• Title/Summary/Keyword: Gait Control

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Musculoskeletal Models to Predict Patient-specific Gait Patterns Using Function-based Morphing Technique (기능기반 형상변형기술을 응용한 환자맞춤형 근골격 모델의 보행패턴 예측에 관한 연구)

  • Park, Byoung-Keon;Koo, Bon-Yeol;Park, Eun-Joo;Chae, Jae-Wook;Lee, Soon-Hyuk;Kim, Jae-Jung
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.6
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    • pp.443-455
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    • 2012
  • The configuration of a musculoskeletal (MS) system is closely related to the individual motions of the human body. Many researches have been focused on evaluating the associations between the MS configuration and the individual motion using patient-specific MS models, but it still remains a challenging issue to accurately predict the motion by differed configurations of the MS system. The main objective of this paper is to predict the changes of a patient-specific gait by altering the geometric parameters of the hip joint using function-based morphing method (FBM). FBM is suitable for motion analysis since this method provide a robust way to morph a MS model while preserving the biomechanical functions of the bones. Computed-muscle control technique is used to calculate the muscle excitations to reproduce the targeted motion within a digital MS model without the motion-captured data. We applied this approach to a patient who has an abnormal gait pattern. Results showed that the femoral neck length and the angle significantly affect to the motion especially for the hip abduction angle during gait, and that this approach is suitable for gait prediction.

Effects of Knee Tracking Training on Gait in Stroke Patients (무릎관절 추적훈련이 편마비 환자의 보행에 미치는 영향)

  • Shin, Hwa-Kyung;Yeom, Ho-Joon;Cho, Sang-Hyun;Jang, Sung-Ho
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.71-79
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    • 2003
  • Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of $-20^{\circ}$ to $20^{\circ}$ and $0^{\circ}$ to $60^{\circ}$. The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.

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Effects of Ankle Joint Mobilization With Movement on Lower Extremity Muscle Strength and Spatiotemporal Gait Parameters in Chronic Hemiplegic Patients (만성 편마비 환자의 발목에 적용한 능동운동을 동반한 관절가동술이 하지근력과 보행의 시공간적 변수에 미치는 영향)

  • An, Chang-Man;Won, Jong-Im
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.20-30
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    • 2012
  • The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

The Effects of Virtual Reality-based Exercise on Energy Expenditure during Gait in Chronic Stroke Patients (가상현실을 이용한 재활운동이 뇌졸중 환자의 보행시 에너지 소모에 미치는 효과)

  • Lee, Dong-Yeop;Shin, Won-Seob
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3826-3832
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    • 2010
  • This study was aimed at determining the effect of virtual reality(VR) based exercise programs on energy expenditure during gait in chronic stroke patients. Thirty-two stroke patients were participated for this study. They underwent stroke for more than 6 months and were assigned to a VR-exercise group (n=16) or a control group (n=16). The VR-exercise group executed a rehabilitation exercise three times a week during 6 weeks. The VR-exercise was performed by PS2 for one hour. Control group maintained their usual life without application of exercise. Energy expenditure index(EEI) during gait was calculated from heart rate and gait velocity. After the completion of the VR-exercise, the EEI was decreased significantly (p<0.05). These results showed that the rehabilitation exercise using a virtual reality is effective in the improvement of energy efficiency during gait in chronic stroke patients.

The effect of single trial transcutaneous electrical nerve stimulation on balance and gait function in elderly people with dementia: a pilot study

  • Jung, Ju Yeon;Jung, Jin-Hwa;Hahm, Suk-Chan;Jung, Kyoungsim;Kim, Sung-Jin;Suh, Hye Rim;Cho, Hwi-young
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.59-64
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    • 2017
  • Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

Effects of a Newly Designed Pelvic Belt Orthosis on Functional Mobility of Adults with Post-Stroke Hemiparesis

  • Cho, Byeong-Mo;Zarayeneh, Neda;Suh, Sang C.
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.125-131
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    • 2020
  • Purpose : Lower extremity orthoses have been used as conservative methods to recover gait of the stroke patients. The purpose of this study is to examine how newly designed pelvic belt orthosis can improve gait ability and dynamic balance of adults with Hemiparesis after stroke. Methods : 22 patients who had hemiparesis after stroke participated in this study. Two groups were randomly created by assigning 10 subjects to the experimental group and the rest of the 12 subjects to the control group. The control group was treated by conventional physical therapy and occupational therapy. Identical therapy protocols were used to treat the experimental group who were assigned to wear the pelvic belt orthosis during post measurement. This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The GAITRite system was used to measure spatial-temporal gain parameters and the balance system SD to measure dynamic balance. The data was analyzed using R version 3.3.1. Random forest, boosting algorithm, and MANOVA test were conducted to determine the effects of independent variables on dependent variables. Results : This study has a group of independent variables including group, gender, age, height, MAS, lesion side, cause and a group of dependent variables including gait speed, cadence, step length, stride length, and dynamic balance. The independent variable "group" has the most important value, which is approximately 25.42 (%IncMSE) representing a value three times greater than the second important predictor "height." Conclusion : As a result of this research, the hypothesis is validated with conclusion that Pelvic Belt orthosis could be effectively used for improving gait ability and balance of the patients with post-stroke hemiparesis.

The Immediate Effect of Functional Massage on Pain, Range of Motion, Balance Ability and Gait Speed in Patients with Total Hip Replacement (기능적 마사지가 엉덩관절 전치환술 환자의 통증, 관절가동범위, 균형능력, 보행속도에 미치는 즉각적인 영향)

  • Park, Si-hyun;Jeong, Eui-young
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.1
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    • pp.9-17
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    • 2022
  • Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.

Effects of kinesio taping on the gait parameters of children with cerebral palsy: a pilot study

  • Jung, Sun-Hye;Song, Sun-Hae;Kim, Da-Rye;Kim, Seul-Gi;Park, Ye-Jin;Son, Yeon-Jung;Lee, GyuChang
    • Physical Therapy Rehabilitation Science
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    • v.5 no.4
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    • pp.205-209
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    • 2016
  • Objective: Children with spastic diplegic cerebral palsy show weakness especially in the lower-extremity rather than upper-extremity muscles and display characteristics such as asymmetric alignment, deficits in postural control or balance ability, and slow walking speed. Various therapeutic interventions are applied to children with cerebral palsy, of which taping is widely used in the field of rehabilitation, however, there are few studies of the effects of kinesio taping on gait patterns of children with cerebral palsy. The present study investigated the effects of kinesio taping on gait parameters of children with cerebral palsy. Design: Cross-sectional study. Methods: Four children with spastic diplegia participated in this study. The participants' gait parameters while walking 10 m with and without kinesio taping (tibialis anterior, quadriceps femoris, and gluteus maximus) were recorded. Gait parameters including gait velocity, cadence, step length, stride length, single support time, and double support time were evaluated using the GAITRite. Mean values were obtained after having the subjects walk three times in each condition with a 5-minute rest period between each condition. The order of each condition was assigned randomly. Results: There were significant improvements in gait velocity, step length, stride length, and single support time of the right leg with kinesio taping condition compared to the without kinesio taping condition taping (p<0.05). However, there were no significant differences in cadence, single support time of the left leg, or double support time. Conclusions: The results show that kinesio taping may have a positive effect for improving gait parameters of children with spastic diplegia. However, its usefulness in the rehabilitation of children with cerebral palsy needs to be further investigated.

Effect of digital therapies on balance and gait in children with cerebral palsy: A systematic review (디지털 치료제가 뇌성마비 아동의 균형 및 보행에 미치는 효과: 체계적 고찰)

  • Jung-Hyun Kim
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.92-110
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    • 2023
  • Background: Digital therapeutics are software medical devices that provide evidence-based treatments to prevent, manage, and treat disease. Digital therapies have recently been shown to be effective in motivating children with cerebral palsy as a tool in neuropsychological therapy. Digital therapies improve postural control, balance and gait in children with cerebral palsy. Therefore, this study aims to investigate the effects of digital therapies on balance and gait in children with cerebral palsy and to provide guidelines for prescribing digital therapies for children with cerebral palsy. Design: A Systematic Review Methods: This study searched for English-language articles published in medical journals from January 2000 to July 2023 using PubMed and MEDLINE based on the year of initiation of the digital therapy. The search terms used in the study were 'digital technology' OR 'digital therapeutic' OR 'mobile application' OR 'mobile health' OR 'virtual reality' OR 'game' AND 'cerebral palsy', 'balance' 'gait' as the main keywords. The final article was assigned an evidence level and a Physiotherapy Evidence Database (PEDro) score to assess the quality of clinical trials studies. Results: The digital therapies applied to improve balance and gait in children with cerebral palsy are game-based virtual reality training and the Nintendo Wii Fit program. Both digital therapy interventions had a significant effect on improving balance in children with cerebral palsy, and virtual reality training significantly improved balance and gait. However, there were no significant improvements in balance and gait within two weeks of treatment, regardless of the type of digital intervention. Conclusion: The study suggests that this data will be important in building the evidence base for the effectiveness of digital therapies on balance and gait in children with cerebral palsy and in advancing clinical protocols.

Influence of Unilateral Muscle Fatigue in Knee and Ankle Joint on Balance and Gait in Healthy Adults

  • Lee, Na-Kyung;Kim, Young-Mi;Kim, Kyoung
    • The Journal of Korean Physical Therapy
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    • v.29 no.1
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    • pp.39-43
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    • 2017
  • Purpose: This study was to investigate the effects of unilateral muscle fatigue in knee and ankle joints on balance and gait in healthy adults. Methods: Exercise inducing muscle fatigue in the knee joint consisted of concentric and eccentric contraction of dominant knee extensors in healthy adults by using the Leg Extension Rehap exercise machine (HUR, Finland). Exercise inducing muscle fatigue in the ankle joint was composed of voluntary contractions and forced contractions of the dominant plantar flexors in healthy adults. Exercises to induce muscle fatigue in the knee and ankle joints were performed until the subject complained of fatigue or pain, the occurrence of muscle fatigue was confirmed by electromyography. We measured static and dynamic balance using the Good Balance system and gait performance by RS-scan. Results: Static and dynamic balance ability and spatial-temporal gait decreased significantly after muscle fatigue in knee and ankle joint. Conclusion: These results show that unilateral muscle fatigue of the lower extremities affected postural control and gait. Therefore, therapists and sport trainers should minimize the risks of fall and injuries related to unilateral muscle fatigue.