• 대한물리의학회지
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• 제9권1호
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• 대한물리의학회지
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• 제7권4호
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• pp.411-421
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• 2012

PURPOSE: The purpose of this study was to investigate the effect of balance rehabilitation training with the visual cue deprivation on gait function in stroke patients in comparison with balance training without the visual cue deprivation. METHODS: Twenty two stroke patients participated in this study. Patients were randomly assigned to one of the two balance training program with and without the visual cue deprivation. Balance training session for each group lasted 50 minutes, 3 times a week for a total of 6 weeks. Gait function was measured with the Functional Gait Assessment (FGA), the self-selective comfortable gait speed (CGS), the maximal gait speed (MGS), and the Gait Analysis System. Temporal and spatial gait parameters of each evaluation were measured before and after the balance training program respectively. RESULTS: After the program, the visual cue deprivation group improved significantly in the FGA, the CGS, the gait velocity, the step time, the step length, the stride length, and the Functional Ambulation Performance (FAP) in comparison with the balance training group with the visual cue (p<.05). CONCLUSION: The gait function of the participants with the visual cue deprivation showed more improvement after the balance training program compared to the patients group without the visual cue deprivation, Therefore, the balance training program with the visual cue deprivation may be useful for rehabilitation of patients with chronic stroke.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.92-101
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• 2023

Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.

• 대한물리의학회지
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• 제17권4호
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• pp.65-73
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• 2022

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

• 제어로봇시스템학회논문지
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• 제21권6호
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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.

• 한국전문물리치료학회지
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• 제10권3호
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• pp.81-90
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• 2003

This study was conducted to assess the effects of the gait training method in incomplete spinal cord injured persons using an auto-walking machine. Persons with incomplete spinal cord injury level C or D on the American Spinal Injury Association impairment scale participated for eight weeks in an auto-walking training program. The gait training program was carried out for 15 minutes, three times per day for 8 weeks with an auto-walking machine. The foot rests of the auto-walking machine can be moved forward, downward, backward and upward to make the gait pattern with fixed on crank. The patient's body weight is supported by a harness during waking training. We evaluated the gait speed, physiologic cost index, motor score of lower extremities and the WISCI (walking index for spinal cord injury) level before the training and after the forth and eighth week of walking training. 1. The mean gait speed was significantly increased from .22 m/s at pre-training to .28 m/s after 4 weeks of training and .31 m/s after 8 weeks of training (p=.004). 2. The mean physiologic cost index was decreased from 4.6 beats/min at pre-training to 3.0 beats/min after 4 weeks and 2.0 beats/min after 8 weeks of training, but it was not statistically significant (p=.140). 3. The mean motor score of lower extrernities was significantly increased from 29.8 to 35.8 after 8 weeks of training (p=.043). 4. The mean WISCI level was significantly increased from level 10 to level 19 after 8 weeks of training (p=.007). The results of this study suggest that the gait training program using the auto-walking machine increased the gait speed, muscle strength and galt pattern (WISCI level) in persons with incomplete spinal cord injury. A large, controlled study of this technique is warranted.

• 한국운동역학회지
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• 제29권2호
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• pp.113-119
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• 2019

Objective: The purpose of this study was to investigate the effect of the falls on the center of pressure (CoP) complexity during gait using non-linear approximate entropy (ApEn). Method: 20 elderly women with experience of falling ($age=72.55{\pm}5.42yrs$; $height=154.40{\pm}4.26cm$; $body\;weight=57.40{\pm}6.21kg$; $preferred\;gait\;speed=0.52{\pm}0.17m/s$) and 20 elderly women with no experience of falling ($age=71.90{\pm}2.90yrs$; $height=155.28{\pm}4.73cm$; $body\;weight=56.70{\pm}5.241kg$; $preferred\;gait\;speed=0.56{\pm}0.13m/s$) were recruited for the study. While they were walking at their preferred gait speed on a treadmill (instrumented dual belt treadmills, Bertec, USA) with a force plate CoP data were collected for the 20 strides. The complexity of the CoP was analyzed using the ApEn technique. Results: The ApEn of the medial-lateral CoP in the fallers showed smaller about 16% compared to the non-fallers (p<.05). The ApEn of the antero-posterior CoP of the fallers showed smaller about 12% compared to the non-fallers, but the difference was not statistically significant. Conclusion: Based on the results of this study, the reduction of the medio-lateral CoP complexity in the elderly gait would be an index to determine the potential fall.

• Physical Therapy Rehabilitation Science
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• 제2권2호
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• pp.104-110
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• 2013

Objective: The purpose of this study was to investigate the effects of intensive gait training with body weight support treadmill training on gait and balance in stroke disability patients. Design: Randomized controlled trial. Methods: Twenty-six stroke patients (20 men and 6 women) participated in this study. All subjects were hospitalized patients. They were randomly divided into two groups: the experimental group (body weight supported treadmill training group, n=14) and control group (treadmill group, n=12). The mean ages were 52.07 years (experimental group) and 53.83 years (control group). Subjects in both groups received conventional training 10 times/wk. Subjects in the experimental group practiced body weight supported treadmill training for 30 minutes a day, 3 day/wk. Subjects in the control group practiced treadmill training for 30 minutes. The Berg Balance Scale (BBS) and GAITRite were used to evaluate balance and gait parameters (step length, cadence and gait speed) before and after the intervention. Results: BBS scores in the experimental group showed significantly greater improvement ($4.33{\pm}1.54$), compared with the control group (p<0.05). Significantly greater improvement in the gait speed ($24.13{\pm}4.53$ cm/s), affected side step length ($10.40{\pm}3.42$ cm), sound side step length ($11.97{\pm}3.29$ cm), and cadence ($23.88{\pm}5.52$ step/min), compared with the control group (p<0.05). Conclusions: Intensive gait training with Body Weight Support Treadmill Training may improve gait and balance in subacute stroke.

• PNF and Movement
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• 제15권3호
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• pp.361-371
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• 2017

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.311-319
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• 2021

Objective: To investigate the effect of emphasized initial contact by using a wearable air-pressure insole to provide auditory-feedback with variations of maximum peak pressure (MPP) of the affected side on spatiotemporal gait parameters and gait symmetry of stroke patients Design: A cross-sectional study Methods: Eighteen stroke patients participated in this study. All subjects walked five trials using an air-pressure insole that provides auditory feedback with different thresholds set on the insole. First, subjects walked without any auditory feedback. Then, the MPP threshold on the affected side was set from 70% and increase threshold by 10% after each trial until 100%. They walked three times or more on the gait analyzer for each trial, and the average values were measured. Before starting the experiment, subjects measured body weight, initial gait abilities and affected side MPP without auditory feedback. Results: Temporal and spatial variables were significantly increased in trials with auditory feedback from air-pressure insole except for non-paralyzed single support time and spatial gait symmetry compared to trials without auditory feedback(p<0.05). Among the four different thresholds, the walking speed, unaffected side single support time, affected and unaffected side stride, and affected side step length were greatest at 80% threshold of maximum peak, while affected single support time, temporal gait symmetry, and unaffected step length were greatest at the maximum peak of 100% threshold. Conclusions: These results indicate that auditory feedback gait using air-pressure insoles can be an effective way to improve walking speed, single support time, step length, stride, and temporal gait symmetry in stroke patients.