• Title/Summary/Keyword: Gait Rehabilitation

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The Effects of Foot Intrinsic Muscle and Tibialis Posterior Strengthening Exercise on Plantar Pressure and Dynamic Balance in Adults Flexible Pes Planus

  • Lee, Da-bee;Choi, Jong-duk
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.27-37
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    • 2016
  • Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.

Comparison of the Electromyographic Changes in the Vastus Medialis Oblique and Vastus Lateralis Muscles According to the Knee Joint Angle During Squat Exercise Using a Gym Ball

  • Jeong, Hee-won;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.9-15
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    • 2016
  • Background: Squatting is one of the best functional exercises to strengthen the quadriceps muscle in independent gait and activities of daily living. Although the use of a gym ball during squat exercise is the most common way of strengthening the vastus medialis oblique (VMO) muscle, published data on this subject are limited. Objects: The purpose of this study was to compare the sequential muscle activation of the VMO and vastus lateralis (VL) muscles during squat exercise using a gym ball at different knee flexion angles. Methods: Forty healthy adults were randomly divided into experimental (squat exercise using a gym ball) and control (squat exercise alone) groups, in which squats were performed at $45^{\circ}$ and $90^{\circ}$ knee flexion. Electromyographic (EMG) activity data were collected over 10 seconds under the 2 angles of knee flexion ($45^{\circ}$ and $90^{\circ}$). Results: There was significant group and time interaction effect for VMO and VL muscle activation at $45^{\circ}$ knee flexion. This was similarly demonstrated at $90^{\circ}$ knee flexion. No significant group main effect and time main effect for VMO and VL muscle activation were noted at $45^{\circ}$ knee flexion, respectively. In contrast, there was significant group main effect and time main effect for VMO and VL muscle activation at $90^{\circ}$ knee flexion. These significant differences were demonstrated through two-way analysis of variance over repeated measurements, suggesting that the EMG activity of the VMO muscle during squatting with a gym ball showed remarkable improvement compared to that of the VL muscle. Conclusion: This research suggests that squat exercise using a gym ball may be more beneficial in improving the activity of VMO than of the VL muscle at both $45^{\circ}$ and $90^{\circ}$ of knee flexion, respectively. We highly recommend squat exercises with a gym ball for selective strengthening of the VMO muscle in knee rehabilitation.

The Effect of Lightly Gripping a Cane on Sit-to-stand Transfer in Post-stroke Patients

  • Choi, Young-eun;An, Duk-hyun
    • Physical Therapy Korea
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    • v.24 no.4
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    • pp.54-59
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    • 2017
  • Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was $52.73{\pm}2.13%$ without a cane, $42.75{\pm}3.26%$ with a strong grip, and $43.00{\pm}2.55%$ with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects' centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

Case Report of Physical Therapy using Proprioceptive Neuromuscular Facilitation for Activity Improvement in a Patient with Parkinson's Disease (파킨슨 환자의 활동 개선을 위한 PNF 개념을 이용한 물리치료 사례보고)

  • Shin, Jae-Wook;Kim, Jwa-Jun
    • PNF and Movement
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    • v.14 no.3
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    • pp.219-229
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    • 2016
  • Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.

Effect of Coordinative Locomotor Training on Balance and Plantar Foot Pressure in Scoliosis Patients -A Single Subject Study- (협응이동훈련이 척추 측만증 고객의 족저압과 균형에 미치는 효과 -단일사례연구-)

  • Kim, Jin-Cheol;Kim, Tae-Yoon;Lee, Jeong-A
    • PNF and Movement
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    • v.15 no.3
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    • pp.227-236
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    • 2017
  • Purpose: The purpose of this study was to investigate the effects of coordinative locomotor training (CLT) on the foot pressure and balance of patients with scoliosis. Methods: This was a single-case A-B-A study involving two patients with scoliosis. The study was designed to perform repeated measurements as follows: 5 times at baseline (A), 10 times during intervention (B), and 5 times after intervention (A). The study period was 5 weeks, and the CLT program was divided into warm up, CLT program, and cool down stages, at 50 min per stage. For the primary outcome measure, Gait View AFA-50 was used to determine the foot pressure and balance ability. For the secondary outcome measure, the SRS-22 questionnaire was used to assess the quality of life of the patients with scoliosis. Descriptive statistics and visual analysis using graphs were used to compare the rates of change. Results: The results of this study showed that the foot pressure and balance ability of the two subjects improved during the intervention period and remained improved even during the baseline period. However, their quality of life did not change after the intervention. Conclusion: CLT may have a positive effect on foot pressure and balance ability in patients with scoliosis. Also, this body function improvement may have positive effects on the performance of daily activities which employ the upright position.

The Effect of Genu Valgum on the Body Mass Index, Moment of Lower Limb Joints, Ground Reaction Force (신체질량지수, 하지관절의 모멘트, 지면반발력이 무릎외반슬에 미치는 영향)

  • Lee, Yong-Seon
    • Korean Journal of Applied Biomechanics
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    • v.25 no.3
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    • pp.257-263
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    • 2015
  • Objective : The purpose of this study was to investigate the effect of genu valgum on the body mass index, movement of lower limb joints, and ground reaction force. Methods : Gait patterns of 30 college students with genu valgum were analyzed and the static Q angle of the femur was measured for selecting genu valgum of the subjects. To analyze the kinetic changes during walking, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. Results : As a result of measuring a relationship between genu valgum and Q-angle, as the Q-angle increases, it showed a genu valgum also increased. Body Mass Index showed a significant difference between the groups was higher in the genu valgum group.(p<.001). The analysis result showed that genu valgum had a significant effect on the internal rotation moment in the hip joint(p<.05). Also, genu valgum had a significant effect on the internal rotation moment of the knee joint(p<.05). The comparative analysis of the Medial-Lateral ground reaction force in the genu valgum group showed a tendency to increase the medial ground reaction force(p<.05). The vertical ground reaction forces of the middle of the stance phase(Fz0) showed a significant increase in genu valgum group(p<.05), in particular the results showed a decrease in the early stance phase(p<.001). Conclusion : In conclusion, the change in body mass is considered to be made by proactive regular exercise for improvement of the genu valgum. In addition, the prevention of the deformation caused by secondary of the genu valgum in this study may be used as an indicator of the position alignment rehabilitation for structural and functional improvements. Applying a therapeutic exercise program for the next lap will require changes in posture alignment.

Intelligent Control of a Virtual Walking Machine for Virtual Reality Interface (가상현실 대화용 가상걸음 장치의 지능제어)

  • Yoon, Jung-Won;Park, Jang-Woo;Ryu, Je-Ha
    • Journal of Institute of Control, Robotics and Systems
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    • v.12 no.9
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    • pp.926-934
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    • 2006
  • This paper proposes intelligent control of a virtual walking machine that can generate infinite floor for various surfaces and can provide proprioceptive feedback of walking to a user. This machine allows users to participate in a life-like walking experience in virtual environments with various terrains. The controller of the machine is implemented hierarchically, at low-level for robust actuator control, at mid-level fur platform control to compensate the external forces by foot contact, and at high-level control for generating walking trajectory. The high level controller is suggested to generate continuous walking on an infinite floor for various terrains. For the high level control, each independent platform follows a man foot during the swing phase, while the other platform moves back during single stance phase. During double limb support, two platforms manipulate neutral positions to compensate the offset errors generated by velocity changes. This control can, therefore, satisfy natural walking conditions in any direction. Transition phase between the swing and the stance phases is detected by using simple switch sensor system, while human foot motions are sensed by careful calibration with a magnetic motion tracker attached to the shoe. Experimental results of walking simulations at level ground, slope, and stairs, show that with the proposed machine, a general person can walk naturally on various terrains with safety and without any considerable disturbances. This interface can be applied to various areas such as VR navigations, rehabilitation, and gait analysis.

Age-related Bimanual Coordination Impairments in Elderly People: a Systematic Review and Meta-analysis (건강한 노인의 양손 협응성 변화 패턴: 체계적 문헌고찰 및 메타분석 연구)

  • Kim, Rye Kyeong;Kang, Nyeonju
    • Korean Journal of Applied Biomechanics
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    • v.31 no.4
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    • pp.259-269
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    • 2021
  • Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I2 = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I2 = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I2 = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I2 = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I2 = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

Effects of Floss Band on Ankle Joint functional Range of Motion and gait ability (발목관절에 플로스밴드 적용이 기능적 관절가동범위와 보행능력에 미치는 영향)

  • Moon, Byoung-Hyoun;Kim, Ji-Won
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.419-425
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    • 2021
  • The objective of this study is to verify the effects of the application of flossband to the ankles of healthy adults on the functional range of ankle and walking ability. Total 20 people participated in the experiment, and through the randomization, one foot was set up as experimental side while the other foot was set up as control side. To analyze the two factors(before/after intervention/experimental side and control side), the two way-repeated ANOVA was conducted. The significance level was set up as 0.05. In the results of this study, compared to the control side, the experimental side showed significant increase in WBLT and heel strike(p=.05). In the test before/after intervention, the experimental side showed significant increase in WBLT, heel strike, and toe off(p=.05). The control side showed significant increase in toe off(p=.05). Thus, the application of floss band on ankle joint performed in this study would be helpful for improving the functional range and walking ability in the sports & rehabilitation field.

Discussion on the Value of Using Gait Analysis System Using Smart Shoes (스마트 신발을 활용한 보행분석 시스템 활용 가치에 대한 논의)

  • Park, Tae-Sung;Shin, Myung-Jun;Lee, Lee-Eun
    • Journal of Convergence for Information Technology
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    • v.9 no.3
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    • pp.128-133
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    • 2019
  • The purpose of this study is to verify whether the data measured by the researcher and the smart shoe sensor data are the same or similar by performing the 6 - minute walking test and time up and go test after putting smart shoes on a normal person. Ten normal adult males participated. After wearing smart shoes, they performed a 6-minute walk test and a time up and go test. The results of this experiment show that the accuracy of the current sensor is high. The difference in the distance of the 6-minute walking test is that the difference is because the turning point, which is not calculated in the actual 30-m track, measures the distance. From this point of view, it can be seen that smart shoes measure more accurate distance and it is expected that various tests will be possible through smart sensors.