• Title/Summary/Keyword: Gait Control

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Characteristics Change of Spatial and Temporal Parameters of Gait in Spastic Hemiplegic Patients by Reciprocal Inhibition (상호억제 기법에 의한 경직성 편마비 환자 보행의 공간적, 시간적 특성 변화)

  • Kim Jong-Soon;Lee Hyun-Ok;Ahn So-Youn;Koo Bong-Oh;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.59-79
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    • 2004
  • The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

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The Change of Lateral Shift of Center of Pressure according to the Gait Improvement in Post-Stroke Hemiplegic Patients (뇌졸중 후 편마비 환자의 보행능력 향상에 따른 질량중심 좌우이동의 변화)

  • Lee, Il-Suk;Park, Kee-Eon;Hong, Hae-Jin;Sung, Kang-Keyng;Lee, Sang-Kwan
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.448-454
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    • 2014
  • Objectives: The aim of this study was to analyze the change of lateral shift of Center of Pressure (CoP) according to the gait improvement in post-stroke hemiplegic patients and to investigate relationship between the change of motor grade and lateral shift of CoP. Methods: We measured the lateral shift of CoP and motor grade of eight post-stroke hemiplegic patients at the beginning of dependent gait and independent gait. Results: We found that CoP tended to be shifted to the non-affected side when patients started to walk independently. Furthermore, there was no relationship between the change of motor grade and lateral shift of CoP. Conclusions: This result may suggest it is more important to control the non-affected side than the affected side, at least until the beginning independent gait.

The Influence of Unstable Modified Wall Squat Exercises on the Gait Variables of Healthy Adults (정상 성인에서 불안정 지지면의 수정된 월-스쿼트 운동이 보행변수에 미치는 영향)

  • Gong, Won-tae;Lee, Jae-nam;Park, Jae-myoung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.9-15
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    • 2016
  • Background: This study was conducted to investigate the effects of unstable modified wall squat exercises accompanied by abdominal drawing-in on the gait variables of healthy adults. Methods: The total number of subjects was 30, and 15 were randomly placed in the training group (TG) and 15 in the control group (CG). To determine the gait variables of TG and CG, step length difference (SLD) stance phase difference (STPD), swing phase difference (SWPD), single support difference (SSD), and step time difference (STD) were measured using OptoGait, a gait analysis system. Results: When the pre-intervention and post-intervention results of TG and CG were compared, statistically significant differences in SLD, STPD, SWPD, SSD and STD of TG were seen. Conclusion: Unstable modified wall squat exercises accompanied by abdominal drawing-in might help reduce the deviation between left and right gait variables during walking.

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The Effects of Robot-Assisted Gait Training for the Patient With Post Stroke: A Meta-Analysis (뇌졸중 환자에게 적용한 로봇보행 재활훈련의 효과: 메타분석)

  • Park, So-Yeon
    • Physical Therapy Korea
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    • v.22 no.2
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    • pp.30-40
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    • 2015
  • Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

Effect of Treadmill Training on Walking Velocity and Gait Endurance in patients with chronic hemiplegia (트레드밀 보행훈련이 만성편마비 환자의 보행 속도와 보행 지구력에 미치는 영향)

  • Kim Sang-Yub
    • The Journal of Korean Physical Therapy
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    • v.16 no.2
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    • pp.44-53
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    • 2004
  • Treadmill training is a new promising therapy in gait rehabilitation of patients with hemiplegia. The purpose of this study was to identify the effect of treadmill training on walking speed and gait endurance in patients with chronic hemiplegia. The subject of this includes twenty patients, who had suffered from chronic hemiplegia and were in the K rehabilitation center; each ten patients were randomly assigned to experimental or control group. Among twenty patients, one group of ten for experiment was treated with progressive speed increase treadmill ambulation traing besides conventional physical therapy(SITAT) while the rest ten for the controlled group was treated with conventional physical therapy(CPT) only, for 8 weeks alike. Before and after the foregoing 8 weeks training, walking velocity and gait endurance were measured to both groups. The data were analyzed by paired t-test. The results of this study are as follows; The SITAT and CPT showed the significant difference in walking velocity and gait endurance. As compared the rehabilitation of dependent varibles between the SITAT and CPT, SITAT showed the significant difference in walking velocity and gait endurance. The outcome suggest that patient with chronic hemiplegia can improve their walking velocity and gait endurance throught treadmill training.

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Clinical Feasibility of Wearable Robot Orthosis on Gait and Balance Ability for Stroke Rehabilitation: A Case Study

  • Shin, Young-Il;Yang, Seong-Hwa;Kim, Jin-Young
    • The Journal of Korean Physical Therapy
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    • v.27 no.2
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    • pp.124-127
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    • 2015
  • Purpose: The emphasis on gait rehabilitation after stroke depends on training support through the lower limbs, balance of body mass over the changing base of support. However, muscle weakness, lack of control of lower limb, and poor balance can interfere with training after stroke. For this case study report, a wearable robot orthosis was applied to stroke patients in order to verify its actual applicability on balance and gait ability in the clinical field. Methods: Two stroke patients participated in the training using the wearable robot orthosis. Wearable robot orthosis provides patient-initiated active assistance contraction during training. Training includes weight shift training, standing up and sitting down, ground walking, and stair up and down Training was applied a total of 20 times, five times a week for 4 weeks, for 30 minutes a day. Gait ability was determined by Stance phase symmetry profile, Swing phase symmetry profile, and velocity using the GAITRite system. Balance ability was measured using the Biodex balance system. Results: Subjects 1, 2 showed improved gait and balance ability with mean individual improvement of 72.4% for velocity, 19.4% for stance phase symmetry profile, 9.6% for swing phase symmetry profile, and 13.6% for balance ability. Conclusion: Training utilizing a wearable robot orthosis can be useful for improvement of the gait and balance ability of stroke patients.

Gait Pattern Generation Algorithm for a Biped Robot with Toes

  • Min, Kwan-Sik;Ahn, Cheol-Ki;Lee, Min-Cheol
    • 제어로봇시스템학회:학술대회논문집
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    • 2002.10a
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    • pp.107.4-107
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    • 2002
  • One of the most important functions of a biped robot is to walk naturally like human. For the human being, toe is very important joint in order to walk naturally. Thus, for a biped robot, the existence of toe joint much affects gait pattern generation and contributes to natural walking, which is similar to the human gait or faster walking like running. Since a conventional biped robot has the feet which consist of soles without toes, it seems difficult to walk naturally. For realizing the gait to be similar to human one, toes are necessary to the biped robot. In this paper, the effect of the toe joint for gait pattern generation is studied. In order to find the effect of toe joint, a biped r...

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A Dynamic Modeling and Analysis for High-speed Walking of a Quadrupedal Robot (사각보행기의 고속 보행제어를 위한 동적 모델링 및 해석)

  • Kang, Sung-Chul;Yoo, Hong-Hee;Kim, Mun-Sang;Lee, Kyo-Il
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.21 no.5
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    • pp.756-768
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    • 1997
  • In order to control a dynamic gait of quadrupedal walking robot, the equations of motion of the whole mechanism are required. In this research, the equations of motion are formulated analytically using Kane's dynamic approach. As a dynamic gait model, a trot gait has been adopted. The degree of freedom of whole mechanism could be reduced to 7 by idealizing the kinematic feature of the trot gait. Using the equations of motion formulated, the results of the redundant-joint torque analysis and the simulation of dynamic walking motion are presented.

Kinetic analysis of the foot and ankle (발과 족관절의 운동학적 분석)

  • Kim, Jae-Hun
    • PNF and Movement
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    • v.6 no.3
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    • pp.29-35
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    • 2008
  • Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

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Kinematic Effects of Newly Designed Knee-Ankle-Foot Orthosis With Oil Damper Unit on Gait in People With Hemiparesis

  • Park, Hyung-Ki;Kim, Tack-Hoon;Choi, Houng-Sik;Roh, Jung-Suk;Cynn, Heon-Seock;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.20 no.1
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    • pp.64-73
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    • 2013
  • The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.