• 제목/요약/키워드: Gait training

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The Effect of Gaze Angle on Muscle Activity and Kinematic Variables during Treadmill Walking

  • Kim, Bo-Suk;Jung, Jae-Hu;Chae, Woen-Sik
    • Korean Journal of Applied Biomechanics
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    • 제27권1호
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    • pp.35-43
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    • 2017
  • Objective: The purpose of this study was to determine how gaze angle affects muscle activity and kinematic variables during treadmill walking and to offer scientific information for effective and safe treadmill training environment. Method: Ten male subjects who have no musculoskeletal disorder were recruited. Eight pairs of surface electrodes were attached to the right side of the body to monitor the upper trapezius (UT), rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), bicep femoris (BF), tibialis anterior (TA), medialis gastrocnemius (MG), and lateral gastrocnemius (LG). Two digital camcorders were used to obtain 3-D kinematics of the lower extremity. Each subject walked on a treadmill with a TV monitor at three different heights (eye level; EL, 20% above eye level; AE, 20% below eye level; BE) at speed of 5.0 km/h. For each trial being analyzed, five critical instants and four phases were identified from the video recording. For each dependent variable, one-way ANOVA with repeated measures was used to determine whether there were significant differences among three different conditions (p<.05). When a significant difference was found, post hoc analyses were performed using the contrast procedure. Results: This study found that average and peak IEMG values for EL were generally smaller than the corresponding values for AE and BE but the differences were not statically significant. There were also no significant changes in kinematic variables among three different gaze angles. Conclusion: Based on the results of this study, gaze angle does not affect muscle activity and kinematic variables during treadmill walking. However, it is interesting to note that walking with BE may increase the muscle activity of the trapezius and the lower extremity. Moreover, it may hinder proper dorsiflexion during landing phase. Thus, it seems to reasonable to suggest that inappropriate gaze angle should be avoided in treadmill walking. It is obvious that increased walking speed may cause a significant changes in biomechanical parameters used in this study. It is recommended that future studies be conducted which are similar to the present investigation but using different walking speed.

Effects of Squat Exercise Combined with Whole-Body Vibration on the Pulmonary Function and the Quadriceps Femoris Activity of Patients with Severe Chronic Obstructive Pulmonary Disease (전신진동을 결합한 스쿼트운동이 중증 만성폐쇄성폐질환 환자의 폐기능과 넙다리네갈래근 활성도에 미치는 영향)

  • Kang, Jeong-Il;Jeong, Dae-Keun
    • Journal of the Korean Society of Physical Medicine
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    • 제15권4호
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    • pp.121-129
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    • 2020
  • PURPOSE: This study aimed to propose an exercise technique that helps improve the skeletal muscle function while suppressing the symptoms of respiratory distress, by mediating squat exercises in whole-body vibration for patients with severe COPD, and comparing the post intervention pulmonary function and activity of quadriceps. METHODS: Totally, 21 patients with severe COPD were randomly assigned to two groups through clinical sampling: experimental group I included 11 patients (Squat exercise combined with whole-body vibration exercise), and experimental group II included 10 patients (Only squat exercise). Before intervention, we measured pulmonary function using a pulmonary function tester, muscle activity of quadriceps using surface EMG, and gait ability using the 6MWT. RESULTS: Comparison of intra-group changes in both experimental groups showed a significant increase in the activity of rectus femoris, vastus medialis, and vastus lateralis, and also in the 6MWT. Intra-group comparisons also revealed significant difference in the activity of rectus femoris, vastus medialis, and vastus lateralis (p < .05). CONCLUSION: Squat exercise combined with whole-body vibration significantly increased the activity of the quadriceps muscle, suggesting that this intervention helps maintain the function of skeletal muscles and prevent muscle atrophy. Therefore, studies to develop protocols using whole body vibration in clinical practice as an exercise method can safely be performed in severe COPD patients, as considered necessary.

The correlations between fall experience, balance, mobility and confidence in persons with stroke

  • Choi, Seokhwa;Lee, Byoung-Hee
    • Physical Therapy Rehabilitation Science
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    • 제9권3호
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    • pp.178-183
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    • 2020
  • Objective: This study conducted in order to investigate the correlations between fall experience, balance, mobility, and confidence. We examined the difference between fall experience, and Berg Balance Scale (BBS), Timed-Up-and-Go test (TUG), Tinetti balance assessment (Tinetti balance [TiB], Tinetti gait [TiG]), and Activities-specific Balance Confidence (ABC) scale scores to see how fall experience, balance, mobility, and confidence of the persons with stroke affects their balance. Design: Cross-sectional study. Methods: Forty-one subjects participated in this study. The BBS includes 14 items, consisting of a 5-point scale from 0 to 4, totaling up to 56 points. The Timed Up and Go-Alone (TUGA) was used to measure the average time to take a 3 m round-trip by getting up and down from a 46-cm high chair with an armrest on a flat floor. The Timed-Up-and-Go-Cognitive (TUGC) was performed by counting backwards and the Timed Up and Go-Manual (TUGM) is performed by holding a cup full of water. The total score for the TiB is 16 points, and the TiG is 12 points, making a total of 28 points. There are 16 items total for the ABC scale. Results: According to the fall experience, BBS, the TUGA and TUGC values were significantly higher in the inexperienced group compared to the experienced group (p<0.05). The number of falls was significantly correlated with BBS, TUGA, TUGC, TUGM, TiB, TiG, TiB+TiG (p<0.05). Conclusions: This study supports that falls experience is strongly related to balance, mobility, and confidence. Optimal balance training programs for fall prevention is still insufficient and must be developed.

The Effects of Dual-Task on Stepping Over Obstacles From a Position of Quiet Stance in Younger and Older Adults: A Pilot Study (장애물 보행시 젊은 사람과 노인들의 보행 양식에 대한 이중과업 수행의 효과)

  • Kim, Hyeong-Dong;Yoon, Bum-Chull
    • Physical Therapy Korea
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    • 제9권4호
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    • pp.1-11
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    • 2002
  • 본 연구의 목적은 이중과업 방법론(dual task methology)을 사용해서 젊은 사람과 노인을 대상으로 독립된 두 사건(two separate concurrent events)을 동시에 수행하는데 요구되는 주의력에 대한 분석과 노인에서의 특징적 차이를 찾는 것이다. 본 실험은 대상자가 힘판(force plate) 위에서 장애물(10cm) 보행시에 경피자극(cutaneous stimulation)에 대하여 마이크로 스위치(micro-switch)를 사용하여 반응하면서 시행되었다. 힘판과 시간(temporal events) 그리고 반응시간(reaction time)에 관한 자료들은 1000 Hz의 주파수로 수집되었다. 반응시간은 대상자들이 서 있는 상태(baseline) 장애물 보행시(dual task)에서 수집되었다. 반응시간은 아중과업 조건에서 대상자 모두에게서 긴 것으로 나타났으며 특히 노인에서 정상 성인보다 반응시간이 긴 것으로 나타났다. 이중과업 조건 하에서 노인 대상자가 정상 성인에 비해 발가락이 장애물에 닫지 않고 통과할 수 있는 공간, 즉 토우 클리어런스( toe-clearance)와 슬관전 굴곡(knee flexion) 각도가 훨씬 큰 것으로 나타났다. 이중과업 조건하에서 모든 대상자가 족관절 배측굴곡(ankle dorsiflexion) 각도를 감소시키는 것으로 나타났다. 노인들은 젊은 대상자들보다 훨씬 더 긴(124 ms) 유각시간을 보여 주었으며 정상 장애물 보행시 유각 시간은 이중과업보다 50 ms 긴 것으로 나타났다. 이러한 보행 특성의 차이는 노인대상자들이 젊은 대상자들보다 장애물 보행시에 이중과업의 영향을 더 받았기 때문인 것으로 판단된다. 이중 과업 시행시 이러한 토우 클리어런스의 감소와 장애물 통과시에 보행 속도의 증가는 아마도 낙상의 가능성을 증가시키는 요인이 될 수 있는 것으로 보여진다. 본 연구의 결과는 다중과업(multitasks)을 필요로 하는 보행 훈련 프로그램(gait training program)의 개발과 시행에 있어서 기초적인 자료를 제공할 수 있는 것으로 보여진다.

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A Case Report of a Proprioceptive Neuromuscular Facilitation Intervention Strategy Applied with an ICF Tool in a Patient with Anterior Cruciate Ligament Reconstruction (ICF 도구를 적용한 앞십자인대 재건술 환자의 고유수용성신경근촉진법 중재전략의 증례)

  • Song, Myung-Soo;Kim, Beom-Ryong;Kim, Chang-Heon;Noh, Hyun-Jeong;Kang, Mi-Gyeong
    • PNF and Movement
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    • 제15권1호
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    • pp.1-11
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    • 2017
  • Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

The Effects of PNF Upper- and Lower-Limb Coordinated Exercise on the Balancing and Walking-Abilities in Stroke Patients (고유수용성신경근촉진법을 적용한 상하지 협응 운동이 뇌졸중 환자의 균형 및 보행능력에 미치는 효과)

  • Cho, Hyuk-Shin;Cha, Hyun-Gyu;Shin, Hyo-Seop
    • PNF and Movement
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    • 제15권1호
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    • pp.27-33
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    • 2017
  • Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.

Effect of Rehabilitation Dog-Walking on Quality of Life, Physical Activity in Stroke Patients (재활견과 걷기가 뇌졸중 환자의 삶의 질과 신체활동에 미치는 영향)

  • Park, Shin-Jun;Park, Joo-Hyun;Kim, Ji-Sung
    • Journal of Convergence for Information Technology
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    • 제11권9호
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    • pp.182-190
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    • 2021
  • Rehabilitation dog-walking can be used to improve physical activity and restore QOL in stroke patients. This study investigated the effect of rehabilitation dog-walking on the QOL and physical activity of stroke patients. Twenty-four stroke patients were recruited for this study. Twenty-four stroke patients were randomized 1:1 into two groups. The evaluator measured stroke specific-quality of life (SS-QOL), six minute walk test, and maximal grip strength on the affected and non-affected side. The experimental group received gait training with a rehabilitation dog for 30 minutes once a week for 8 weeks. As a result of the study, there was a significant increase in SS-QOL, six minute walk test, and maximal grip strength on the affected side in the experimental group after the intervention. In addition, the experimental group showed significant improvement in SS-QOL, six minute walk test, and maximal grip strength on the affected side than the control group. Rehabilitation dog-walking may be an intervention method that can improve QOL and physical activity after stroke.

The Effects of the Convergence Pulmonary Function in the 20s Men of Mild Intellectual Disabilities with Obesity to Tredmill Exercise (트레드밀 훈련이 경도의 지적장애를 가진 20대 남성 비만인의 복합적인 폐기능에 미치는 영향)

  • Seo, Kyo-Chul;Park, Seung-Hwan;Cho, Mi-Suk
    • Journal of the Korea Convergence Society
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    • 제12권8호
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    • pp.77-83
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    • 2021
  • The purpose of this study was to determine whether the convergence pulmonary function of the 20s men of mild intellectual disabilities with obesity to tredmill exercise. Ten subjects of mild intellectual disabilities with obesity(experimentals) and ten contrary subjects(controls) were participated in the experiment. experimental group conducted treadmill gait training and control group conducted automed exercise. Subjects were assessed for their respiratory function by using Fit mate. The result of the experiments showed high pulmonary function than the controls. Thus, it suggests that the respiratory functional data of 20s men of mild intellectual disabilities with obesity can be used as a various respiratory one for the exercise programs in the area.

The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement

  • Kim, San-Han;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • 제11권1호
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    • pp.16-23
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    • 2022
  • Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

The Effects of a Group Exercise Program with Competitive Games on Balance in Chronic Stroke Patients (경쟁적 게임을 적용한 집단 운동 프로그램이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Yong-Ho, Cho;Sun-Wook, Park
    • Journal of the Korean Society of Physical Medicine
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    • 제17권4호
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    • pp.133-139
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    • 2022
  • PURPOSE: The purpose of this study was to investigate the effects of a group exercise program with competitive games on balance in chronic stroke patients. METHODS: The subjects were chronic stroke patients living at home after their discharge from the hospital. A total of 32 subjects were divided into two groups. The experimental group performed a group exercise program with competitive games, and the control group performed individual exercises. The exercise program duration was one hour, and it comprised 10 minutes of stretching, 40 minutes of the main exercise, and 10 minutes of stretching at the end. The experimental group was divided into two teams of 8 players each and played competitive games (transfer a gym ball to another person, relay 10 m walking and return, transfer an object to the next person using both arms while sitting). The control group performed an arm/trunk exercise for 15 minutes and gait training for 25 minutes. These exercises were conducted twice a week (4 weeks). The Berg Balance Scale (BBS) and timed up-and-go (TUG) tests were performed to confirm the change in balance. RESULTS: In the experimental group, BBS showed a significant increase (p < .05) and TUG showed a significant decrease (p < .05). In the control group, there was no statistically significant change in the BBS. However, the TUG showed a significant decrease (p < .05). The BBS and TUG both showed statistically significant differences (p < .05) in the between-group comparison of the change in pre-post intervention values. CONCLUSION: A group exercise program with competitive games to improve the balance ability for fall prevention in chronic stroke patients could be used as a good intervention method.