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.
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.
Park, Hyung-Ki;Kim, Tack-Hoon;Choi, Houng-Sik;Roh, Jung-Suk;Cynn, Heon-Seock;Kim, Jong-Man
한국전문물리치료학회지
/
제20권1호
/
pp.64-73
/
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.
Purpose: This study was to investigate the effect of an arm sling on gait with hemiparesis. Methods: Fifteen patients(8 male, 7 female) with hemiparesis participated in this study and walked self-selected speed over 10m walkway, randomly without arm sling, with Single strap hemisling and Rolyan humeral cuff sling. It were filmed by 5 video camera and used with 3-dimensional motion analyzer system. The following gait variables were analyzed: temporo-spatial parameters, kinematic parameters. Results: In the comparison of temporo-spatial parameters each trial, walking velocity and single support time on affected side was significantly increased and step length on affected side, step length asymmetry ratio, single support time asymmetry ratio was significantly decreased in the Single strap hemisling and Rolyan humeral cuff sling. In the comparison of kinematic parameters each trial, maximal angle of the hip flexion on affected side was significantly increased in the Single strap hemisling and Rolyan humeral cuff sling and maximal angle of the knee flexion on affected side was significantly increased in the Rolyan humeral cuff sling and maximal angle of the ankle dorsiflexion on affected side was significantly increased in the Single strap hemisling. Conclusion: An arm sling improved walking velocity and decreased asymmetry and increased maximal angle of hip, knee, ankle flexion on affected side with hemiparesis caused by stroke.
The purpose of this study was to investigate the influence of the static pelvic inclination and declination in the static standing position on weight bearing rate and gait elements. Fourteen healthy adults in their twenties were participated. Two groups of healthy adults were allocated in this study: above and below the average of pelvic tilt. The correlation between the pelvic inclination, weight bearing rate and gait elements were measured. There was a statistical correlation between the pelvic tilt and step. Also, there was a statistical difference when we compared anterior declination with swing period and posterior declination with step. There was an asymmetric correlation between pelvic tilt and step. However, there was no statistical difference between the groups above and below the average of pelvic tilt. This result indicates that dipper pelvic inclination doesn't affect the asymmetry of step.
Purpose : This study was performed for find out temporal spatial parameter of the gait according to age. Method : Four groups of healthy people were allocated randomly in this study : group I(little child, 15), group II(child, 18) and group III(young people, 17), group(elder people, 16). This study was performed from 01 December to 31 December in 2007. Results : The results were as follows : 1. The swing phase was the longest group II, group IV was the shortest. Each groups, there was significant difference in swing phase(p<.05). 2. The stance phase was the longest group IV, group II was the shortest. Each groups, there was significant difference in stance phase(p<.05). 3. The single support time was the longest group II, group IV was the shortest. Each groups, there was significant difference in single support time(p<.05). 4. The double support time was the longest group IV, group II was the shortest. Each groups, there was significant difference in double support time(p<.05). 5. The gait velocity was the fastest group II, group I was the slowest. Each groups, there was significant difference in gait velocity(p<.05). 6. The toe in/out was very increased group IV, group I was very decreased. Each groups, there was significant difference in toe in/out(p<.05). 7. The cadence was the highest group I, group IV was the lowest. Each groups, there was significant difference in cadence(p<.05). 8. The step length was the longest group III, group I was the shortest. Each groups, there was significant difference in step length(p<.05). 9. The step length asymmetry ratio was the highest group IV, group III was the lowest. Each groups, there was no significant difference in step length asymmetry ratio(p>.05). 10. The single support time asymmetry ratio was the highest group I, group IV was the lowest. Each groups, there was no significant difference in single support time asymmetry ratio (p>.05). 11. The FAP was the highest group III, group I was the lowest. Each groups, there was significant difference in FAP(p<.05).
Purpose : This study was performed to investigate the effects of somatosensory training on the spatiotemporal gait parameters and balance in patients with stroke patients. Methods : 24 stroke survivors were allocated in this study, and randomly divided into experimental(n=12) and control group(n=12), independently. Experimental group was applied somatosensory training program plus conventional physical therapy, and control group was applied only conventional physical therapy. All subjects were administered for 30 minutes per day during 8 weeks(5 times a week). Results : Spatiotemporal parameters of gait were significant difference between pre and post intervention in experimental group, except of step length asymmetry ratio(SLAR) and single support time asymmetry ratio (SSAR)(p<.05). But control group had no statistical significance(p>.05). And also there was significant difference between experimental and control group(p<.05), except of cadence and SSAR(p>.05). Balance parameters were significant difference between pre and post intervention in experimental group(p<.05). But control group had no statistical significance(p>.05). And experimental timed up and go test was significantly decreased than control group(p<.05), but berg balance scale and functional reach test were not significant difference between experimental and control group(p>.05). Conclusion : This study was suggested that somatosensory training has effectiveness on the spatiotemporal gait parameters and balance in patients with stroke survivors. So this therapeutic intervention will be effectivelyapply to the stroke survivors in the clinical setting.
The aim of this study was to develop and verify gait training system for post-stroke hemiplegia patients with step length asymmetry. Most post-stroke hemiplegic patients show gait asymmetry and weight shifting training has been suggested as a useful method for improving the walking ability. However, verbal cue by physical therapist may be not effective. Therefore, our weight shift training system was designed to give a feedback to patients through precise plantar pressure and center of pressure (COP) measurement. This weight shifting biofeedback training system is composed of F-Scan plantar pressure measurement system and software development kit (SDK) for Windows operating system. Two post-stroke patients with step length asymmetry were enrolled in this study. After training for six weeks, the weight shift score and step length ratio of two all patients were improved and approached to them of non-disabled. This system developed in this study may improve the step length asymmetry, and therefore this system is also expected to improve a walking ability in hemiplegic patients.
The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.
Objectives : The purpose of this study is to identify influence that PNF method have an effect in function restoration of the impaired patients of central nervous system. Methods : The data were collected by 15 adult stroke patients. The treatment was based on proprioceptive neuromuscular facilitation techniques. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was significantly increased in the PNF method. The gait velocity, cadence and single support time asymmetry ratio was significantly increased in the PNF method. The Motor Assessment Scale was significantly increased in the PNF method. Conclusions : Based on these results, it is concluded that the forced PNF method for 6 weeks can be improve the temporal-spatial gait parameters including FAP in hemiplegic patients. Therefore, the forced PNF method is useful to improve the function restoration in hemiplegic patients. Further study should be done to analyze the effects of intervention duration of treatment, optimal time to apply the treatment in more long peried.
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