• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.315-324
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• 2014

PURPOSE: This study aimed to determine the correlation of weight bearing ability at the affected side with balance and gait abilities for the development of pressure biofeedback based equipment to stroke patients. METHODS: This study included 35 patients with stroke patient. The tests were conducted to determine the weight bearing ratio while pushing a step forward the affected side, static balance ability using the total length of COP(Center of pressure), sway velocity of COP, COP velocity at the X and Y axis. Functional reaching test (FRT), berg balance scale (BBS) were used to assess the dynamic balance ability and timed up and go test (TUG), 10m walk test (10mWT) were used assess the gait ability respectively. In order to determine the correlation between measured variables, bivariate correlation analysis was conducted. RESULTS: A significant correlation of the weight bearing ratio were shown with COP total length and velocity(r=-.34), Y-axis velocity(r=-.39), FRT(r=.42), BBS(r=.54), TUG (r=-.39), and 10m walking test (r=-.42). CONCLUSION: This study result showed that as patients with stroke had more weight bearing ratio at the affected side, not only their static and dynamic balance abilities increased more but also functional gait ability improved more. These results mean that, to improve stroke patients' static, dynamic balance ability and gait ability, weight bearing training with the affected side foot placed one step forward necessary for gaits are important.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.231-240
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• 2019

Purpose : This study aimed to determine whether resistance exercise using elastic bands for 6 weeks could improve the muscle strength, muscle tone, balance and gait among stroke patients. Methods : A total of 11 stroke patients who had agreed to participate in the study were randomly divided into 3 groups receiving elastic band resistance training on their less affected side (experimental group 1, n=4), affected side (experimental group 2, n=3), and both the sides (experimental group 3, n=4). Muscle strength, muscle tone, balance and gait were assessed using a hand-held dynamometer, the modified ashworth scale (MAS), the berg balance scale (BBS), and G-walk respectively, before and after training. Wilcoxon signed-rank test was used to analyze intergroup changes after the intervention, whereas the Kruskal Wallis H test, and Mann-Whitney U test were used to analyze intergroup changes in all variables. Results : Strength in all the muscle, except for the flexor and extensor muscles in the affected knees, was increased in all the groups, however, no significant difference was observed. No change in the muscle tone (MAS) was found in any group. All the groups showed increased BBS scores walking speed, and walking symmetry following training, although, the differences were not significant. Changes in the affected step length of experimental group 1 were significantly greater than those of experimental group 3, whereas changes in the affected step length in experimental group 3 were significantly greater than those of experimental group 2. Conclusion : Our results suggest that resistance exercise using elastic bands are a potential intervention for improving lower extremity muscle strength, balance, and gait among stoke patients.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.101-113
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• 2016

Objective: The purpose of this study was to investigate the effect of leg length discrepancy (LLD) on the human body during gait and standing posture. Methods: The study group comprised of 17 adult participants with LLDs of <1 cm. LLDs were artificially induced to 0, 1, 2, and 3 cm. The proportion of weight distribution, shift of the mean center of pressure, and Cobb's angle were measured in the standing position. Kinematic variables such as walking and striding width and time, and the proportion of stance phase for single- and double-limb gait were measured as well. The participants were required to either stand or walk on a treadmill (Zebris FDM) with a pressure plate, and the Cobb's angle measurements were obtained from radiographs. Results: A discrepancy of 3 cm in leg length resulted in a statistically significant shift of the center of pressure in the standing position. Moreover, the Cobb angle increased as the discrepancy became larger. The step length and width of the longer (left) leg during gait statistically significantly increased when the discrepancy was 2 cm. In addition, step time was statistically significant when the discrepancy between the longer (right) and shorter (left) legs was more than 2 cm. The proportion of single-limb stance phase was statistically significant as the discrepancy became larger, especially when the discrepancy was >2 cm for the longer (right) leg and 1 cm for the shorter (right) leg. Conclusion: The study showed that LLD influenced deformations of the human body and walking.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.2
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• pp.1-11
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• 2016

Purpose : The purpose of this study was to identify whether virtual reality-based exercise could improve on balance, gait and fall efficacy in patients with Parkinson's disease. Methods : Ten patients with Parkinson's disease were randomly divided into either an experimental or control group. The experimental subjects performed vertual reality-based exercise, whereas the control subjects performed conventional physical therapy for 4 weeks. The balance, gait and fall efficacy of all subjects were assessed by using the Measurement Training and Documentation (MTD) balance system, force platform system, Korean version of Berg Balance scale (K-BBS), 6 Minute Walk Test (6MWT), and Korean version of Fall efficacy scale (K-FES) at pre training and post training. Wilcoxon signed rank test was used to analyze change before and after intervention in intra-group. Mann Whitney U test was used to analyze changes of all variables in inter-groups. Results : Subjects in the experimental group showed significant improvements in difference of weight distribution, K-BBS scores, antero-posterior and medio-lateral sway length, ground reaction force (GRF), 6MWT, and step length following training. The changes of difference of weight distribution, K-BBS scores, AP Sway Length, GRF, 6MWT, step length and K-FES scores in the experimental group were significantly more than them of the control group. Conclusion : The result of this study suggest that virtual reality-based exercise training is an intervention to improve on balance, gait, and falls efficacy in patients with Parkinson's disease.

• Korean Journal of Applied Biomechanics
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• v.24 no.4
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• pp.445-453
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• 2014

The purpose of this study was to analyze the gait characteristics and interaction between lower extremity joints according to shoe's heel heights in young women. Participants were selected as subject consisted of young and healthy women (age: $23.71{\pm}1.49yrs$, height: $165.92{\pm}2.00cm$, body weight: $54.37{\pm}3.46kg$) and walked with 3 types of shoe's high-heel (0, 5, 9 cm). The variables analyzed consisted of the displacement of Y axis in center of mass ([COM]; (position, velocity), front rear(FR) and left right(LR) angle of trunk, lower extremity joint angle (hip, knee, ankle) and asymmetric index (AI%). The displacement of Y axis in COM position showed the greater movement according to increase of shoe's heel heights, but velocity of COM showed the decrease according to increase of shoe's heel heights during gait. The hip and knee angle didn't show significant difference statistically according to increase of shoe's heel height, but left hip and knee showed more extended posture than those of right hip and knee angle. Also ankle angle didn't show significant difference statistically, but 9 cm heel showed more plantarflexion than those of 5 cm and 0 cm. The asymmetric index (AI%) showed more asymmetric 9 cm heel than those of 0 cm and 5 cm. The FR and LR angle in trunk tilting didn't show significant difference statistically according to the increase of shoe's heel height during gait in young women.

• Korean Journal of Applied Biomechanics
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• v.29 no.2
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• pp.105-112
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• 2019

Objective: The main purpose of this study was to investigate the effects of wearing an ankle weight belt while performing gait in water by focusing on the effect of using ankle weights have on the gait kinematics and the muscle activities for developing optimum training strategies. Method: A total of 10 healthy male university students were recruited for the study. Each participant was instructed to perform 3 gait conditions; normal walking over ground, walking in water chest height, and walking in water chest height while using ankle weights. All walking conditions were set at control speed of $4km/h{\pm}0.05km/h$. The depth of the swimming pool was at 1.3 m, approximately chest height. The motion capture data was recorded using 6 digital cameras and the EMG was recorded using waterproof Mini Wave. From the motion capture data, the following variables were calculated for analysis; double and single support phase (s), swing phase (s), step length (%height), step rate (m/s), ankle, knee, and hip joint angles ($^{\circ}$). From the electromyography the %RVC of the lower limb muscles medial gastrocnemius, rectus femoris, erector spinae, semitendinosus, tibialis anterior, vastus lateralis oblique was calculated. Results: The results show significant differences between the gait time, and step length between the right and left leg. Additionally, the joint angular velocities and gait velocity were significantly affected by the water resistance. As expected, the use of the ankle weights increased all of the lower leg maximum muscle activities except for the lower back muscle. Conclusion: In conclusion, the ankle weights can be shown to stimulate more muscle activity during walking in chest height water and therefore, may be useful for rehabilitation purposes.

• PNF and Movement
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• v.18 no.3
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• pp.383-392
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• 2020

Purpose: Balance and gait dysfunction caused by aging affect elderly individuals' independent life, which, in turn, can reduce their overall quality of life. The purpose of this study is to compare the differences in the vestibular function of healthy elderly and young adults based on the subjective visual vertical (SVV) test as well as to compare and analyze the gait ability between these two groups to study the differences and association between vestibular, dizziness, and balance ability. Methods: The subjects were 18 young and 16 elderly adults with no neurological or musculoskeletal damage. To evaluate vestibular function, a subjective visual vertical test was performed. To evaluate the gait function, the step time, step length, stride length, stance phase ratio, and swing phase ratio were measured. Balance was evaluated using the Berg Balance Scale (BBS), and dizziness was evaluated using a dizziness handicap inventory (DHI). Results: There were significant differences in the SVV, BBS, and DHI between the young and elderly adults (p < 0.05). The gait variables of the older adults were all significantly different (except for the swing phase ratio) than those of the young adults (p < 0.05). As the result of correlation analysis, the SVV values of the young adults showed a significant negative correlation with step length and stride length (p < 0.05), while the SVV values of the elderly adults only showed a significant positive correlation with the DHI (p < 0.05). Conclusion: The elderly appeared to show a decrease in vestibular function when compared to the young adults, and it is thought that walking and balance function declined, while dizziness increased. Moreover, it is believed that these results can be used as basic data for vestibular rehabilitation in the future.

• Korean Journal of Applied Biomechanics
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• v.20 no.1
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• pp.33-39
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• 2010

The purpose of this study was to investigate the changes in walking pattern of the elderly during inclined walkway with uneven surfaces and level walking. 10 young($26.3{\pm}1.3$ years, $174.3{\pm}5.3\;cm$, $69.5{\pm}9.5\;kg$) and 13 elderly($72.4{\pm}5.2$ years, $164.5{\pm}5.4\;cm$, $66.1{\pm}9.6\;kg$) male subjects were participated in the experiment. Experiment consisted of 2 walking conditions: horizontal and inclined walkway with uneven surfaces. 3D motion capturing system were used to acquire and analyze walking motion data with sampling frequency of 120 Hz. To compare differences between conditions, kinematic variables(walking speed, stance-swing ratio, hip joint angle, knee joint angle, ankle joint angle, pelvic rotation angle) were used. Results showed that there were some changes of elderly walking pattern in inclined walkway with uneven surfaces: hip joint(adduction and rotation) and pelvic movement pattern. These changes by inclination and surface may affect gait pattern of young subjects as well as elderly subjects. However, in case of elderly it revealed more unstable gait than the young. Further study is necessary to clarify changes in walking pattern for elderly by considering various gait variables including head movement and various walkway conditions.

• The Journal of Korean Physical Therapy
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• v.9 no.1
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• pp.127-145
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• 1997

The purpose of this study wa9 to analyse the gait patterns of two female children with hemiplegic cerebral palsy by using the three-dimensional video motion analysis technique. Case 1 has mild spastic hemiplegia on the right side while Case 3 has moderate spastic hemiplegia on the left side. A group of 10, normal female children of the same age(7-8 years old) were selected as the control group for comparison. Time and distance variables as well as the Center of Mass displacement, and the pelvic and joint motions in three anatomical planes were analysed for this purpose. The following observations were made through the analysis : Case 1 revealed an asymmetrical gait pattern in which the step length of the unaffected side was shorter than that of the affected side, which wan a result of the effort to minimize loading on the affected leg by shortening the swing phase of the unaffected leg. Case 1 scored similar phase ratios, cadence and walking velocity to the normal group. A slight posterior tilt of the pelvis was observed throughout the gait cycle. Less hip and knee flexion than the normal group was observed, and demonstrated hyperextension of the knee in the terminal stance phase. The main problem in case 1 originated from the insufficient dorsiflexion of the affected foot during the swing phase. Therefore, Case 1 has difficulty with foot clearance in the swing phase. Usually, this is compensated for by using exessive hip abduction and medial rotation in conjuction with trunk elevation as well as increased vortical displacement of the center of mass. Case 1 revealed a foot-flat initial contact pattern. Case 2 was characterized by a consistent retraction ef the affected aide of the body througout the gait cycle, As a result, an asymmetrical gait pattern with increased stance phase ratios of the unaffected side was observed. In spite of this the step lengths of both sieds were similar. Case 2 scored lower cadence and walking speed than the normal group with lower gait stability. The main problem in Case 2 originated from an excessive plantaflexion of the affected foot which, in turn, rebutted in high hip and knee flexion. Hyperextension of the knee was observed at mid-stance, and execessive anterior tilt of the pelvis throughout the gait cycle was noticed. A gait pattern with high hip abduction and medial circumduction was maintained for the stability in the stance phase and foot clearance in the swing phase. Case 2 revealed a forefoot-contact initial contact pattern.

• Korean Journal of Applied Biomechanics
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• v.19 no.1
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• pp.159-166
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• 2009

The purpose of this study was to develop and automatic gait event detection algorithm using single accelerometer which is attached at the top of the shoe. The sinal vector magnitude and anterior-posterior(x-axis) directional component of accelerometer were used to detect heel strike(HS) and toe off(TO), respectively. To evaluate proposed algorithm, gait event timing was compared with that by force plate and kinematic data. In experiment, 7 subjects performed 10 trials level walking with 3 different walking conditions such as fast, preferred & slow walking. An accelerometer, force plate and 3D motion capture system were used during experiment. Gait event by force plate was used as reference timing. Results showed that gait event by accelerometer is similar to that by force plate. The distribution of differences were spread about $22.33{\pm}17.45m$ for HS and $26.82{\pm}14.78m$ for To and most error was existed consistently prior to 20ms. The difference between gait event by kinematic data and developed algorithm was small. Thus it can be concluded that developed algorithm can be used during outdoor walking experiment. Further study is necessary to extract gait spatial variables by removing gravity factor.