• 대한통합의학회지
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• 제9권4호
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• pp.291-298
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• 2021

Purpose: The Pedisole is a newly developed shoe-mounted wearable assessment system for analyzing balance and gait. This study aimed to determine the reliability and validity of the parameters provided by the system for static balance and gait analysis of healthy adults. Methods: This study included 38 healthy adults (22.4±1.9 years) with no history of injury in the lower limbs. All participants were asked to perform balance and gait tasks for undertaking measurements. For analysis of balance, both the smart Pedisole and Pedoscan systems were concurrently used to analyze the path length of the center of pressure (COP) and the weight ratio of the left and right for 10 s. Gait was measured using the smart Pedisole and GaitRite walkway systems simultaneously. The participants walked at a self-selected preferred gait speed. The cadence, stance time, swing time, and step time were used to analyze gait characteristics. Using the paired t-test, the intra-class coefficient correlation (ICC) was calculated for reliability. The Spearman correlation was used to assess the validity of the measurements. In total, data for balance from 36 participants and the gait profiles of 37 participants were evaluated. Results: There were significant differences between the COP path lengths (p<.050) derived from the two systems, and a significant correlation was found for COP path length (r=.382~.523) for static balance. The ICC for COP path length and weight ratio was found to be greater than .687, indicating moderate agreement in balance parameters. The ICC of gait parameters was found to be greater than .697 except for stance time, and there was significant correlation (r=.678~.922) with the GaitRite system. Conclusion: The newly developed smart insole-type Pedisole system and the related application are useful, reliable, and valid tools for balance and gait analysis compared to the gold standard Pedoscan and the GaitRite systems in healthy individuals.

• 한국운동역학회지
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• 제17권4호
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• pp.99-106
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• 2007

The gait instability in the elderly has been associated with age-related deterioration in physical strength and reducing the potential for elderly falls requires regular exercise. In 2005, National Center for Injury Prevention and Control(NCIPC) reported that most elderly falls occur during activities in daily living(ADL). To better reveal biomechanic mechanisms underlying age-related degeneration in gait stability, and to enhance the assessment of falls risk, an accurate quantification of a person's balance maintenance during locomotion is needed. Instantaneous orientation of the line connecting COP and COM can characterize whole body position with respect to the supporting foot during gait and the angle between this line and the vertical line passing through the COP known as a good assessment to detect the elderly gait instability. Therefore the purpose of this study was to investigate a 6-month walking exercise effects in reducing elderly fall risk factors by using COP-COM inclination angles. Twenty-two community-dwelling elderly participated this study. The participants performed a walking exercise(3 times/week, 1 hour/visit) for 6 months. Laboratory kinematics during walking was assessed at months 0, 3 and 6. Significant increased in gait velocity was found among periods(p=.011, $1.25{\pm}.03$, $1.32{\pm}.03$, and $1.39{\pm}.04\;m/s$ in 0-, 3-, and 6-month, respectively). Also, significant differences in anterior and posteriror inclination angles were found among the periods(p<.05; posterior inclination angles: $12.8{\pm}2.2$, $11.0{\pm}2.9$, & $10.9{\pm}1.9$; anterior inclination angles: $13.7{\pm}1.7$, $14.6{\pm}3.2$, & $1.46{\pm}.21$ in 0month, 3month, & 6month, respectively). These findings provide evidence of significant reduced fall risk factors of community-living older adults associated with a systematic walking program.

• 한국운동역학회지
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• 제25권4호
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• pp.441-451
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• 2015

Objective : The purpose of the study was to investigate and compare the differences between Parkinson's disease rating, balance, fall and gait scales. Results : Parkinson's disease rating scales include the Hoehn-Yahr Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). The Hoehn-Yahr Scale can measure disease rates easily; however it is not sensitive enough to evaluate the disease's process and management. UPDRS's advantage is in it's higher inter-reliability score; however it is more complicated to use. Parkinson's balance scales are comprised of the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence Scale (ABC). BBS has the advantage in that it is cheaper to measure and simple in use. ABC's advantage is especially in it's ability to measure higher functional levels; however it is more difficult measure responses due to scores appearing in both extremes. The Fall Efficacy Scale (FES) and The Survey of Activities and Fear of Falling in the Elderly (SAFE) are Parkinson's fall scales. FES's leverage over SAFE is that it is simpler to measure; however it does not coincide with responses which proves disadvantageous in measuring balance loss in high-level Parkinson's patients. SAFE's advantage is in it's simpler use and ability to be utilized without encountering the fear of fall; however it's at a disadvantage in regards to its use with multilateral aspects providing insufficient inspection. Lastly, the Dynamic Gait Index (DGI) and the Functional Gait Assessment (FGA) are Parkinson's gait scales. DGI is advantageous in its ability to test gait ability when exposed to a variety of external environments; however it is disadvantageous in that it registers higher scores with activities. FGA's advantage is in it's dynamic balance test; however it at a disadvantage with those unable to walk. Conclusion : A researcher of Parkinson's patients must choose each scale while considering their positive and negative characteristics.

• 대한물리의학회지
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• 제3권4호
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• pp.215-224
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• 2008

Purpose : The purpose of this study was to evaluate the effects of the Hahoe mask dance on the gait and muscle activity in the elderly who lived at a elderly welfare facility. Methods : Dancing group was consisted of 20 subjects(over 70 years). The time of measurement was assigned in pre measurement, after 1 month, after 2 months. Subjects was received the Hahoe mask dance for three times a week during 8 weeks. The control group was consisted of 20 the elderly (similar age) who didn't received dancing. Assessment of gait function included the gait velocity, step time, stride, step length, it was analyzed in activity for 4 muscles (rectus femoris, biceps femoris, tibialis anterior, and lateral gastrocnemius). Results : Activities for muscles of control group was decreased in rectus femoris, bieps femoris, however, those of experimental group was increased significantly(p<.05). While control group showed decrease in the gait velocity per second (p<.05), experimental group showed statistically significant increase(p<.05). Control group had a significant long time than that of control group in gait time of right and left foot(p<.05). Control group was a little longer than control group in stride time of right and left foot(p<.05). Step length for control group was shorter than that for experimental group both foots(p<.05). Conclusion : In conclusion, this study confirmed that activities for 4 muscles by EMG have showed significant increases, so we will use a programme of muscle improvement in elderly community welfare faculty. We recommend that further research should explore the degree of muscle activity by larger sample sizes and longer follow-up periods.

• 한국전문물리치료학회지
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• 제22권3호
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• pp.81-90
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• 2015

This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; $n_1=14$) and a group to receive RAS using a metronome only (the control group; $n_2=14$). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients' gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at ${\alpha}=.05$. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients' gait.

• Physical Therapy Rehabilitation Science
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• 제5권1호
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• pp.34-39
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• 2016

Objective: Hip abductors play a role in providing stability and movement to the lower limbs. The purpose of this study was to examine the effects of hip abductor fatigue on static balance and gait in the general population. Design: One group pre-test post-test design. Methods: Thirteen university students in their twenties volunteered for the study and had underwent a functional assessment. To induce fatigue, the subjects were instructed to raise their dominant lower extremity up against a load of 50% of 1 repetition maximum while producing hip abduction in a side-lying position. Subjects were instructed to maintain an abduction speed of 30 repetitions per minute to induce fatigue. Muscle fatigue was considered to be established when subjects were unable to perform hip abduction three consecutive times along with the metronome. A post-test of balance and gait was performed immediately in order to prevent fatigue recovery. The center of pressure (COP) distance area was measured using the Zebris FDM-S Multifunction Force measuring plate. Gait performance was analyzed using the GAITRite. Results: The COP distance was increased after fatigue was induced. There was a significant increase in the standard deviation of the medio-lateral and antero-posteror distance (p<0.05). Although there was no significant difference in gait parameters, there was a significant decrease in single support time after fatigue was induced (p<0.05). Conclusions: There was an increase in static balance instability and a significant decrease in single support time during gait due to hip abductor muscle fatigue.

• The Journal of Korean Physical Therapy
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• 제19권2호
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• pp.1-10
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• 2007

Purpose: This study was conducted to investigate whether therapeutic exercise has effectiveness on the balance and gait in older adults. Methods: 30 patients were participated in this study. To evaluate the effects of therapeutic exercise, patients were evaluated by using One leg stand test which was static balance test, Berge balance test, Functional reach test and Get up and go test which was dynamic balance test. Finally Gait pattern were assessed by using 3-dimensional gait analysis system. The assessment parameters were evaluated before and after treatment. And we received a consent form from all patients. The data were analyzed by paired t-test for compare pre and after therapeutic exercise. Results: One leg stand test was significantly increased after than before therapeutic exercise. Get Up and Go test was significantly decreased after than before therapeutic exercise. Functional Reach test was significantly increased after than before therapeutic exercise. Burge Balance test was significantly increased after than before therapeutic exercise. Stride length was significantly increased after than before therapeutic exercise. Cadence was significantly increased after than before therapeutic exercise. Velocity was significantly increased after than before therapeutic exercise. Conclusion: We thought that therapeutic exercise that is mat exercise has effectiveness on the balance and gait in older adults.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.249-256
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• 2014

Purpose: The aim of this study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using sprinter and skater on balance and gait in the stroke patients. Methods: Twenty-two subjects were randomly assigned to the experimental group (n=11) and the control group (n=11). The experimental group performed PNF pattern exercise using sprinter and skater for 15 minutes with conventional physical therapy for 35 minutes (matt and gait training for 15 minutes + FES stimulation for 20 minutes), while the control group performed only conventional physical therapy for 50 minutes (matt and gait training for 30 minutes + FES stimulation for 20 minutes). Both groups performed therapeutic interventions for five days per week, for a period of four weeks. Functional Reach Test (FRT) and Berg Balance Scale (BBS) were used for assessment of balance, and Timed-Up and Go test (TUG) was used for testing of gait. Results: The experimental group showed significant improvements in the FRT and the BBS, while the control group did not show significant changes in two measurements. The experimental group also showed significant improvements, however, the control group did not show significant changes in the TUG. In post-values of three measurements, significant differences were observed between the two groups (p<0.05). Conclusion: This study demonstrated that PNF pattern exercise using sprinter and skater may be used to improve balance and gait function in stroke patients. Thus, we suggested that PNF pattern exercise using sprinter and skater would be a therapeutic intervention in stroke rehabilitation.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.77-85
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• 2014

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

• 대한통합의학회지
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• 제9권2호
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.