigned to either an experimental group (EG) or a control group (CG). The EG received gait initiation training with increased CoP posterior distances the maximum the rear on gait training. The CG received general gait training. Both groups received training three times a week over a period of four consecutive weeks. The figures for CoP distances the maximum the rear, CoP distances time the mover the maximum the rear, the Tinetti Performance-Oriented Mobility Assessment (POMA), and gait velocity were recorded both before and after the training sessions for both groups. The EG's results for CoP distances the maximum the rear, CoP distances time the mover the maximum the rear, and POMA improved after training (p<.05). In terms of the rate of change of CoP distances the maximum the rear, the EG demonstrated a significantly higher increase (p<.05) than did the CG. The results of this study suggest that increased CoP distances the maximum the rear affect the gait initiation and gait performance of stroke patients. Further studies with a larger sample size are necessary to verify the accuracy of the results of this study.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.39-48
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• 2020

PURPOSE: This study examined the effects of integrating transcutaneous electrical nerve stimulation into treadmill gait training by applying functional electrical stimulation on the spasticity, balance, and gait ability of chronic stroke patients METHODS: Twenty participants were assigned randomly to two groups: the treadmill gait training group with applied functional electrical stimulation (FES) with integrated transcutaneous electricalstimulation (TENS) (experimental group, EG, n = 10) and the treadmill gait training group with FES (control group, CG, n = 10). Both groups received treadmill gait training with FES for 30 minutes a time, four times a week, during five weeks. The experimental group received additional TENS on their L3, L5, and S2 dermatome for 30 minutes before the interventions. The spasticity, balance, and gait ability were evaluated before and after the training to compare the intergroup and intragroup changes. RESULTS: Both groups showed significant improvements in the static, dynamic balance, and gait ability (p < .05), but did not show any significant changes in the muscle tone. The EG showed significant improvements in the static balance ability and gait cycle compared to the CG (p < .05). CONCLUSION: Treadmill gait training combined with FES with integrated TENS is an effective method for improving the static balance and gait cycle. On the other hand, the effects of treadmill gait training with FES on spasticity need to be studied further.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.220-226
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• 2012

The purpose of this study was to identify the effect of treadmill gradient training on lower limb muscle activity in chronic stroke patients. The subject were 32 stroke patients.. Subjects were randomly divided into three group which were control group($0^{\circ}$treadmill training(n=10)) and experimental group($5^{\circ}$treadmill training (n=10) and $10^{\circ}$treadmill training(n=12)). Three groups received treadmill gradient training for 30 minutes while 3 times per week for 6 weeks in addition to conventional physical therapy. Muscle strength was measured by EMG on rectus femoris, biceps femoris, tibialis anterior and gastrocnenius for muscle activities. In comparison of activity of rectus femoris and gastrocnemius between pre and post value, the activity of rectus femoris was significant in the experimental and control group(p<.05) and the activity of biceps femoris was significant in the $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group(p<.05). The activity of tibialis anterior was significant in the $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group(p<.05). In comparison of the difference of activity of rectus femoris among 3 groups, there was a significant difference between the $5^{\circ}$treadmill gait training group and control group(p<.05). and difference of activity of tibialis anterior was significant difference between the $10^{\circ}$treadmill gait training group and control group(p<.05). These findings suggest that $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group can be used to improve lower limb muscle activity in chronic stroke patient. In conclusion, these treadmill gradient training helped improving function of gait ability in chronic stroke patient.

• Physical Therapy Korea
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• v.27 no.3
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• pp.178-184
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• 2020

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

• Journal of IKEEE
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• v.16 no.3
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• pp.235-243
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• 2012

In this study, we developed two legged multi-joint robot by using wireless servo motor that was applied by wireless sensor network technology, which is widely used recently, and performed an experiment of walking method of two legged multi-joint robot. We constructed the star network with servo motors which were used at each joint of two-legged robot. And we designed the robot for operation by transmission of joint control signal from main control system or by transmission of the status of each joint to the main control system, so it operates with continuously checking the status of joints at same time. We developed the humanoid robot by using wireless digital servo motor which is different from existing servo motor control system, and controlled it by transmitting the information of angles and speeds of robot joints to the motor(node) as a feedback through main control system after connecting power and setting up the IDs to each joint. We solved noisy problem generated from wire and wire length to connection point of the control device by construction of the wireless network instead of using existing control method of wiring, and also solved problem of poor real time response to gait motion by controlling the position with continuous transmission of control signals to each joint. And we found that the effective control of robot is able by performing the simulation on walking motion in advance with the developed control algorithm which was downloaded into installed memory. Also we performed the stable walking with two-legged robot by attaching pressure sensor to robot sole. And we examined the robot gait operated by application of calculated algorithm on robot movement to each joint. In this study, we studied the method of controlling robot gait motion by using wireless servo motors and measured the torque applied to each joint, and found that the developed wireless servo motor by ZigBee sensor network offers easier control of two legged robot gait and better circuit configuration of it than the existing wired control system could do.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.21-31
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• 2017

PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.

• Journal of Magnetics
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• v.20 no.2
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• pp.133-137
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• 2015

This study was conducted to determine the effects of repetitive transcranial magnetic stimulation (rTMS) integrated mirror therapy on the gait of post-stroke patients. Thirty patients who were six months post-stroke were assigned to either the experimental group (n = 15) or the control group (n = 15). Stroke patients in the experimental group underwent rTMS and mirror therapy for the lower limbs, while those in the control group underwent rTMS and sham therapy. Participants in both groups received therapy five days per week for four weeks. A significant difference in post-training gains for the single support phase, step length, stride length and velocity was observed between the experimental group and the control group (p < 0.05). The experimental group showed a significant increment in the single support phase, step length, stride length, swing phase, velocity, cadence, double support phase and step width as compared to pre-intervention (p < 0.05). The control group showed a significant increment in step length, velocity, cadence and step width compared to preintervention (p < 0.05). Further investigation of the availability and feasibility of rTMS integrated mirror therapy for post-stroke patients as a therapeutic approach for gait rehabilitation is warranted.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.5-23
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• 2002

Purpose: To determine the effect of the Fall Prevention Program(EPP) on gait, balance and muscle strength in elderly women at a nursing home. Method: The subjects of this consisted of 38 elderly women between the ages of 70 to 89 years living at a nursing home located in Seoul. Each of the experimental group and control group was composed of 19 subjects. The subjects in experimental group have participated in FPP for the 8 weeks which consisted of exercise, education and foot care. They started to exercise for 40 minutes per session, 3 sessions a week during the 1st week at 40% of age adjusted maximum heart rate. From the 2nd week to the 4th week, they increased the duration of exercise to 50 minutes per session and the intensity to 60% of age-adjusted maximum heart rate. They participated in 50 minutes at 60% of age-adjusted maximum heart rate from the 5th week to the 8th week. Each exercise session consisted of 10 minutes of warming-up exercise, 30 minutes of conditioning exercise and 10 minutes of cooling-down exercise. They participated in education for 20 minutes per week from the 1st week to the 4th week. Then they participated in a 30-minute foot care program per week from the 5th week to the 8th week. Gait, balance and muscle strength for each subject were measured before and after FPP. Gait was evaluated by step length, step width, gait speed and walking distance. Balance was measured by the duration of standing on one leg with their eyes closed and open each, and a get-up and go test. Grip strength was measured by hand dynamometer. Hip extensor and flexor strength, knee extensor and flexor strength and ankle plantarflexor and dorsiflexor strength were measured by manual muscle tester. Data was analyzed using SPSS form Windows. t-test and Chi square test were utilized as a homogeneity test. Repeated measure ANOVA was used to test the effect of FPP. Result: 1) Step width significantly decreased, and step length, gait speed and walking distance significantly increased in the experimental group compared with the control group after FPP(p<0.005). 2) There was no significant change in standing time on one leg with their eyes closed after FPP. The standing time on leg with their eyes open and the time of "get-up and go" significantly decreased in the experimental group compared with the control group after FPP(p<0.005). 3) Muscle strength-grip strength, hip extensor and flexor strength-significantly increased in the experimental group compared with the control group after FPP(p<0.005). 4) There was no significant difference of frequency of fall between the experimental group and control group during the period of FPP. Conclusion: These results suggest that FPP can increase gait, balance and muscle strength of elderly women at a nursing home.