• Title/Summary/Keyword: Gait Pattern

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Targetting Balance and Gait Rehabilitation with Multichannel Transcranial Direct Current Stimulation in a Sub-Acute Stroke Survivor-A Case Report

  • Gakhar, Kazal;Arumugam, Narkeesh;Midha, Divya
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.8-15
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    • 2022
  • Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

Effectiveness of home-based therapy on gross motor function in children with cerebral palsy: A systematic review (뇌성마비 아동의 대동작 기능에 대한 가정중심치료 효과 : 체계적 고찰)

  • Jung-Hyun, Kim
    • Journal of Korean Physical Therapy Science
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    • v.29 no.4
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    • pp.27-42
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    • 2022
  • Background: Although children with cerebral palsy (CP) are able to walk independently, gait imbalance occurs due to abnormal muscle tone, musculoskeletal deformity, loss of balance, and selective motor control impairment. Gait restriction in the community and school is a major problem of rehabilitation in CP. Home-based therapy (HBT) provides a variety of interventions in which the therapist and the parent work together to resolve the activities and problems caused by the child's body structure. Therefore, we investigate the effectiveness of home-centered therapy on gross motor function in CP and try to present the possibility of clinical application. Design: A Systematic Review Methods: Research papers were published from Jan, 2012 to Jan, 2022 and were searched using Medline and PubMed. The search terms are 'family-centered' OR 'home-based' AND 'cerebral palsy'. A total of nine papers were analyzed in this study. The paper presented the quality level based on Physiotherapy Evidence Database (PEDro) scores to assess the quality of randomized clinical trials studies. Results: The results showed that HBT for strengthening exercise in lower extremity has a positive effect on the isokinetic torque and gross motor function. home-based treadmill therapy in CP is effective to perform at least 12 sessions of treadmill HBP in which the therapist determines the treadmill speed every week and the child's own gait pattern is modified. Conclusion: These results suggest that it will be important data for founding evidence on the effectiveness of home-centered therapy on gross motor function in children with cerebral palsy to advance clinical protocols.

The Difference in the Smoothness of the Movement according to Shoe, Velocity, and Slope during Walking (보행시 신발, 속도, 경사도에 따른 동작의 부드러움 차이)

  • Choi J.S.;Tack G.R.;Yi J.H.;Lee B.S.;Chung S.C.;Sohn S.H.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.169-170
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    • 2006
  • The purpose of this study was to evaluate the smoothness of the gait pattern according to shoe, walking speed, and slope. Eleven male university students used three types(running shoes, mounting climbing boots, elevated forefoot walking shoes) of shoes at various walking speeds(1.19, 1.25, 1.33, 1.56, 1.78, 1.9, 2.0, 2.11, 2.33m/s) and gradients (0, 3, 6, 10%) on a treadmill. Three-dimensional motion analysis (Motion Analysis Corp, Santa Rosa, CA, USA) was conducted with 4 Falcon high speed cameras. The results showed that elevated forefoot walking shoes had the lowest value of normalized jerk at the heel, which means that elevated forefoot walking shoes had the smoothest walking pattern at the heel. In contrast, elevated forefoot walking shoes had greater normalized jerk at the center of mass (COM) at most walking speeds, which means that the smoothness of gait pattern at the center of mass is the lowest for the elevated forefoot walking shoes. This movement at the COM might even have a beneficial effect of activating muscles in the back and abdomen more than other shoes.

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The Effects of Coordinative Locomotion Training Using the PNF Pattern on Walking in Patients with Spinal Cord Injury (PNF 패턴을 결합한 협응적 이동 훈련이 척수손상환자의 보행에 미치는 효과)

  • Hwang, Sang-Su;Maeng, Gwan-Cheol;Kim, Jin-In;Jung, Chang-Wook
    • PNF and Movement
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    • v.14 no.2
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    • pp.67-74
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    • 2016
  • Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.

Biologically Inspired Approach for the Development of Quadruped Walking Robot (사족보행 로봇의 개발을 위한 생체모방적 접근)

  • Kang Tae-Hun;Song Hyun-Sup;Choi Hyouk-Ryeol
    • Journal of Institute of Control, Robotics and Systems
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    • v.12 no.4
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    • pp.307-314
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    • 2006
  • In this paper, we present a comprehensive study for the development of quadruped walking robot. To understand the walking posture of a tetrapod animal, we begin with a careful observation on the skeletal system of tertapod animals. From taking a side view of their skeletal system, it is noted that their fore limbs and hind limbs perform characteristic roles during walking. Moreover, the widths of footprints and energy efficiency in walking have a close relationship through taking a front view of their walking posture. According to these observations, we present a control method where the kinematical solutions are not necessary because we develop a new rhythmic gait pattern for the quadruped walking robot. Though the proposed control method and rhythmic pattern are simple, they can provide the suitable motion planning for the robot since the resultant movement is based on the animal's movements. The validity of the proposed idea is demonstrated through dynamic simulations.

Walking Pattern Analysis Using an Acceleration Sensor Device

  • Hong, Ju-Hee;Han, Kap-Soo;Kim, Kyungho
    • Journal of Electrical Engineering and Technology
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    • v.12 no.1
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    • pp.396-401
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    • 2017
  • In this paper, a device to analyze gait pattern was developed by using a 2-axis acceleration sensor attached to the foot. The 1st low-pass filter was adapted to limit the frequency band up to 5 Hz. An algorithm to detect the peak value exceeding the threshold voltage of an X-axis acceleration sensor and a Z-axis acceleration sensor was developed and normal and abnormal walking patterns were thus differentiated. Also, MCU and Bluetooth were combined to transfer the data to other MCUs to display on an LCD; the size of the device could then be reduced. The new algorithm and the device allowed the individual walking patterns to be easily measured at a low cost and with less restriction on activities compared to conventional multiple pressure sensors or motion camera system.

Experimental Study on Modifiable Walking Pattern Generation for Handling Infeasible Navigational Commands

  • Hong, Young-Dae;Lee, Bumjoo
    • Journal of Electrical Engineering and Technology
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    • v.10 no.6
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    • pp.2368-2375
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    • 2015
  • To accommodate various navigational commands, a humanoid should be able to change its walking motion in real time. Using the modifiable walking pattern generation (MWPG) algorithm, a humanoid can handle dynamic walking commands by changing its walking period, step length, and direction independently. If the humanoid is given a command to perform an infeasible movement, the algorithm substitutes the infeasible command with a feasible one using binary search. The feasible navigational command is subsequently translated into the desired center-of-mass (CM) state. Every sample time CM reference is generated using a zero-moment-point (ZMP) variation scheme. Based on this algorithm, various complex walking patterns can be generated, including backward and sideways walking, without detailed consideration of the feasibility of the navigational commands. In a previous study, the effectiveness of the MWPG algorithm was verified by dynamic simulation. This paper presents experimental results obtained using the small-sized humanoid robot platform DARwIn-OP.

Dynamic Simulation of Modifiable Walking Pattern Generation to Handle Infeasible Navigational Commands for Humanoid Robots

  • Hong, Young-Dae;Lee, Ki-Baek;Lee, Bumjoo
    • Journal of Electrical Engineering and Technology
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    • v.11 no.3
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    • pp.751-758
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    • 2016
  • The modifiable walking pattern generation (MWPG) algorithm can handle dynamic walking commands by changing the walking period, step length, and direction independently. When an infeasible command is given, the algorithm changes the command to a feasible one. After the feasibility of the navigational command is checked, it is translated into the desired center of mass (CM) state. To achieve the desired CM state, a reference CM trajectory is generated using predefined zero moment point (ZMP) functions. Based on the proposed algorithm, various complex walking patterns were generated, including backward and sideways walking. The effectiveness of the patterns was verified in dynamic simulations using the Webots simulator.

Differences in the Length Change Pattern of the Medial Gastrocnemius Muscle-Tendon Complex and Fascicle during Gait and One-legged and Two-legged Vertical Jumping (보행과 한발·두발 수직점프 수행 시 내측비복근 근-건 복합체와 근섬유다발의 길이 변화 패턴의 차이)

  • Lee, Hae-Dong;Han, Bo-Ram;Kim, Jin-Sun;Oh, Jeong-Hoon;Cho, Han-Yeop;Yoon, So-Ya
    • Korean Journal of Applied Biomechanics
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    • v.25 no.2
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    • pp.175-182
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    • 2015
  • Objective : The purpose of this study was to investigate difference in fascicle behavior of the medial gastrocnemius during the locomotion with varying intensities, such as gait and one-legged and two-legged vertical jumping. Methods : Six subjects (3 males and 3 females; age: $27.2{\pm}1.6yrs.$, body mass: $62.8{\pm}9.8kg$, height: $169.6{\pm}8.5cm$) performed normal gait (G) at preferred speed and maximum vertical jumping with one (OJ) and two (TJ) legs. While subjects were performing the given tasks, the hip, knee and ankle joint motion and ground reaction force was monitored using a 8-infrared camera motion analysis system with two forceplates. Simultaneously, electromyography of the triceps surae muscles, and the fascicle length of the medial gastrocnemius were recorded using a real-time ultrasound imaging machine. Results : Comparing to gait, the kinematic and kinetic parameters of TJ and OJ were found to be significantly different. Along with those parameters, change in the medial gastrocnemius (MG) muscle-tendon complex (MTC) length ($50.57{\pm}6.20mm$ for TJ and $44.14{\pm}5.39mm$ for OJ) and changes in the fascicle length of the MG ($18.97{\pm}3.58mm$ for TJ and $20.31{\pm}4.59mm$ for OJ) were observed. Although the total excursion of the MTC and the MG fascicle length during the two types of jump were not significantly different, however the pattern of length changes were found to be different. For TJ, the fascicle length maintained isometric longer during the propulsive phase than OJ. Conclusion : One-legged and two-legged vertical jumping use different muscle-tendon interaction strategies.

The 3-D Motion Analysis of Kinematic Variety on Lower Extremity during Ramp Ascent at Different Inclinations (정상인의 오름 경사로 보행 시 경사각에 따른 하지 관절의 삼차원적 동작 분석)

  • Han, Jin-Tae;Lee, Jong-Dae;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.633-650
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    • 2005
  • The aim of this study was to investigate the kinematics of young adults during ascent ramp climbing at different inclinations. Twenty-three subjects ascended a four step at four different inclinations(level, $8^{\circ},\;16^{\circ},\;24^{\circ}$). The 3-D kinematics was analysed by a camera-based falcon system. Groups difference was tested with one -way ANOVA and SNK test. The different kinematic patterns of ramp ascent were analysed and compared to level walking patterns. The kinematics of ramp walking could be clearly distinguished from the kinematics of level walking. In sagittal plane, Ankle joint was more dorsiflexed at initial contact and Max. dorsiflex. during stance phase with $16^{\circ},\;24^{\circ}$ inclination and more plantarflexed at toe off and Max. plantarflex. during swing phase with $24^{\circ}$(p<.001). Knee joint was more flexed at initial contact with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was more flexed at initial contact and Max. flex. during swing phase with $16^{\circ},\;24^{\circ}$ inclination and at toe off with $24^{\circ}$(p<.001) and was more extended at Max. ext. during stance phase with $24^{\circ}$(p<.05). In frontal plane, ankle joint was more everted at Max. eversion. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Knee joint was more increased at Max. varus. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was not differentiated with different inclinations. In horizontal plane, all joints were not differentiated with different inclinations. Conclusionally, In ascent ramp walking, the different gait pattern generally occurred at over $16^{\circ}$ on the ascending ramp in sagittal and frontal plane. These results suggest that there is a certain inclination angle or angular range where subjects do switch between a level walking and a ascent ramp walking gait pattern. This shows their motor control strategy between level and ascent ramp walking. Further studies are necessary to confirm and detect the ascent ramp gait patterns.

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