• Journal of Institute of Control, Robotics and Systems
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• v.21 no.6
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• pp.553-559
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• 2015

The purpose of this research is to develop a gait assistive device to enhance the gait stability and training efficiency of stroke patients. The configuration of this device is mainly composed of a motored wheel and a single cane whose lower end is attached to a motored wheel frame. A patient can feel haptic information from continuous ground contact from the wheel while walking through the grip handle. In addition, the wheeled cane can avoid using excessive use of the patient's upper limb for weight support and motivate the patient to use a paralyzed lower limb more actively. Moreover, the proposed device can provide intuitive and safe user interaction by integrating a force sensor and a tilt sensor equipped to the cane frame, and a switch sensor at the cane's handle. The admittance control has been implemented for the patient to change the walking speed intuitively by using the interaction forces at the handle. A hemi-paretic stroke patient participated in the walking assistive experiments as a pilot study to verify the effectiveness of the proposed haptic cane system. The results showed that the patient could improve walking speed and muscle activations during walking with a constant speed mode of the haptic cane. Moreover, the patient could maintain the preferred walking speeds and gait stability regardless of the magnitude of resistance forces with the admittance control mode of the haptic cane. The proposed robotic gait assistive device with a simple and intuitive mechanism can provide efficient gait training modes to stroke patients with high possibilities of widespread utilizations.

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.125-131
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• 2016

Objective: The purpose of this study was to investigate the effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in stroke patients. Design: Randomized controlled pilot trial. Methods: Fifteen subjects were randomly divided into three groups where five subjects were in the visual feedback robotic device assist gait training (VRGT) group, five subjects in the auditory stimulation robotic device assist gait training (ARGT) group, and five subjects in the control group. Subjects received visual feedback and auditory stimulation while undergoing robotic gait training for 45 minutes, three times a week for 2 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 2 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test (10MWT) pre- and post-intervention. Results: All subjects showed that BBS, TUG test, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved post-treatment (p<0.05). The VRGT and the ARGT showed significant improvements in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). The VRGT group showed a significant improvement in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). In addition, it has been confirmed that VRGT had significantly improved in BBS, TUG test, and 10MWT scores compared with the auditory stimulation and control group (p<0.05). Conclusions: The results of this study showed improved balance and gait abilities after VRGT and ARGT groups compared with general physical therapy and was found to be effective in enhancing the functional activity of persons affected with stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.211-223
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• 2021

Purpose : The purpose of this study was to examine the effect of task-oriented circuit training using unstable support surface on balance, gait ability, and balance confidence in subacute stroke patients. Methods : Forty-five patients with subacute stroke were randomly divided into the three following groups of 15: 1) TOCT-US group; task-oriented circuit training using unstable surface (experimental group 1), 2) TOCT-SS group; task-oriented circuit training using stable surface (experimental group 2), and 3) CON group; conventional physical therapy (control group). All patients participated in one of the three training programs for 6 weeks, 30 minutes per session, 3 times per week. Patients' balance ability was assessed using the BT-4, BBS (berg balance scale), TUG (time up and go test), and LOS (limit of stability). Gait speed was measured to examine gait ability. K-ABC (activities-specific balance confidence scale) was also used to assess the level of patients' confidence in daily activities. Results : After the intervention, the sway area in experimental groups 1 and 2 decreased, but that in the control group increased. Experimental group 1 showed significant improvement compared with experimental group 2 and the control group. BBS, TUG, and LOS scores of experimental group 1 were significantly improved compared with those of experimental group 2 and the control group. Also, gait speed significantly improved in experimental group 1 compared with experimental group 2 and the control group. Experimental groups 1 and 2 showed significant improvement in K-ABC scores after training. Conclusion : Patients with subacute stroke had significantly improved balance, gait, and level of confidence in performing activities of daily living following task-oriented circuit training using the unstable surface. This indicates that task-oriented circuit training using unstable surfaces can be an effective treatment method for the recovery of balance and gait in subacute stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.49-60
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• 2022

Purpose : The purpose of this study was to identify whether gym-ball exercise in standing position was an effective intervention for improving muscle strength, balance, gait, and fall efficacy in stroke patients. Methods : Twenty-four stroke patients were randomized into three groups: experimental group 1 (n=8), experimental group 2 (n=8), and control group (n=8). Experimental groups 1, 2 and the control group performed the gym-ball exercise in standing position, same exercise without a gym-ball, and general physical therapy for 4 weeks, five times a week in 30-minute sessions. Muscle strength, balance, gait, and fall efficacy were assessed using a handheld dynamometer, the Berg Balance Scale (BBS), the wearable BTS G-WALK® sensor, and the Korean version of the Falls Efficacy Scale (K-FES), before and after training, respectively. Comparisons within and between groups were analyzed using the Wilcoxon signed rank test, Kruskal Wallis H test, and Mann-Whitney U test. Bonferroni correction was performed when significant differences between groups were identified (p<.017, .05/3). Results : Regarding muscle strength, BBS score, cadence and FES-K were significantly improved after intervention in all three groups. The weight bearing rate, gait speed and step length in experimental group 1 and 2 were significantly improved after the intervention. The stride length in experimental group 1 were significantly improved after the intervention. Experimental group 1 had significantly improved BBS score and stride length after intervention than experimental group 2 and control group. Experimental group 1 and 2 improved muscle strength, weight bearing rate, and FES-K score more than the control group. Experimental group 1 showed significant improvement in cadence, gait speed, and step length after the intervention than control group. Conclusion : This study showed that exercise with gym-ball in standing position can be an effective intervention to improve balance and gait in stroke patients than the same exercise without gym-ball.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.2
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• pp.45-57
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• 2018

Purpose : This study was conducted to evaluate the effects of an task oriented training program combined with action-observation on balance and gait ability of patients with chronic stroke. Method : The subjects of this study were 30 patients with hemiplegia who agreed to participate and were picked up. Participants were randomly divided into equal groups; namely, an experimental group that underwent task oriented training combined with action-observation for at least 30 minutes/day for 6 weeks and a control group that underwent general task-oriented training. Patients' balance was assessed using the Sway Length, Sway Area and Limit of Stability test. In addition, gait ability was assessed using the 10 Meter Walking Test to measure the taken to walk 10 meters. Gait time and speed taken to walk 10 meters were used to examine gait ability. Results : There were significant improvements in the subscales of the balance and gait ability test of those who participated in the action-observational training program, while the control group showed only significant changes in the evaluation items of the sway length in eyes opened condition and gait time. Conclusion : Therefore, Action-observational training program effectively improved the balance and gait ability in patients with stroke.

• Journal of Institute of Control, Robotics and Systems
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• v.8 no.2
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• pp.142-150
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• 2002

This paper presents a systematic method of the zigzag gait planning for quadruped walking robots. When a robot walks with a zigzag gait, its body is allowed to move from side to side, while the body movement is restricted along a moving direction in conventional continuous gaits. The zigzag movement of the body is effective to improve the gait stability margin. To plan a zigzag gait in a systematic way, the relationship between the center of gravity(COG) and the stability margin is firstly investigated. Then, new geometrical method is introduced to plan a sequence of the body movement which guarantees a maximum stability margin as well as monotonicity along a moving direction. Finally, an optimal swing-leg sequence is chosen for a given arbitrary configuration of the robot. To verify the proposed method, computer simulations have been performed for both cases of a periodic gait and a non-periodic gait.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.270-277
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• 2021

Objective: The purpose of this study is to compare the effect of static balance, lower extremity function, and gait ability between a lower extremity restrain robot gait training and a general robot gait training in subacute stroke subjects. Design: Two-group pretest-posttest design. Methods: A total of 12 subacute stroke patients were randomly divided into an Experimental group (n=6) and a control group (n=6). Both groups were performed for four weeks, three times a week, for 20 minutes. To compare the Static balance function, the center of pressure (COP) path-length and COP velocity were measured. The Fugl-Meyer assessment lower extremity (FMA-LE) were evaluated to compare the Lower Extremity function. 2D Dartfish Program and 10 Meter Walking Test (10 MWT) on Gait ability were evaluated to compare the gait function. Results: In the intra-group comparison, Experimental groups showed significant improvement in COP path-length, velocity, Lower Extremity Function, 10 MWT, Cadence, by comparing the parameters before and after the intervention (p<0.05). Comparison of the amount of change between groups revealed significant improvement for parameters in the COP path-length, velocity, Lower extremity function, 10 MWT by comparing the parameters before and after the intervention (p<0.01). Conclusions: The Experimental group showed enhanced efficacy for variables such as COP path-length, velocity, Lower extremity function, 10 MWT as compared to the control group.

• The Journal of Korean Physical Therapy
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• v.34 no.6
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• pp.326-331
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• 2022

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.155-164
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• 2024

PURPOSE: The purpose of this study was to evaluate the effects of simultaneous application of gaze stabilization exercise and cognitive training on the balance and gait ability in subacute stroke patients. METHODS: Thirty-five patients diagnosed with stroke within 3-6 months were randomly assigned, and the experimental group (n = 18) to which both gaze stabilization exercise and cognitive training were applied and the control group (n = 17) to which only gaze stabilization exercise was applied were targeted. It was performed for 30 minutes at a time, three times a week, for a total of 4 weeks. Berg Balance Scale, Timed Up and Go test, 10Meter Walking Test, and Walking symmetry were evaluated. RESULTS: In the comparison of changes between Berg Balance Scale, Time Up and Go test, 10 Meter Walking Test, and Gait symmetry, both experimental and control groups showed significant differences before and after the intervention, and in the evaluation of Gait symmetry, significant differences between groups. CONCLUSION: As a result of this study, when gaze stabilization exercise and cognitive training were allied simultaneously, it was possible to improve the balance and gait ability of subacute stroke patients, and had a more significant effect on gait ability. In considered that training that simultaneously applies gaze stabilization exercise and cognitive training can be presented as a balance and gait rehabilitation for stroke patients on the future.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.365-371
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• 2014

Purpose: The aim of this study is to examine the effects of training in vestibular sensory stimulation on balance and gait of stroke patients. Methods: Twenty patients were randomly assigned to either the experimental group (n=10) or the control group (n=10). Patients in the experimental group received rotational stimulation training, vertical-horizontal stimulation training, gait training on a flat surface with vestibular sensory stimulation, and gait training on soft ground with vestibular sensory stimulation. Patients in the control group received general treadmill gait training. The intervention was applied four times per week, 25 minutes each time, for a period of four weeks. We measured Berg Balance Scale (BBS), Biodex Balance System, Timed up to Go (TUG) test and Dynamic Gait Index (DGI) to evaluate balance and gait ability. Results: BBS differed significantly in both groups between before and after the intervention (p<0.05) and changes in BBS after the intervention differed between the two groups (p<0.05). According to the Biodex Balance System test result, only the experimental group showed significant changes in balance in the conditions of static eyes open (SEC), dynamic eyes open (DEO), and dynamic eyes closed (DEC) (p<0.05). TUG test results differed significantly between prior to and after the training in both the experimental group and the control group (p<0.05) and changes in TUG after the intervention differed significantly between the two groups (p<0.05). DGI results showed significant change after the intervention in the experimental group only (P<0.05). Conclusion: Training in vestibular sensory stimulation was effective in improving static-dynamic balance and gait ability of stroke patients.