• Title/Summary/Keyword: Gait Control

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A Comparison of the Effects of Barefoot Walking and Sneakers Walking on a Sandy Beach on Pain, Disability, Motor Function, Sleep Satisfaction, and Quality of Life in the Elderly with Low Back Pain (모래사장 위 맨발걷기와 운동화걷기가 허리통증이 있는 노인의 통증, 장애, 운동기능, 수면만족도, 삶의 질에 미치는 효과 비교)

  • Lee, Gain;Jeon, Jaejung;Hahm, Sukchan
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.29-38
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    • 2020
  • Purpose : The purpose of this research was to investigate the effects of barefoot walking on the sandy beach on pain intensity, disability, motor function, sleep satisfaction, and quality of life in the elderly with low back pain (LBP). Methods : A single-blinded randomized controlled trial was conducted involving 32 elderly with LBP who underwent sand walking barefoot (intervention, n=16) or with sneakers (control, n = 16). Both walking methods were carried out for 30 minutes per day, three times a week for four weeks. Pain intensity and disability were assessed using the visual analog scale and Oswestry disability index, respectively. Balance and gait were evaluated using the Berg balance scale and timed up and go test, respectively. Sleep satisfaction was quantified with the Verran and Snyder-Halpern sleep scale. Finally, quality of life was assessed through the WHO quality of life scale's abbreviated Korean version. Results : Compared with the control group, the intervention group showed significant differences in pain intensity (p=.005), disability due to LBP (p=.002), static balance ability (p=.003), dynamic balance ability (p=.002), and sleep satisfaction (p=.017). There was no significant difference in the quality of life between the two groups. Conclusion : Barefoot walking on a sandy beach is significantly effective in improving pain, disability due to LBP, balance ability, and sleep satisfaction in the elderly with LBP. Further studies with larger sample sizes and longer intervention periods must to be conducted to generalize using barefoot walking in LBP management.

Effects of Weight-Bearing Training with Elastic Bands on less - Affected Side during Functional Electronic Stimulation on Walking and Balance in Stroke Patients (기능적 전기자극시 비 마비측에 탄력밴드를 적용한 체중지지훈련이 뇌졸중 환자의 보행과 균형에 미치는 영향)

  • Jeong, Chae-min;Woo, Young-Keun;Won, Jong-im;Kim, Su-Jin
    • PNF and Movement
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    • v.20 no.3
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    • pp.417-430
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    • 2022
  • Purpose: The purpose of this study was to examine the effect of weight-bearing training with an elastic band during functional electrical stimulation (FES) on walking and balance functions in stroke patients. Methods: Twenty patients with chronic stroke were divided into an experimental group assigned to weight-bearing training with an elastic band during functional electrical stimulation (FES; n=10) and a control group assigned to weight-bearing training alone during FES (n=10). The patients in both groups attended physical therapy sessions five times a week for four consecutive weeks. The experimental group underwent weight-bearing training with an elastic band during FES five times a week for four weeks. The control group underwent weight-bearing training during FES. Balance parameters were measured before and after the intervention using the Balancia program. Moreover, all patients were evaluated using the Berg Balance Scale (BBS), the Time Up and Go Test (TUGT), and the Wisconsin Gait Scale (WGS) before and after each intervention. Results: The results showed that weight-bearing training with elastic bands during FES and weight-bearing training during FES had a significant effect on the affected side's weight-bearing ratio, BBS, TUGT, and WGS in both groups (p <0.05). Additionally, the results showed that the changes observed in the two groups indicate significant differences in path length, average speed, BBS score, TUGT time, and WGS score between the groups (p < 0.05). Conclusion: In patients with stroke, weight-bearing training with an elastic band during FES affected on walking and balance. Therefore, it is an optional intervention for the balance and walking ability of stroke patients.

Development of Closed-loop Control Type FES System for Restoration of Gait in Patients with Foot Drop (족하수 환자의 보행보조를 위한 피드백 제어형 전기자극기 개발)

  • 정호춘;임승관;이상세;진달복;박병림
    • Journal of Biomedical Engineering Research
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    • v.20 no.2
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    • pp.183-190
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    • 1999
  • The purpose of this study was to develop a portable and convenient closed-loop contrel type electrical stimulator for patients with foot drop. This system restores walking movement as well as prevents from atrophy or necrosis of lower limb muscles and increases blood circulation in hemiplegic patients caused by traffic accident, industrial disaster or stoke. This system detects the changes of the ankle joint angle during walking, and then controls the stimulus intensity automatically to maintain the programmed level of the ankle joint angle. Also, this automatic system controls the stimulus intensity which is affected by increased electrode impedance resulting from long time use. The system detects the joint angle by an optical sensor and includes modified PID control which adjusts the stimulus intensity if the joint angle deviates from the preset value. Stimulus parameters are 30~80 volt, 40 Hz, and 0.2 ms. The system was applied to five hemiplegic patients for 42 days. Duration of stimulation was 15 min/day for the first week and then the duration was gradually increased to 30, 60, 90 and 120 min/day. The muscle force was increased up to 29.7%, muscle fatigue was decreased compared with the level before stimulation and the pattern of locomotion was improved. These results suggest that the electrical stimulator with closed-loop control type is more convenient and effective in restoration of locomotion of patients with foot drop than open-loop system.

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Correlations of Cerebellar Function with Psychotic Symptoms and Cognitive Function in Schizophrenic Patients (남자 정신분열병 환자의 소뇌기능과 정신증상 및 인지기능간의 연관성)

  • Kim, Seo Young;Jun, Yong Ho;Kwon, Young Joon;Jeong, Hee Yeon;Hwang, Bo Young;Shim, Se Hoon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.3
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    • pp.184-193
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    • 2007
  • Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

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The Change of ${\alpha}$-motor neuron excitability in Spastic Stroke Patients by Pre-tibia Muscle Isometric Contraction (전경골근 등척성 수축에 의한 경직성 뇌졸중 환자의 비복근 ${\alpha}$-운동 신경원 흥분 변화)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.1
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    • pp.11-28
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    • 2005
  • Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had 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 received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse 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 Effect of Pelvic Stability Exercise Program on Pain and Hip Joint of Patients with Chronic Low Back Pain involving Sacroiliac Joint Pain (골반안정화 운동프로그램이 엉치엉덩관절 통증을 동반한 만성요통환자의 통증과 엉덩관절에 미치는 영향)

  • Kang, Jeong-Il;Choi, Hyun
    • Journal of Digital Convergence
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    • v.11 no.4
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    • pp.331-338
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    • 2013
  • For this research, 27 out of 52 patients with chronic low back pain involving sacroiliac joint pain were classified into the experimental group to conduct pelvic exercise program and traditional physical therapies in parallel, and the remaining 25 ones were classified into the control group to only apply traditional physical therapies for 6 weeks. After that, their clinical samples were randomly extracted. Before the experiment, both of the experimental group and the control group had the Oswestry disability index test to see how big their pain was and their hip joint angles were analyzed during walking. After the post-test, finally, the results of the Oswestry disability index test and hip joint angles while walking before and after the experiment were compared between two groups to know the effect of pelvic stability exercise program. Within-group results and between-group results both displayed significantly reduced low back pain, and when comparing hip joint angles of the experimental group, there were differences between mid stance phase, terminal stance phase, pre swing phase and early swing phase of the right hip joint, and mid stance phase, terminal stance phase, pre swing phase and early swing phase of the left hip joint. In the control group, there were significant differences between mid stance phase, terminal stance phase and early swing phase of the right hip joint, and loading response phase, mid stance phase, terminal stance phase and pre swing phase of the left hip joint. as a result, pelvic stability exercise program is helpful to gait rhythm on stance phase and swing phase although effective to decrease Oswestry disability index including pain.

A Study on the Mode Change Technique of Intelligent Above-Knee Prosthesis Based on User Intention Capture (지능형 대퇴 의족 사용자의 의도 검출을 통한 제어 모드 변경 기법에 관한 연구)

  • Shin, Jin-Woo;Eom, Su-Hong;You, Jung-Hwun;Lee, Eung-Hyuk
    • Journal of IKEEE
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    • v.24 no.3
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    • pp.754-765
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    • 2020
  • Currently, Intelligent femoral prostheses that support the corresponding mode in walking and specific movements are being studied. Certain controls such as upstairs, sitting, and standing require a technique to classify control commands based on the user's intention because the mode must be changed before the operation. Therefore, in this paper, we propose a technique that can classify various control commands based on the user's intention in the intelligent thigh prosthesis system. If it is determined that the EMG signal needs to be compensated, the proposed technique compensates the EMG signal using the correlation between the strength and frequency components of the normal EMG signal and the muscle volume estimated by the pressure sensor. Through the experiment, it was confirmed that the user's intention was accurately detected even in the situation where muscle fatigue was accumulated. Improved intention detection techniques allow five control modes to be distinguished based on the number of muscle contractions within a given period of time. The results of the experiment confirmed that 97.5% accuracy was achieved through muscle tone compensation even if the strength of the muscle signal was different from normal due to muscle fatigue after exercise.

Rheumatic Arthritis-induced Alteration of Morphology and Function in Muscles

  • Hong, Yun-Kyung;Kim, Joo-Heon;Javaregowda, Palaksha Kanive;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • v.35 no.2
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    • pp.151-157
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    • 2011
  • Clinical arthritis is typically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Arthritis-induced muscle weakness is a major problem in aged people, leading to a disturbance of balance during the gait cycle and frequent falls. The purposes of the present study were to confirm fiber type-dependent expression of muscle atrophy markers induced by arthritis and to identify the relationship between clinical signs and expression of muscle atrophy markers. Mice were divided into four experimental groups as follows: (1) negative control (normal), (2) positive control (CFA+acetic acid), (3) RA group (CFA+acetic acid+type II collagen), and (4) aging-induced OA group. DBQA/1J mice (8 weeks of age) were injected with collagen (50 ${\mu}g/kg$), and physiological (body weight) and pathological (arthritis score and paw thickness) parameters were measured once per week. The gastrocnemius muscle from animals in each group was removed, and the expression of muscle atrophy markers (MAFbx and MuRF1) and myosin heavy chain isoforms were analyzed by reverse transcription-polymerase chain reaction. No significant change in body weight occurred between control groups and collagen-induced RA mice at week 10. However, bovine type II collagen induced a dramatic increase in clinical score or paw thickness at week 10 (p<0.01). Concomitantly, the expression of the muscle atrophy marker MAFbx was upregulated in the RA and OA groups (p<0.01). A dramatic reduction in myosin heavy chain (MHC)-$I{\beta}$ was seen in the gastrocnemius muscles from RA and OA mice, while only a slight decrease in MHC-IIb was seen. These results suggest that muscle atrophy gene expression occurred in a fiber type-specific manner in both RA- and OA-induced mice. The present study suggests evidence regarding why different therapeutic interventions are required between RA and OA.

Effect of Robot Assisted Rehabilitation Based on Visual Feedback in Post Stroke Pusher Syndrome (푸셔 증후군이 있는 뇌졸중 환자에서 시각적 피드백기반 로봇보조 재활치료의 효과)

  • Kim, Min-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.562-568
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    • 2016
  • This study to investigated the therapeutic effect of robot-assisted rehabilitation (Lokomat) with virtual reality (VR) on Pusher syndrome (PS) after stroke. A total of 10 patients presented with PS after stroke were recruited. The participants were divided into two groups: Lokomat (n=5) and control groups (n=5). Lokomat and conventional physical therapy (CPT) were performed together in the experimental group, and the patients in the control group were treated with CPT only twice a day. One session of intervention was carried out for 30 minutes five times per week for 4 weeks. Scale for contraversive pushing (SCP), Berg balance scale (BBS), falling index (FI), and Timed up and go test (TUG) were measured before and after the intervention. The Lokomat group produced significantly better outcomes in SCP (p=0.046), BBS (p=0.046), FI (p=0.038), and TUG (p=0.038) compared with the control group after 4 weeks of intervention. In addition, there were significant correlations between SCP and BBS (p=0.024), FI (p=0.039), and TUG (p=0.030). In conclusion, Lokomat with VR more effectively aided recovery from PS after stroke, and restoration of PS symptoms was related with improvement of balance and gait function.

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

  • Lee, Jaesong;Park, Wonil;Sung, Eunsook;Kim, Bokbeom;Kim, Nahyun;Park, Saejong;Shin, Chulho;Park, Jonghoon
    • Korean Journal of Exercise Nutrition
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    • v.24 no.4
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    • pp.34-43
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    • 2020
  • [Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.