• 한국콘텐츠학회논문지
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• 제11권4호
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• pp.207-214
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• 2011

이 연구는 건강한 성인을 대상으로 30%체중지지 수행력이 되먹임 형태와 보행보조도구에 따라 차이가 있는지를 알아보고, 이를 통해 효과적인 체중지지 훈련방법을 제안하기 위해 실시되었다. 20명의 건강한 성인이 참여하였으며, 겨드랑이 목발과 바퀴보행기를 이용하여 3점 보행을 하는 동안 오른쪽 발에 체중의 30%만 부하하도록 하였다. 훈련을 위해 동적 되먹임과 정적 되먹임을 제공하였다. 훈련 직후와 훈련 3일 후, 보행 동안 %체중지지를 측정하기 위해 힘판을 이용하였고 보행관련 변수를 측정하기 GAITRite를 사용하였다. 30%체중지지의 정확성은 겨드랑이 목발을 이용하고 동적 되먹임을 받았을 때가 가장 정확하였다(p>0.05). 보행보조도구와 되먹임 형태에 따라 %체중지지는 유의한 차이를 보였으며(p<0.05), 훈련 직후와 훈련 3일후의 %체중지지는 유의한 차이를 보이지 않았다(p>0.05). 또한 보행보조도구에 따라 보행속도와 입각기비율이 유의한 차이를 보였다(p<0.05). 따라서 효과적인 체중지지 훈련을 위해서는 가능한 경우 겨드랑이 목발을 이용하여 동적 되먹임을 통한 %체중지지를 교육하는 것이 필요할 것으로 생각된다.

• 대한물리치료과학회지
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• 제12권4호
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• pp.33-41
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• 2005

The purpose of this report was to describe the gait pattern and parameters of the complicated bilateral amputee with right transtibial and left tarsometatarsal amputation. Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed at pre and post-test. Treadmill Training with 15 degree, incline was practiced for 8weeks, 3times per week. In linear parameters, the Velocity, Stride length and Single limb support were increased than pre-test. but Cadence and Double limb support were less post-test than pre-test. In kinematics, the maximal pelvic tilt angle showed right side $21.87^{\circ}$, left side $20.67^{\circ}$ at pre-swing phase, and decreased as compared with pre-test. Especially, the inimal hip flexion angle showed right side $-6.83^{\circ}$, left side $1.52^{\circ}$ at pre-swing phase and increased as compared with pre-test. The maximal knee flexion angle disclosed right side $2.66^{\circ}$, left side $21.71^{\circ}$ at stance phase, and decreased as compared with pre-test. In kinetics, the hip extension moment on initial contact stage was right side 0.938NM/Kg, left side 0.09NM/Kg, which was impaired compared with normal person.

• The Journal of Korean Physical Therapy
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• 제25권1호
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• pp.23-28
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• 2013

Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.

• PNF and Movement
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• 제16권3호
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• pp.317-332
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• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• The Journal of Korean Physical Therapy
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• 제34권1호
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• pp.45-50
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• 2022

Purpose: The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p<0.05), and stride time was significantly greater (p<0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p>0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p<0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p<0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p>0.05). Conclusion: A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.

• 대한물리치료과학회지
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• 제10권2호
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• pp.37-41
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• 2003

The aim of this study is to present the basic reference data Effect of uneffected side insole on Gait Pattern in Hemiplegia Patients. The basic gait parameters were extracted from 10 Adult Hemiplegia Patients, 5 left Hemiplegia Patients and 5 right Hemiplegia Patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the shoes to the 1cm insole in shoes were $70.58{\pm}12.67\;steps/min$, to $77.28{\pm}14.58\;steps/min$.(p>0.05) 2) The mean Walking Speed of the shoes to the 1cm insole in shoes were $0.40{\pm}0.17\;m/s$, to $0.49{\pm}0.18\;m/s$.(p>0.05) 3) The mean Stride Length of the shoes to the 1cm insole in shoes were $0.67{\pm}0.20\;m$, to $0.75{\pm}0.19m$.(p>0.05) 4) The mean anterior angles of pint on the pelvic tilt for different the shoes to the 1cm insole in shoes were $13.22{\pm}7.25^{\circ}$, to $11.68{\pm}4.02^{\circ}$.(p>0.06) 5) The mean maximal angles of pint on the hip flexion motion for different the shoes to the 1cm insole in shoes were $24.62{\pm}8.35^{\circ}$, to $24.74{\pm}9.12^{\circ}$.(p>0.05) 6) The mean maximal angles of joint on the knee flexion motion for different the shoes to the 1cm insole in shoes were $34.27{\pm}16.71^{\circ}$, to $35.93{\pm}18.22^{\circ}$.(p>0.05) insole in shoes were $15.97{\pm}7.72^{\circ}$, to $18.77{\pm}11.03^{\circ}$.(p>0.05) 7) The mean maximal angles of joint on the ankle dorsiflexion motion for different the shoes to the 1cm. 8) The mean maximal angles of joint on the ankle plantarflexion motion for different the shoes to the 1cm insole in shoes were $-4.24{\pm}10.66^{\circ}$, to $-7.04{\pm}11.00^{\circ}$.(p<0.05)

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2010년도 추계학술대회 논문집
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• pp.1009-1010
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• 2010

• 재활복지공학회논문지
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• 제9권4호
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• pp.319-329
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• 2015

본 논문에서는 다자유도 동적 하네스 시스템 개발을 위해 일상동작에서와 트레드밀 보행 시 하네스 체중 지지에 따른 하지 동작 패턴에 관한 연구를 수행하였다. 건강한 성인 남성 5명을 대상으로 일상생활 동작과 하네스 체중지지에 따른 좌, 우 대퇴직근, 외측광근, 전경골근, 외측 비복근과 족압을 측정하였다. 실험 결과, 일상생활 동작 수행 시 EMG는 각 구분 동작들에 따른 특이적인 근육 활성을 나타내었다. 슬관절의 굴곡과 신전을 요하는 앉기, 서기, 계단 오르기, 계단 내리기 동작에서의 외측광근의 활성이 두드러졌다. 족압 분포의 경우 일상생활 동작 중 중력방향으로 내려오는 계단 내려오기 동작에서 가장 큰 족압 분포 값을 보였다. 수동형 하네스 체중 지지율이 증가에 따라 근육 활성도와 족압 분포 값은 감소하는 경향을 보였다. 이러한 결과를 토대로 체중지지를 통한 보행 훈련이 체중지지율 변화에 따라 다양한 환자 군에 적용 시킬 수 있을 것이다 판단된다.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.113-117
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• 2012

Purpose: The purpose of this study was to analyze the weight bearing of the cane and foot for the different walking aids during walking. Methods: A total of 12 subjects (6 males, 6 female) with stroke were enrolled in the study. Foot sensor and an instrumented cane were integrated to analyze the vertical peak force on the foot and cane. Results: The vertical peak force applied on the quad cane gait resulted in a significantly higher rate, which was $10.60{\pm}6.48%$ of the body weight, when compared to that of mono cane gait which was $7.91{\pm}4.11%$. The results indicated significantly lower vertical peak force on the affected foot, without the help of a walking aid, as compared to that of walking with a cane (respectively, p<0.05). However, results showed that the differences in vertical peak force on the affected foot, between mono cane and quad cane, were not significant. Conclusion: In conclusion, the vertical peak forces were significantly greater, during a comparison between walking with a quad cane and walking with a mono cane. On the contrary, no significant difference in the vertical peak force on the affected foot between walking with quad cane and walking with a mono cane. Muscle activation pattern and walking pattern should be measured in future studies, to study the differences between walking with various walking aids in the lower and higher functioning hemiparetic subjects, as its use may mask underlying gait impairment.

• Annals of Rehabilitation Medicine
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• 제39권6호
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• pp.897-904
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• 2015

Objective To investigate differences in plantar pressure distribution between a normal gait and unpredictable slip events to predict the initiation of the slipping process. Methods Eleven male participants were enrolled. Subjects walked onto a wooden tile, and two layers of oily vinyl sheet were placed on the expected spot of the 4th step to induce a slip. An insole pressure-measuring system was used to monitor plantar pressure distribution. This system measured plantar pressure in four regions (the toes, metatarsal head, arch, and heel) for three events: the step during normal gait; the recovered step, when the subject recovered from a slip; and the uncorrected, harmful slipped step. Four variables were analyzed: peak pressure (PP), contact time (CT), the pressure-time integral (PTI), and the instant of peak pressure (IPP). Results The plantar pressure pattern in the heel was unique, as compared with other parts of the sole. In the heel, PP, CT, and PTI values were high in slipped and recovered steps compared with normal steps. The IPP differed markedly among the three steps. The IPPs in the heel for the three events were, in descending order (from latest to earliest), slipped, recovered, and normal steps, whereas in the other regions the order was normal, recovered, and slipped steps. Finally, the metatarsal head-to-heel IPP ratios for the normal, recovered, and slipped steps were $6.1{\pm}2.9$, $3.1{\pm}3.0$, and $2.2{\pm}2.5$, respectively. Conclusion A distinctive plantar pressure pattern in the heel might be useful for early detection of a slip event to prevent slip-related injuries.