• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.385-394
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• 2010

Purpose : The present study was to examine the difference and severity of asymmetry in independently ambulating stroke survivors and to establish the association between gait asymmetry, velocity, and the motor function of lower extremity. Methods : The subjects used in this study were 43 subjects with hemiparesis being able to walk independently. Motor function of lower extremity was measured clinically with the Fugl Meyer-Lower /Extremity Assessment. Overground gait velocity and spatia-temporal parameters were collected by the GAITRite system. Results : Thirty(69.77%) patients showed statistically significant temporal asymmetry while 28(65.1%) exhibited statistically significant spatial asymmetry. One-way ANOVA results showed a main effect of temporal asymmetry group(normative, mild, severe) for gait velocity(F=74.129), FM-L/E(F=17.270), swing-stance symmetry(F=66.869, F=13.485, respectively), spatio-temporal asymmetry(F=13.166, F=31.800, respectively) 66, F=31.800, respectively). Gait velocity was negatively associated with temporal asymmetry(r=-.83), spatial asymmetry(r=-.60). Motor function of lower extremity was also associated with temporal asymmetry(r=-.58), and spatial asymmetry(r=-.50). Conclusion : The study attempted to establish the standard assessment of hemiparesis gait symmetry in light of the complex relationship with motor impairment and gait velocity. More future work will need to link the degree of gait asymmetry to clinically relevant outcomes to better establish the clinical significance of such observations.

• Physical Therapy Korea
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• v.22 no.2
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

• The Journal of Korean Physical Therapy
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• v.18 no.3
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• pp.1-7
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• 2006

Purpose: This study was performed to determine the difference or temporal-spatial gait asymmetry ratio according to static pelvic inclination level in hemiplegic patients. Methods: The subjects were 25 hemiplegic patients who was experienced stroke on MCA territory. Gait parameters and static pelvic inclination were recorded by $GAITRite^{(R)}$ system and radiologic PACS. The subjects were divided into three group according to static pelvic inclination. In the group I, the subjects have static pelvic inclination below $58^{\circ}$. The group II has $58^{\circ}{\sim}62^{\circ}$ or static pelvic inclination and the group m has over $62^{\circ}$ or static pelvic inclination. The data or three groups were analysed with ANOVA. Results: In comparison or single support time asymmetry ratio among 3 groups, the score or group II was significantly higher than the other groups(p<0.05). But the swing time asymmetry ratio was not significant(p>0.05). Conclusion: Asymmetry ratio of single support time was statistically significant by static pelvic inclination level. But asymmetry ratio or group II was the highest among three groups. It means that the patients or normal range of pelvic inclination was showed the most asymmetry or gait. And swing time asymmetry ratio was not significant among three groups. Even if the patient has normal ranged static pelvic inclination, it doesn't suggest that the patient has low gait asymmetry.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.205-212
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• 2012

Purpose : The aim of this study was to investigate the relationship between weight-supporting asymmetry and gait symmetry in patients with stroke. Methods : Sixty two stroke patients with hemiplegia stood quietly with eye opens on a force platform to calculate weight-supporting asymmetry from vertical reaction force. The GAITRite was used to evaluate their gait parameters. The data were analyzed using Pearson correlation. Results : The results of this study was showed that the medio-lateral index (ML) was correlated with symmetry rate (SR), symmetry index (SI), and Gait asymmetry (GA) of step time and length but stronger correlation with spatial gait symmetry than temporal symmetry. In gait symmetry, step length has stronger correlation with weight-supporting asymmetry than step time. Conclusions : The results of this study shows weight-supporting asymmetry was correlated with more spatial gait symmetry than temporal symmetry.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.89-98
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• 2020

PURPOSE: This study investigated the effects of unilateral static stretching on the flexibility and symmetry of the lower leg, and temporal gait variables in gait asymmetry people. METHODS: Twenty gait asymmetry people were divided into a unilateral static stretching group (USG, n = 10) and control group (CON, n = 10). The USG performed unilateral static stretching for 60 minutes, three times a week, and eight weeks. The flexibility of the lower leg (SR), and symmetry (BR), and temporal gait variables (Step length; SL, gait speed; GS) were measured before, after four and eight weeks of unilateral static stretching. Moreover, SI (symmetry index; SI) was calculated from the measured SL value. Statistical analyses were conducted using one-way ANOVA and two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Scheffe. RESULTS: SR and BR in the dominant and non-dominant side, and GS were increased significantly at USG after eight-weeks compared to before unilateral static stretching (p < .05). The difference in BR in the dominant and non-dominant side, and step length (SI) decreased significantly at USG after eight-weeks compared to before unilateral static stretching (p < .05). CONCLUSION: Unilateral static stretching improves the flexibility and symmetry of the lower leg, and temporal gait variables in gait asymmetry people.

• Physical Therapy Korea
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• v.20 no.1
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• pp.64-73
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• 2013

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2013.05a
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• pp.1449-1450
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• 2013

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.10 no.1
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• pp.83-101
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• 2004

The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not, significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of single support time asymmetry before and after experiment, the single support time asymmetry was no significant difference between groups(p>.05). In the comparison of difference of the single support time asymmetry between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of step length asymmetry before and. after experiment, the step length asymmetry was not significant difference between the experimental group and the control group(p>.05). In the comparison of difference of the single step length asymmetry between groups, there was not significant difference between the experimental group and the control group(p>.05).

• Physical Therapy Korea
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• v.22 no.4
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• pp.27-33
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• 2015

The purpose of this study was to find which spatiotemporal gait parameters gained from stroke patients could be predictive factors for the gait part of Tinetti Performance-Oriented Mobility Assessment (POMA-G). Two hundred forty-six stroke patients were recruited for this study. They participated in two assessments, the POMA-G and computerized spatiotemporal gait analysis. To analyze the relationship between the POMA-G and spatiotemporal parameters, we used Pearson's correlation coefficients. In addition, multiple linear regression analyses (stepwise method) were used to predict the spatiotemporal gait parameters that correlated most with the POMA-G. The results show that the gait velocity (r=.67, p<.01), cadence (r=.66, p<.01), step length of the affected side (r=.49, p<.01), step length of the non-affected side (r=.53, p<.01), swing percentage of the non-affected side (r=.47, p<.01), and single support percentage of the affected side (r=.53, p<.01) as well as the double support percentage of the non-affected side (r=-.42, p<.01) and the step-length asymmetry (r=-.64, p<.01) correlated with POMA-G. The gait velocity, step-length asymmetry, cadence, and single support percentage of the affected side explained 67%, 2%, 2%, and 1% of the variance in the POMA-G, respectively. In conclusion, gait velocity would be the most predictive factor for the POMA-G.