• Journal of Biomedical Engineering Research
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• v.44 no.3
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• pp.190-203
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• 2023

The purpose of this study is to provide basic data to ensure the safety and essential performance of a Lower Extremity robotic assisted gait training system and to provide advanced technology and technical basis to the industry handling the system. Based on IEC 60601-1:2012/AMD2:2020 (Medical Electrical Equipment - General requirements for basic safety and essential performance of medical electrical equipment), IEC 62366-1:2015/AMD1:2020 (Medical devices - Part 1: Application of usability engineering to medical devices) and EN ISO 14971:2019 (Medical devices - Application of risk management to medical devices), the requirements for ensuring the safety and essential performance of the Lower Extremity robotic assisted gait training system were derived. Through the Delphi survey method and scenario analysis, which reflects the opinions and knowledge of experts in the fields of development, testing and review of technical documents, and quality assurance of medical devices, validity and reliability were conducted and obtained results with adequate content validity ratio (CVR; 0.7≤) and excellent reliability (Cronbach's α; 0.9≤). As a result, it was confirmed that the reliability and validity of the risk management process to ensure the safety and essential performance of the Lower Extremity robotic assisted gait training system are required a model can be established to provide measures to reduce risks according to the level of risk exposure caused by usage.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.63-71
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• 2019

PURPOSE: This study was examined the effects of coordinative locomotor training (CLT) on the postural imbalance and gait in children. METHODS: Four children were sampled as subjects. A single subject study (A-B-A') was conducted by measuring the following: baseline five sessions;, intervention phase, 15 sessions;, and postline (A') five sessions. The research period was eight weeks. The CLT program consisted of warming-up exercise, main exercise, and finishing exercise, and it was performed for one hour per day. A oneleg standing test (OLST) was performed determine the static balance. A functional reach test (FRT) was performed determine the reactionary balance. To determine the dynamic balance, the time up and go test (TUG) was performed. A 10m walking test (10 MWT) was performed to determine the walking ability. A statistical test was performed through descriptive statistics to present the average and standard deviation, and the variation rate was compared using a visual analysis method with graphs. RESULTS: As a result of CLT application, all four subjects improved the OLST, FRT, TUG, and 10 MWT compared to the intervention period baseline, and postline period. CONCLUSION: CLT appeared to improve the posture imbalance and gait in children.

• Physical Therapy Korea
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• v.17 no.3
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• pp.11-19
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• 2010

The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

• Korean Journal of Applied Biomechanics
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• v.23 no.3
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• pp.235-243
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• 2013

The purpose of this study was to analyse scientific according to period of rehabilitation training of ACL patients. ACL patients seven subjects participated in this study. Gait (1.58 m/sec) analysis was performed by using a 3-D Cinematography, a Zebris system and a electromyograph system. The data were analyzed by paired t-test. The joint angles were recorded from the ankle, knee, hip joints. Peak max dorsi-flexion and peak max plantar-flexion identified significant differences (p<0.05). Another angles were no significant difference. Vertical force (Fz) and max pressure variables improved 6 month RTP better than 3 month RTP. EMG were collected from 4 muscles (rectus femoris, biceps femoris, gastrocnemius, tibialis anterior) with surface electrides in gait system. EMG signals were rectified and smoothed data. EMG signas were no significant difference but they also improved 6 month RTP better than 3 month RTP. More research is necessary to determine exactly what constitutes optimal rehabilitation training period for ACL patients.

• Physical Therapy Korea
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• v.15 no.4
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• pp.27-33
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• 2008

The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• Journal of Korean Physical Therapy Science
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• v.30 no.4
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• pp.92-110
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• 2023

Background: Digital therapeutics are software medical devices that provide evidence-based treatments to prevent, manage, and treat disease. Digital therapies have recently been shown to be effective in motivating children with cerebral palsy as a tool in neuropsychological therapy. Digital therapies improve postural control, balance and gait in children with cerebral palsy. Therefore, this study aims to investigate the effects of digital therapies on balance and gait in children with cerebral palsy and to provide guidelines for prescribing digital therapies for children with cerebral palsy. Design: A Systematic Review Methods: This study searched for English-language articles published in medical journals from January 2000 to July 2023 using PubMed and MEDLINE based on the year of initiation of the digital therapy. The search terms used in the study were 'digital technology' OR 'digital therapeutic' OR 'mobile application' OR 'mobile health' OR 'virtual reality' OR 'game' AND 'cerebral palsy', 'balance' 'gait' as the main keywords. The final article was assigned an evidence level and a Physiotherapy Evidence Database (PEDro) score to assess the quality of clinical trials studies. Results: The digital therapies applied to improve balance and gait in children with cerebral palsy are game-based virtual reality training and the Nintendo Wii Fit program. Both digital therapy interventions had a significant effect on improving balance in children with cerebral palsy, and virtual reality training significantly improved balance and gait. However, there were no significant improvements in balance and gait within two weeks of treatment, regardless of the type of digital intervention. Conclusion: The study suggests that this data will be important in building the evidence base for the effectiveness of digital therapies on balance and gait in children with cerebral palsy and in advancing clinical protocols.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.33-39
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• 2016

PURPOSE: The purpose of this study was to investigate whether a circuit aerobic exercise program positively affects pulmonary function and gait endurance in chronic stroke patients. METHODS: Twenty-four chronic stroke patients were allocated equally and randomly to an experimental group (n=12) or a control group (n=12). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally performed a circuit aerobic exercise for 30 minutes, while the control group additionally performed a general aerobic exercise, i.e., gait training on the treadmill for 30 minutes. These 30-minute exercise sessions were held three times per week for six weeks. Pulmonary function was assessed using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV), and gait endurance was assessed using the 6-minute walk test (6MWT). RESULTS: In the both groups, FVC, FEV1, MVV, and 6MWT were significantly increased after training. Members of the experimental group showed significant improvements in FVC, FEV1, and MVV, and significantly greater improvements than controls (p<.05). However, 6MWT improvements were not significantly different in the two groups (p>.05). CONCLUSION: The devised circuit aerobic exercise program offers an effective rehabilitation aerobic exercise for improving pulmonary function and gait endurance in patients after chronic stroke.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.171-180
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• 2021

The present study investigated the effects of dynamic tubing gait (DTG II) program on the balancing ability for the promotion of life care of patients with chronic stroke. In the study, 25 sessions of DTG II program (30 minutes per session, 5 sessions per week, for a total of 5 weeks) were applied to 10 patients with chronic stroke. To determine the effects of DTG II program for improving balance, surface electromyography(external oblique, erector spinae, iliopsoas, gluteus maximus), symmetry index test on three pelvic axes, and dynamic gait index test were performed before and after the intervention. The results showed statistically significant differences between preand post-intervention measurements of the gluteus maximus muscle at early and mid-stance phases(p<.05). The pelvic symmetry index differed significantly between pre- and post-intervention measurements of diagonal and rotational movement(p<.05). Comparison of dynamic gait index also showed statistically significant differences between pre- and post-intervention measurements(p<.05). Based on these findings, it was determined that the DTG II program was able to improve the balancing ability of patients with chronic stroke by activating their trunk muscles and improving the symmetry of diagonal pelvic movement and rotation. Therefore, DTG II program is recommended as an interventional method to improve life-care through improving the balancing ability of patients with chronic stroke.

• Physical Therapy Korea
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• v.21 no.4
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.