• Physical Therapy Rehabilitation Science
• /
• v.3 no.1
• /
• pp.49-54
• /
• 2014

Objective: This study aimed to identify how various applications of weight bearing on the affected side of hemiplegia patients affect the ability of balance keeping of the affected leg and the gait parameters. Design: Cross-sectional study. Methods: Eighteen patients with hemiplegia participated in this study. There were twelve males and six females. This study investigated the effects of the single-leg stance exercise on dynamic balance, weight bearing, and gait ability compared with four conditions. Dynamic balance and weight bearing were measured using the step test (ST) of the affected side in stroke patients. In addition, gait parameters were measured using the optogait system for analysis of the spatial and temporal parameters of walking in stroke patients. Results: This study investigated the effect of the single leg stance exercise on the paralysis side. The ST showed significant findings for all conditions (p<0.05). Therefore, knee extension and flexion exercise on the affected side single-leg stance (condition 4) significantly improved dynamic balance and weight bearing on the affected side (p<0.05). In the condition of moving the knee joint in a single-leg stance was discovered that the stance phase time significantly increased more than in the condition of supporting the maximal voluntary weight on the affected side (p<0.05). Conclusions: Single-leg stance on the paralysis side with knee flexion and extension increased symmetry in weight bearing during stance phase time. This study suggests that single-leg stance exercises augments improved gait function through sufficient weight bearing in the stance phase of the affected side.

• Korean Journal of Applied Biomechanics
• /
• v.30 no.3
• /
• pp.265-273
• /
• 2020

Objective: The aim of this study was to investigate the effect of participation in contact sports on neurocognitive scores, dual-task walking velocity, and cognitive costs in retired athletes. Method: Forty-four retired athletes (mean age = 26.4±5.5 yrs) and thirty-eight controls (mean age = 26.1±4.9 yrs) participated in this study. Neurocognitive score was collected using computerized neurocognitive testing using RehaCom. Gait velocity was collected one single task, four dual-tasks, and two multi-tasks using Optogait. Mann-Whitney U test was performed to compared differences in cognitive scores among groups. A mixed-design two-way ANOVA and Bonferroni posthoc test were used to assess the effect of group and walking tasks for each condition. Results: The auditory divided attention of neurocognitive score of retired athletes was higher than the control group (p < 0.05). No statistical differences were observed in the other neurocognitive scores between groups. The changes in walking velocity and cognitive costs according to the dual-task walking tests differed between the two groups (p < 0.05). Conclusion: Although participation in contact sports did not affect the neurocognitive results of retired athletes, it could be confirmed that the reduction in walking velocity and an increase in cognitive costs during dual-task walking. Rather than observing only neurocognitive scores as a single evaluation item for cognitive evaluation of retired athletes in relation to daily life, the application of the dual-task gait test may provide useful information.

• Physical Therapy Korea
• /
• v.13 no.2
• /
• pp.35-42
• /
• 2006

The walker provides stability for walking for people whose lower extremities are disabled. It is important to measure and determine the appropriate height of a walker to conserve energy and to improve function. The purposes of this study were to examine effects of walker height and gait velocity on triceps, latissimus dorsi muscle activation, and energy expenditure index (EEI) during ambulation with a walker. Fifteen healthy subjects participated in this study. Each subject was assigned a walker with one of three heights (high, standard, lower height) and of two gait velocities (comfortable gait velocity or fast gait velocity). Electromyographic data were collected from triceps and latissimus dorsi, and EEI was determined from each condition. Two-way repeated analysis of variance (ANOVA) was used to determine the statistical significance. Post hoc comparison was performed with the Bonferroni test. The results of this study were summarized as follows: 1. There was a significant difference in the %MVIC of triceps among different walker height factors. Post hoc comparison revealed that %MVIC of dominant triceps brachii was more significantly increased in patients who used the higher walker than those who used the lower walker (p<.05). 2. There were significant differences in the %MVIC of the latissimus dorsi among different walker height factors and gait velocity factors. Post hoc comparison revealed that the %MVIC of dominant latissimus dorsi was also more significantly increased in patients who used the higher walker than those who used the lower walker (p<.05) and in those who used the faster gait velocity than those who used the slower gait velocity (p<.05). 3. There were significant differences in the EEI among different walker height factors and gait velocity factors. Post hoc comparison revealed that the EEI was significantly increased among those who used higher and lower walkers compared with the standard walker. The EEI was also more significantly increased among those who used the fast gait velocity than those who used the slower gait velocity (p<.05). It has been concluded that increased muscle activation in triceps and latissimus dorsi was required when the walker height increased and that more energy was exp ended when the gait velocity increased. Therefore, from the findings of this study, it is recommended that walker height be adjusted according to the purposes of gait training and that healthy subjects conserve energy when ambulating with standard walkers in a comfortable gait velocity.

• Korean Journal of Applied Biomechanics
• /
• v.27 no.3
• /
• pp.229-238
• /
• 2017

Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks (S1) and the condition of wearing socks with taping therapy and inner arch support (S2). The dependent variables were resting calcaneal stance position (RCSP), plantar pressure distribution during gait, and underlying and medial longitudinal arch angle measured using radiography. Statistical analysis was performed using the Wilcoxon test with SPSS 23.0 for comparison of S1 and S2. Results: In the RCSP measurement, the angle range of S2 changed to normal. Meary's angle appeared to be less than the angle of S1, indicating alleviation of the degree of pes planus. The calcaneal pitch angle increased at S2 from that at S1. The plantar pressure distribution was divided into four areas (toe, forefoot, midfoot, and hindfoot). At S2, the maximum pressure increased in the toe and midfoot. The maximum force increased significantly in the toe and midfoot but decreased significantly in the forefoot and hindfoot. In addition, the contact area increased overall especially at the midfoot and hindfoot. Contact time decreased in the toe and forefoot, but increased in the midfoot and hindfoot. Conclusion: Taping therapy and inner arch support showed structural improvement of the pes planus. In addition, the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking.

• Korean Journal of Applied Biomechanics
• /
• v.16 no.1
• /
• pp.65-79
• /
• 2006

The purpose of this study was firstly to investigate correctional function of custom semi-rigid foot orthotics for excessively pronated people during gait by observing comfort, navicular movement and leg muscles' activity according to short-term and mid-term wearing duration and secondly to understand positive and/or negative point of view of a recently proposed paradigm related to foot orthotics more profoundly. Sixteen subjects who showed excessive pronation at navicular drop test were recruited for this study. Custom semi-rigid foot orthotics were made fitting for foot characteristics of the subjects by podiatry division of Otto Bock Korea company. While wearing the foot orthotics for two months, comfort of wearing were questioned and vertical navicular movement and electromyography of leg muscles during gait were measured at the condition of both immediately after and 2 months after including a control condition, respectively. The subjects were required to walk on a treadmill at the speed of 1.5m/s and four digital video camera filmed the movement of navicular process at the speed of 60 frames/s. In conclusion, in excessively pronated group continuous increase of comfort from short-term to mid-term wearing of custom foot orthotics is assumed to be closely related with short-term and mid term correctional action, of which are consisted the decrease of the range of navicular drop and navicular raisins- the faster timing of minimum navicular position occurring, and the decrease of leg muscles' activities. This conclusion could lead to positively accept new paradigm related to foot orthotics suggested by Nigg and the author suggest that in the future study the variable which could observe navicular movement would be one of major variables to study preferred path of skeleton in the paradigm.

• PNF and Movement
• /
• v.16 no.3
• /
• pp.317-332
• /
• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.2
• /
• pp.83-87
• /
• 2018

Objective: The purpose of this study was to investigate the relationship between heart rate (HR), self-awareness of exercise intensity (rating of perceived exertion, RPE), and 5-meter walk test (5MWT) of persons affected by stroke during backward walking according to the preferred stride frequency (PSF), PSF+3 and PSF+6 conditions. Design: Cross-sectional study. Methods: A total of 11 persons with stroke (9 males, 2 females) participated voluntarily. All patients underwent backward walking under the PSF, PSF+3, and PSF+6 conditions in underwater and ground environments, and each condition was performed for 5 minutes. The HR, RPE, and walking speeds were measured during walking, and the measured values from underwater and ground environments were compared. Results: The HR and RPE in the ground environment were significantly increased (p<0.05), and although the 5MWT showed an increase in speed, it was not significant. The HR and RPE in the underwater environment were also significantly increased (p<0.05), however, although the 5MWT results was increased, it was not significant. The HR and RPE were significantly increased in the PSF+6 condition (p<0.05). Conclusions: The results of this study showed that backward gait training underwater can provide an appropriate exercise intensity for stroke survivors and suggests that exercises performed in an underwater environment is more effective compared to the ground environment.

• Physical Therapy Rehabilitation Science
• /
• v.8 no.3
• /
• pp.141-145
• /
• 2019

Objective: The purpose of this study was to compare walking conditions (straight line and curved path) on walking patterns in persons who had experienced hemiplegic stroke and to determine whether if they adapt their walking pattern and performances according to changes in environmental conditions. Design: Cross-sectional study. Methods: Forty-four hemiplegic stroke survivors participated in this study. This study measured walking performance in three different walking conditions, such as straight walking, the more-affected leg in the inner curve walking, and less-affected leg in the inner curve walking conditions, and a 2-dimentional gait analysis system was used as a primary measurement. This study also measured secondary clinical factors including the Timed Up-and-Go Test, the Trunk Impairment Scale, and the Dynamic Gait Index. Results: After analyzing, cadence and step length of the less-affected side, stride length in the more-affected side, and stride length in less-affected side were significantly different among the three different walking conditions in this study (p<0.05), but other temporospatial parameters were not significant. Cadence was the largest in the straight walking condition. Step length in the less-affected side, stride length in the more-affected side, and stride length in less-affected side were also the longest in the straight walking condition. Conclusions: The results of the study suggest that hemiplegic stroke survivors show walking adaptability according to changes in walking demands and conditions, and moreover, cadence and step and stride lengths were significantly different between straight and curved walking conditions.

• Journal of Institute of Control, Robotics and Systems
• /
• v.16 no.10
• /
• pp.948-956
• /
• 2010

The purpose of this study was to test the effectiveness of a prototype KAFO (Knee-Ankle-Foot Orthosis) powered by two artificial pneumatic muscles during walking. We had previously built powered AFO (Ankle-Foot Orthosis) and KO (Knee Orthosis) and used it effectively in studies on assistance of plantaflexion and knee extension motion. Extending the previous study to a KAFO presented additional challenges related to the assistance of gait motion for rehabilitation training. Five healthy males were performed gait motion on treadmill wearing KAFO equipped with artificial pneumatic muscles to power ankle plantaflexion and knee extension. Subjects walked on treadmill at 1.5 km/h under four conditions without extensive practice: 1) without wearing KAFO, 2) wearing KAFO with artificial muscles turned off, 3) wearing KAFO powered only in plantaflexion under feedforward control, and 4) wearing KAFO powered both in plantaflexion and knee extension under feedforward control. We collected surface electromyography, foot pressure and kinematics of ankle and knee joint. The experimental result showed that a muscular strength of wearing KAFO powered plnatarfexion and knee extension under feedforward control was measured to be lower due to pneumatic assistance and foot pressure of wearing KAFO powered plnatarfexion and knee extension under feedforward control was measured to be greater due to power assistance. In the result of motion analysis, the ankle angle of powered KAFO in terminal stance phase was found a peak value toward plantaflexion and there were difference of maximum knee flexion range among condition 2, 3 and 4 in mid-swing phase. The current orthosis design provided plantaflexion torque of ankle jonit in terminal stance phase and knee extension torque of knee joint in mid-swing phase.

• Physical Therapy Rehabilitation Science
• /
• v.3 no.2
• /
• pp.134-141
• /
• 2014

Objective: The purpose of this study was to compare with different distance across three conditions in stroke survivors with the grading of cognitive state. Design: Cross-sectional study. Methods: Twelve stroke patients who agreed to active participation were included. Participants were allotted to normal cognitive (CN) group (n=7) and cognitive impairment (CI) group (n=5) and then walked on a self-paced walkway at three conditions on the Time Up and Go (TUG) test and the 6 minute walk test (6MWT): 1) walking with your comfortable speed, 2) walking while carrying a tray with glasses, 3) walking with a verbal cognitive task. The TUG test was repeated three successful times on each condition. For the 6MWT, participants were tested one time. Results: The CI group walked slower than the CN group at the three conditions on the TUG test. However, there was no significant difference between two groups to each condition. A significant effect of dual tasking was found only in error of verbal cognitive task condition for the TUG test (p<0.05). On the 6MWT, the participants in the CI group walked short distance rather than the CN group (p<0.05). There were significant differences between two groups not only at all conditions but also at error of verbal cognitive task condition as well (p<0.05). Conclusions: To consider the results of different distances such as the TUG test and the 6MWT, we think that exercises in long distance would be more effective to patients with CI. Those would be improved patient's endurance in cognitive problem.