• 한국전문물리치료학회지
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• 제9권2호
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• pp.43-50
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• 2002

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.

• 한국엔터테인먼트산업학회논문지
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• 제14권3호
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• pp.363-373
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• 2020

본 연구는 뇌졸중 환자에게 엔터테인먼트요소가 가미된 가상현실과 시각적 되먹임 보행 훈련 프로그램을 병행하여 보행능력과 삶의 질을 향상시키고자 하였다. 이에 휘돌림 보행을 하는 뇌졸중 환자 10명을 선정하여, 가상현실과 힘판을 통한 시각적 되먹임 트레드밀보행훈련을 일일 30분씩, 주5회, 5주간 총 25회 실시하였다. 이러한 보행훈련의 효과를 알아보기 위해 관절가동범위검사, 근활성도 검사, 버그 균형 척도(BBS), 보행분석, 삶의 질(SS-QOL) 평가를 중재 전·후 시행하였다. 본 연구결과, 보행 흔듦기 시기에 마비측 관절가동범위와 근활성도, 동적균형능력, 보행능력, 삶의 질이 중재 후 통계학적으로 유의하게 차이가 있었다(p<0.05). 본 연구결과를 통해 본 연구의 보행훈련이 휘돌림 보행을 하는 뇌졸중 환자의 발처짐, 근활성도, 동적 균형 및 보행능력을 향상시키고, 이로 인한 삶의 질도 개선하는 것을 알 수 있었다. 따라서 휘돌림 보행을 하는 뇌졸중 환자의 보행능력 향상과 삶의 질 개선을 통한 라이프케어증진을 위해 가상현실과 힘판을 통한 시각적 되먹임 트레드밀보행훈련 프로그램 적용을 권장한다.

• 대한중풍순환신경학회지
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• 제14권1호
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• pp.23-30
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• 2013

■ Objectives This study is to examine change of gait parameters on shoes sole height(high heels, MBT shoes, house shoes) through gait analyzer. ■ Methods The subjects of this study were 12 women in their twenties. Gait analysis system is 5m in total length and gait is led to be comfortable. They put three kinds of shoes each and were led to walk 5m on gait analysis system. ■ Results There were significant differences in step length, single support and load response of gait parameters and in stride length and total double support at double support phase. ■ Conclusion Muscle activity differs in that different that shoes sole height and form because tibialis anterior muscle has strengthen and gastrocnemius has stretched. Therefore we think that patients with knee joint problem consider gait parameters when shoes select.

• 한국운동역학회지
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• 제15권1호
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• pp.177-195
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• 2005

The purpose of this study was to analyze the kinematic variables of ankle joints and EMG signal of the lower limbs muscle activity for the different walking speed. The subjects were 6 males of twenties. It was classified into three different walking speed-0.75m/s, 1.25m/s, 1.75m/s. The walking performances were filmed by high speed video camera and EMG signal was gained by ME3000P8 Measurement Unit. Tibialis anterior(TA), Gastrocnemius medial head(GM), Gastrocnemius lateral head(GL), Ssoleus(SO) were selected for the dorsiflexion and plantarflexion of the ankle joint. The result of this study were as follows: 1. In the gait cycle, The time parameters for the phases were showed significant difference without the terminal stance phase and terminal swing phase for the different walking speed. 2. The angle of ankle joint was no significant difference for each time point and MDF, MPF but increasing walking speed the angle had the increasing pattern slightly. 3. The angular velocity of ankle joint was showed the significant difference for LHC, RTO, RKC, LHU, MPF and MDF point along the walking speed. 4. TA was showed about 2-3 times muscle activity at the 1.75m/s than 1.25m/s in some phases. And it was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 0.75m/s. GM was showed about 2-3 times muscle activity in the 1.75m/s than 1.25m/s, and even much muscle activity at the 0.75m/s than 1.25m/s in some phases. GL was showed increasing pattern of muscle activity specially in the initial swing phase as the walking speed increased. SO was showed about 3 times muscle activity in the 1.75m/s than 1.25m/s during the plantarflexion of ankle joint. It was showed the similar muscle activity between the 0.75m/s and 1.25m/s but, showed a little much muscle activity in the 1.25m/s.

• 한국콘텐츠학회논문지
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• 제12권1호
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• pp.318-328
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• 2012

본 연구는 PNF 결합패턴이 뇌졸중 환자의 마비측 하지 근 활성도와 보행 능력에 어떠한 영향을 미치는 지를 알아보고자 실시하였다. 뇌졸중 환자 20명을 대상으로 하여 PNF 결합패턴(주 4회, 6주간)을 적용하는 실험군(n=10)과 일반 운동치료만을 적용하는 대조군(n=10)으로 무작위 배정하였다. 하지 근 활성도 측정은 활동전위의 실효치 값으로 분석하였고, 보행능력검사는 10MWT, DGI, F8WT를 이용하여 측정하였다. 운동 적용 방법에 따른 측정 시점에 대한 대조군과 실험군의 유의성 검정은 Two-way repeated measure ANOVA를 실시하였다. 그 결과, 근 활성도를 알아보기 위해 측정한 RF(p<.05), VM, TA, LH, LG(p<.001) 근육 모두 각 측정 시기에서 통계적으로 유의한 증가가 있었으며, VM, TA, LH, LG(p<.001)에서 측정시간과 군 간의 상호작용이 나타났다. 보행능력을 알아보기 위해 실시한 10MWT, DGI, F8WT 검사에서도 각 측정 시기에서 통계적으로 유의한 향상이 있었으며(p<.001), 10MWT(p<.05), DGI(p<.001), F8WT(p<.01)에서 측정시간과 군 간의 상호작용이 나타났다. 본 연구의 결과로 보아 PNF 결합패턴은 뇌졸중 환자의 마비측 근 활성도를 증가시키는데 도움을 주고, 보행 능력 개선에 유용한 전략으로 사용될 수 있음을 증명하였다.

• 한국운동역학회지
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• 제22권3호
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• pp.333-339
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• 2012

Freezing of gait is a severely problem in people with Parkinson's disease. The purpose of this study was to investigate the muscle activities of adductor longus, gluteus medius, gluteus maximus, biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior using Noraxon 8 channels EMG system during stop task in patients with Parkinson's disease. Seven parkinson's patients and age matched normal participants were recruited in the study. Filtered EMG signals were rectified, smoothed and integrated. To control for the altered timing and magnitude of activity, iEMG was normalized for time and peak value. The results indicated that the patients with Parkinson showed decreased gait cycle, stance phase, swing phase time, swing phase time ratio and increased stance phase time ratio than normal participants. The patients with Parkinson showed decreased gastrocnemius muscle activity time ratio, while increased tibialis anterior muscle activity time ratio than normal participants. During stance phase before stop, the patients with Parkinson showed relatively lower average and peak iEMG in anterior tibialis and gastrocnemius muscle than normal participants. During swing phase before stop, the patients with Parkinson showed relatively higher average iEMG in gastrocnemius muscle than normal participants. During stop phase, the patients with Parkinson showed relatively lower average and peak iEMG in anterior tibialis and gastrocnemius muscle than normal participants.

• 대한물리의학회지
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• 제13권3호
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• pp.27-37
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• 2018

PURPOSE: The purpose of this study was to investigate and evaluate muscle activity and foot pressure during gait, and isokinetic strength and balance in persons with functional ankle instability (FAI). METHODS: Nine healthy subjects (CON, n=9) without FAI and 11 patients (FAI, n=11) with FAI participated in the study after having been screened with an ankle instability instrument and a balance error scoring system. In addition, FAI was classified as non-involved (FAI-N) or involved (FAI-I), and CON was classified as dominant or non-dominant. All subjects were evaluated for isokinetic strength (plantar flexion, dorsiflexion, inversion and eversion of $30^{\circ}/sec$ and $60^{\circ}/sec$), balance (static and dynamic), muscle activity (tibialis anterior, peroneus longus and gastrocnemius) and foot pressure (static and dynamic) during gait. RESULTS: Results showed that plantar flexion (p<.05), dorsiflexion (p<.05), inversion (p<.01) and eversion (p<.00) of $60^{\circ}/sec$ were significantly decreased in FAI-I compared to those in FAI-N and CON. C 90 of static balance with eyes open (p<.01) and closed (p<.00) were significantly increased in FAI compared to those in CON. Forward position of dynamic balance (p<.01) was significantly decreased in FAI compared to that in CON. Gastrocnemius and peroneus longus of dynamic muscle activity (p<.01), left and right weight distribution of static foot pressure (p<.00) and pressure distribution of dynamic foot pressure (p<.00) were significantly decreased in FAI-I compared to those in FAI-N. CONCLUSION: We demonstrated that ankle strength, balance, muscle activity and foot pressure were significantly correlated with FAI.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.363-377
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• 2021

본 연구에서는 만성 파킨슨병 환자의 동적탄력튜빙 보행 훈련 (I, II)이 자세정렬, 보행, 삶의 질에 미치는 영향을 조사하였다. 총 3명의 만성 파킨슨병 환자를 모집하여 사례 연구를 시행하였다(Hoehn 및 Yahr 1-3단계 각 1명). 동적탄력튜빙 보행 훈련 (I 및 II)은 파킨슨병 환자에게 하루 30분, 주 5일, 5주 동안 25세션 적용되었다. 본 연구의 효과를 알아보기 위해, 자세정렬검사, 근 활성도검사, 보행분석 및 파킨슨병 환자의 삶의 질을 평가하였다. Dynamic tubing 보행 훈련(I, II) 중재 후 몸통 굽힘은 감소되었다. 또한 초기 접촉기(IC)에서 중간 디딤기(Mst)까지 보행 시 넙다리네갈래근, 뒤넙다리근, 앞정강근(TA)의 근 활성도가 증가하고 장딴지근의 근활성도가 감소하였다. 척추세움근(ES T12, L3)의 근활성도는 H&Y I, III 단계에서 증가하고 H&Y II 단계에서 감소하였다. 압력 중심(COP) 매개변수인 보행선의 길이, 한 발 지지선, 앞/뒤 위치, 좌우대칭 값이 개선되었다. 시공간 보행 매개변수인 보폭, 보폭, 의 속도는 증가하고 분당걸음수는 감소되었다. 나아가 파킨슨 병 환자의 삶의 질도 개선되었다. 이러한 연구 결과를 바탕으로 동적탄력튜빙 보행 훈련 (I 및 II)은 약물 내성이 절반으로 감소된 5년 이상된 만성 파킨슨병 환자의 자세, 보행, 삶의 질을 개선하기 위한 새로운 접근 방식으로 적용될 수 있을 것이다.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.44-57
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• 2007

Purpose: The objective of this study is to analyze the activities of muscles importantly functioning when walking with different inclinations and speeds of a treadmill, in order to provide basic data on walking exercise using a treadmill. Method: The selected subjects of this study were 16 men and women who had lower extremity injury. A treadmill was used to provide the activation of muscle, and the electromyography was used to analyze the muscle activity variables. The Biodex was used to measure the value of maximum isometric contraction. The inclinations of the treadmill were 0%, 5% and 10%, respectively, and its speeds were 2Km/h. 3Km/h, 4Km/h, 5Km/h, and 6Km/h, respectively. Result: For quadriceps femoris muscle and trunk muscle, there were significant differences in muscle activity when different speeds were applied at 0%, 5% and 10% inclinations.(p<0.05) The activity of vastus medialis muscle was 9.78% at 0% inclination and 2km/h speed, whereas it was 9.32% at 0% inclination and 3km/h, which was slightly lower. The activity of erector spinae muscle was 24.93% at 0% inclination and 2km/h speed, whereas it was 24.84% at 0% inclination and 3km/h, whereas it was 23.99% at 0% inclination and 4km/h, which was slightly lower. The activity of vastus medialis muscle was 11.89% at 10% inclination and 2km/h speed, whereas it was 10.65% at 10% inclination and 3km/h, which was slightly lower. The activity of rectus femoris muscle was 10.26% at 10% inclination and 2km/h speed, whereas it was 9.77% at 10% inclination and 3km/h, which was slightly lower. Conclusion: It was found that the activities of trunk muscle and quadriceps femoris muscle increase as the inclination and the speed of a treadmill increase during treadmill walking.

• 한국전문물리치료학회지
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• 제26권4호
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• pp.35-41
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• 2019

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.