• PNF and Movement
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• 제15권3호
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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.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.11-19
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• 2016

Background: In the stroke patients with the characteristics of hemiplegic gait, turning direction of the affected and unaffected side influences turning time. Therefore, it is important to investigate the walking response to turning directions in stroke patients. Objects: This study aimed to measure the walking time while turning direction in hemiplegic patients depending on balance ability measured by Berg Balance Scale. Methods: A group of forty-five subjects with stroke (Berg Balance Scale score${\geq}46$ were twenty-eight, Berg Balance Scale score${\leq}45$ were seventeen) were enrolled in this study. Subjects were asked to perform the Timed Up and Go test. Testing indications included two directions for turning in each subject. These indications were for turning toward the affected and unaffected side in stroke patients. The duration of total analysis duration, sit to stand phase, stand to sit phase, mid-turning phase, and end turning phase were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 45 points of Berg Balance Scale score. The significance level was set at ${\alpha}=.05$. Results: There were significant increase time in the analysis duration and end turning phase duration while subjects were turned the unaffected side in stroke patients that presented a Berg Balance Scale score${\leq}45$ (p<.05). However, the comparison between the affected side and the unaffected side in the stroke patients with Berg Balance Scale score${\geq}46$, revealed no significant differences of the measured parameters. Conclusion: This finding should be suggested in the specific definition of turning direction for evaluation with Timed Up and Go test in the Berg Balance Scale score${\leq}45$, and other intervention for hemiplegic patients need to be suggested the direction of turning during walking training program.

• 한국운동역학회지
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• 제18권4호
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• pp.49-57
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• 2008

이 연구는 고령자를 대상으로 탄성저항운동을 수행하였을 경우 운동 전 후로 보행 시 지면반력 신호 크기와 이들의 variability에 어떠한 영향을 미치는 가를 구명하고자 하였다. 이를 위하여 여성 고령자 12명을 대상으로 12주간 탄성저항운동을 실시하였으며, 운동 전 후로 보행 시 3방향 지면반력 신호의 주파수 크기와 variability 값을 산출하였다. FFT(fast Fourier transform)를 이용하여 주파수 분석을 하였으며, PSD(power spectral density)를 계산하였다. 총 대상자들의 변이 계수(SD/Mean*100)을 이용하여 집단 간 variability를 계산하였다. 그 결과 다음과 같은 결론을 얻었다. 지면반력 신호의 주파수 크기는 좌우 방향에서 운동 전보다 운동 후에 작은 값을 보였으며, 통계적으로도 유의한 차이(p<.05)가 나타났다. 지면반력 신호의 variability에서는 좌우 방향에서 운동 전보다 운동 후에 큰 값이 나타났으며, 통계적으로도 유의한 차이(p<.05)가 나타났다.

• 한국운동역학회지
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• 제25권3호
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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.

• 생명과학회지
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• 제19권9호
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• pp.1299-1303
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• 2009

뇌졸중 환 6명을 대상으로 발병후 3개월 지난 시기에 1차 실험을 실시하였고, 6개월 지난 시기에 2차 실험을 하여 뇌졸중환자들을 대상으로 운동학적변인, 각운동학적변인 그리고 지면반력과 발바닥의 압력분포를 알아보았다. 운동학적변인의 결과 통계적으로 유의한 차이는 나타나지 않았으나 6개월간 꾸준히 재활운동에 참가한 환자는 3개월 때 보다 훨씬 보폭(step length)이 크게 나타났으며(11.18 cm, 12.25 cm, p=0.58), 보폭의 빈도(step time) 또한 빠르게 나타났다(1.20 sec, 1.18 sec, p=0.53). 환측의 발만 지지면에 닿아 있는 시간(single support time)의 연구에서는 재활운동에 꾸준히 참가한 환자가 발을 지면으로부터 빨리 떼는 것으로 나타났다(34.97%, 29.02%, p=0.74). 환측다리 움직임의 빠르기를 나타내는 변인(cadence)에서는 1분당 움직임의 회수가 6개월 운동에 참가한 사람의 보폭회수가 3개월 운동에 참가한 사람의 보폭회수 보다 훨씬 빠르게 나타났다(21.04 step/min, 28.89 step/min, 0.27). 각 운동학변인에서는 통계적으로 모든 변인에서 유의한 차이는 나타나지 않았으나 평균의 비교에서 꾸준하게 6개월 동안 재활운동에 참가한 환자는 발목관절, 무릎관절 그리고 엉덩관절 모두의 가동범위가 크게 나타났다. 걷기동작에서 상해의 원인이되는 최초 접촉 순간의 충격력(impact force)의 비교에서는 6개월간 꾸준히 재활운동에 참가한 환자는 충격력이 작게 나타났다(1.20 N/kg, 1.13 N/kg, p=0.45). 전방으로의 추진력(anterior propulsion force)과 후방으로의 감속력(posterior braking force)은 통계적으로 유의한 차이(p=0.28, p=0.39)를 나타내지 않았으나 재활운동에 꾸준히 참가한 환자들은 전후방의 힘(0.10 N/kg, 0.15 N/kg; -0.12 N/kg, -0.18 N/kg)이 좋아지는 것을 볼 수 있었다. 걷기 동작 시 환측발의 최대 압력분포값은 통계적으로 유의한 차이(p=0.24)는 없었으나 6개월 재활훈련참가자(15.51 N/$cm^2$)가 3개월 재활훈련참가자(13.99 N/$cm^2$) 보다 지면을 더욱 가볍게 밟고 지나가는 것으로 나타났다. 위의 연구결과들을 바탕으로 볼 때 뇌졸중 환자들은 꾸준하게 재활운동에 참가하여야 하며 주위 사람들의 관심이 항상 필요하다고 사료된다.

• 한국운동역학회지
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• 제26권4호
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• pp.397-405
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• 2016

Objective: Pilates is a low/mid-intensity exercise that can be easily performed by elderly individuals as it is an individual body-oriented exercise. It is also a cardio workout that can be performed anywhere to develop strength and flexibility. Therefore, we investigated the effects of 8 week Pilates program on the balancing ability of elderly individuals. Method: The research participants were selected from elderly residents in B city. Ten individuals voluntarily signed an agreement to undergo free measurements as well as to participate in the workout program. (Height: $157.1{\pm}11.9cm$, Weight: $61.7{\pm}8.0kg$). The Pilates exercise was performed 60 minutes a day, three times a week for a total of eight weeks. The measurement variables used to test balance were the vestibular test, 5 m habitual and maximum walk test and 3 m tandem walk test. A series of paired t-test were conducted using IBM SPSS Statistics 23.0 to analyze all the research data collected in order to determine the balance ability of the participants before and after the Pilates program. Additionally, the statistically significant level for all analysis was set to ${\alpha}=.05$. Results: In the vestibular test, some meaningful changes were observed in the length envelope area (ENV) while standing on one foot, but there were no significant differences in the ENV, rectangle(REC), root mean square, and total length. Results also revealed that statistically significant differences existed in the 5 m habitual and maximum walk test, as well as the 3 m tandem walk test. Conclusion: To summarize the findings, the 8 week Pilates program employed in this study significantly improved the dynamic balance of the elderly participants. Thus, elderly individuals that frequent perform Pilates are expected to enjoy positive benefits such as increased balance and fewer falling accidents.

• 한국운동역학회지
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• 제33권2호
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• pp.62-72
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• 2023

Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

• 한국운동역학회지
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• 제28권1호
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• pp.45-54
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• 2018

Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at ${\alpha}=.05$. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.

• 대한물리의학회지
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• 제16권3호
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• pp.89-97
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• 2021

PURPOSE: This study examined the effects of coordinative locomotor training on the spine appearance and quality of life of patients with idiopathic scoliosis. METHODS: This study included two patients with idiopathic scoliosis: one with a thoracic and lumbar type scoliosis and the other with thoracic type scoliosis. The study design was a single case study (A-B-A'), with a baseline-intervention/phase-post-intervention. The baseline (A) was designed and measured five times, intervention phase (B) ten times, and post-intervention (A') five times. The coordinative locomotor training program was divided into 10 minutes of warm-up exercise, 30 minutes of the main exercise, and 10 minutes of the finishing exercise, for 50 minutes each time. The primary outcome measurements were measured using the Cobb's angle, Adam's test, and Gait view pro 2.0 to determine the changes in the spine appearance. The secondary outcome measurements were compared before and after using the SRS-22 questionnaire to determine the quality of life of the scoliosis patients. A statistical test analyzed the mean and standard deviation, and the rate of change was presented by a visual analysis method using descriptive statistics and graphs. RESULTS: The findings showed that the spine appearance and quality of life of the two subjects were improved compared to the baseline measurements during the intervention phase, and the improved state was maintained during the post-intervention period. CONCLUSION: These findings indicate that coordinative locomotor training may help improve the spine appearance and quality of life of patients with idiopathic scoliosis.

• 대한의용생체공학회:의공학회지
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• 제19권5호
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• pp.519-530
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• 1998

본 논문에서는 하지 전단 환자의 보행 성능을 개선하고, 활동성을 증대시긴 목적으로 에너지 저장형 의족의 유연 용골 선계를 위한 기초 연구를 수행하였다. 문헌에서 얻을 수 있는 2차원 시상면에서의 정성걸음새와 인체측정 데이터를 분석하여, 의족의 유연 용골 기초 구조 모델을 제시하였다. 기초 구조 모델은 단순한 빔과 선혈 회전 스프링 ·댐퍼로 구성되었다. 고강도 경량 소재를 의족의 유연 용골 기초 구조에 적용하기 위해 탄소섬유 강화 복합재료를 용골의 기초 구조 소재로 선정하였다. 빔의 형상 변화에 따른 복원변형에너지를 유한요소해석에 의해 계산해내고, 빔형상 변화가 설계변수가 될 수 있음을 제시하였다. 복원변형에너지를 많이 저장할 수 있는 유연 용골 구조의 설계를 위해, 직교배열표를 이용한 조지전 시뮬레이션 계획을 세우고, 유한요소 프로그램인 ABAQUS를 이용하여 계획에 따른 유한요소해석을 수행하고, 분산활석을 통해 효과적인 에너지 저장형 의족의 유연 용골 구조를 얻어냈다. 유연 용골 구조를 이용한 의족걸음새의 동적 시뮬레이션 모델을 완성하고, 한 보행 사이클 동안의 동적 해석을 수행하였다. 그리하여 의족 시스템 개발을 위한 효과적 설계 과정이 제시되었다.