• Title/Summary/Keyword: Gait function

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The Effects of Two Motor Dual Task Training on Balance and Gait in Patients with Chronic Stroke (이중운동과제 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 효과)

  • Cho, Ki-Hun;Lee, Wan-Hee
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.7-14
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    • 2010
  • Purpose: The goal of this study was to investigate the effect of balance and gait ability through two motor dual task training in chronic stroke subjects. Methods: A group of twenty-five subjects who were six months post stroke participated in this study, where they were designated into pretest-posttest control The subjects were randomly allocated into two groups: experimental (n=13) and control (n=12). Both groups received physical therapy for 5 session 30 minutes per week during 6 weeks. Experimental group practiced additional two motor dual task training programs for thirty minutes a day, three days a week during six weeks. Evaluation of results was obtained through analyzing static balance, dynamic balance and gait function. Results: There was significant improvement among the group that practiced the additional two motor dual task training in that the postural sway area with open eye and close eye on the foam surface, the dynamic balance (p<0.05), and the gait function (p<0.05). Conclusion: Two motor dual task training improved static balance on the foam, dynamic balance, gait function. These results suggest that two motor dual task training is a feasible and suitable treatment for individuals with chronic stroke.

Effect of Action Observational Training on Gait in People with Stroke

  • Lee, JongSu;Kim, YoungMi;Lee, DongKyu
    • The Journal of Korean Physical Therapy
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    • v.32 no.1
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    • pp.1-6
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    • 2020
  • Purpose: This study examined the effects of action observational training to improve the gait function for patients with stroke. Methods: The participants were divided into two groups: right hemiplegia group (n=12) and left hemiplegia group (n=12). All groups received conventional therapy for five sessions for 30 minutes, each for three weeks. Left and right hemiplegia group practiced additional action observational training for five sessions for 20 minutes each for three weeks. They participated in three weeks of action observational training coupled with immediate physical practice (intervention), followed by a final assessment. The duration of each action observation video sequence was 10 minutes, followed immediately by practice of the observed motor skill (10 minutes). The gait velocity, cadence, swing time, step length, and BOS (base of support) were examined using the GAITRite system. Results: The results of this study showed significant improvement in the gait function. The outcomes of the gait abilities from gait velocity, cadence, swing time, step length of the affected side, and BOS (base of support) were improved significantly in the right hemiplegia group (p<0.05). In the left hemiplegia group, there was no significant improvement in the gait velocity, cadence, and BOS except for the swing time and step length of the affected side. The left and right group comparisons between the groups were not significant (p<0.05). Conclusion: Action observation training improves the gait function. These results suggest that action observational training is feasible and suitable for stroke patients.

Changes of Gait Variability by the Attention Demanding Task in Elderly Adults

  • Yeo, Sang Seok
    • The Journal of Korean Physical Therapy
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    • v.29 no.6
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    • pp.303-306
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    • 2017
  • Purpose: Gait variability is defined as the intrinsic fluctuations which occur during continuous gait cycles. Increased gait variability is closely associated with increased fall risk in older adults. This study investigated the influence of attention-demanding tasks on gait variability in elderly healthy adults. Methods: We recruited 15 healthy elderly adults in this study. All participants performed two cognitive tasks: a subtraction dual-task (SDT) and working memory dual-task (WMDT) during gait plus one normal gait. Using the $LEGSys^+$ system, we measured the coefficient of variation (CV %=$100{\times}$[standard deviation/mean]) for participants' stride time, stride length, and stride velocity. Results: SDT gait showed significant increment of stride time variability compared with usual gait (p<0.05), however, stride length and velocity variability did not difference between SDT gait and usual gait (p>0.05). WMDT gait showed significant increment of stride time and velocity variability compared with usual gait (p<0.05). In addition, stride time variability during WMDT gait also significantly increased compared with SDT gait (p<0.05). Conclusion: We reported that SDT and WMDT gait can induce the increment of the gait variability in elderly adults. We assume that attention demanding task based on working memory has the most influence on the interference between cognitive and gait function. Understanding the changes during dual task gait in older ages would be helpful for physical intervention strategies and improved risk assessment.

Effect of Action Observation Training with Auditory Feedback for Gait Function of Stroke Patients with Hemiparesis

  • Kim, Hyeong Min;Son, Sung Min
    • The Journal of Korean Physical Therapy
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    • v.29 no.5
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    • pp.246-254
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    • 2017
  • Purpose: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis Methods: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). Results: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p<0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p<0.05). Conclusion: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.

A Novel System with EMG-controlled FES Enhanced Gait Function and Energy Expenditure for Older Adults

  • Jang-hoon Shin;Hye-Kang Park;Joonyoung Jung;Dong-Woo Lee;Hyung cheol Shin;Hwang-Jae Lee;Wan-hee Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.2
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    • pp.152-162
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    • 2024
  • Objective: This study was conducted to analyze the effect of wearable Electromyography-controlled functional electrical stimulation (EMG-controlled FES) System on Gait Function and cardiopulmonary metabolic efficiency during walking in older adults. Design: Cross-section study Methods: Total 22 older adult participants suitable to selection criteria of this study participated in this study. The EMG-controlled FES System, which functions as a wearable physical activity assist FES system was used. All participations performed randomly assigned two conditions (Non-FES assist [NFA], FES assist [FA]) of walking. In all conditions, spatio-temporal parameters and kinematics and kinetics parameters during walking was collected via 3D motion capture system and 6 minutes walking test (6MWT) and metabolic cost during walking and stairs climbing was collected via a portable metabolic device (COSMED K5, COSMED Srl, Roma, Italy). Results: In Spatio-temporal parameters aspects, The EMG-controlled FES system significantly improved gait functions measurements of older adults with sarcopenia at walking in comparison to the NFA condition (P<0.05). Hip, knee and ankle joint range of motion increased at walking in FA condition compared to the NFA condition (P<0.05). In the FA condition, moment and ground reaction force was changed like normal gait during walking of older adults in comparison to the NFA condition (P<0.05). The EMG-controlled FES system significantly reduced net cardiopulmonary metabolic energy cost, net energy expenditure measurement at stairs climbing (P<0.05). Conclusions: This study demonstrated that EMG-controlled FES is a potentially useful gait-assist system for improving gait function by making joint range of motion and moment properly.

The Effects of Cognition-Exercise Program Using Step on Cognitive Function, Gait, and Depression in Elderly with Mild Cognitive Impairment (스텝을 활용한 인지-운동프로그램이 경도인지장애 노인의 인지기능, 보행, 우울에 미치는 효과)

  • Ju, Eunsol;Bang, Yosoon;Oh, Eunju
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.3
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    • pp.21-31
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    • 2020
  • Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

The effect of single trial transcutaneous electrical nerve stimulation on balance and gait function in elderly people with dementia: a pilot study

  • Jung, Ju Yeon;Jung, Jin-Hwa;Hahm, Suk-Chan;Jung, Kyoungsim;Kim, Sung-Jin;Suh, Hye Rim;Cho, Hwi-young
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.59-64
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    • 2017
  • Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

Effects of Removable Ankle-Foot Orthosis in Chronic Patients With Hemiplegia During Gait Training: A Pilot Study

  • Kim, Hyung-geun;Oh, Yong-seop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.91-97
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    • 2015
  • This study was conducted to investigate the effects of the removable ankle-foot orthosis (RAFO) which was developed to improve the gait of stroke patients. The subjects of this study were five stroke patients who agreed to participate in this study by signing a written consent form. To verify gait improvement after wearing the orthosis, a Timed Up and Go test and Functional Gait Assessment were performed, and spatiotemporal gait variables such as gait speed, cadence, stride length, double limb support, and the efficient gait test of body sway angle were performed. For every variable, the differences prior to and after wearing the RAFO were compared using the Wilcoxon signed-rank test. Every gait variable improved significantly after wearing the RAFO compared to prior to wearing it. The pilot study will enhance future efforts to evaluate orthotic function objectively during gait in stroke patients.

ELECTRICAL STIMULATION FOR THE RESTORATION OF GAIT FUNCTION IN HEMIPLEGIC PATIENTS (일측 마비환자의 전기자극에 의한 보행기능의 회복)

  • Jeong, D.H.;Park, B.R.;Kim, S.S.;Lee, C.H.;Hong, S.H.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.203-208
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    • 1992
  • In order to restore the gait function by functional electrical stimulation(FES) in hemiplegic patients, an electrical stimulator and foot sensor were developed on the basis of optimal parameters which resulted from animal experiments. Physical properties of the soleus muscle were quite different from those of themedial gastrocnemius muscle, that is, the former had a characteristic or slow muscle and the letter had a characteristic of fast muscle in rats. Optimal parameters for electrical stimulation were 0.2ms of pulse width and 20Hz of frequency in the soleus muscle and 0.3ms, 40Hz in the medial gastrocnemius muscle. Amplitude modulated electrical stimulator with -15V of maximal output was made and automatic on-off time if the stimulator was 5 seconds. The foot sensor composed of 3 sensors in 3 pressure points of the foot was made in order to control the gai t function by closed loop feedback system. The gait function was improved by using the stimulator and foot sensor in peroneal palsy. These results suggest that the electrical stimulator with closed loop feedback system may restore the gait function in hemiplegic patients.

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The Clinical Application of modified Emory Functional Ambulation Profile for Chronic Stroke Patients (만성 편마비 환자의 modified Emory Functional Ambulation Profile의 임상 적용)

  • Kim, Seong-Yeol;Lee, Je-Hoon;An, Seung-Heon
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.655-666
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    • 2010
  • Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.