• 제목/요약/키워드: Hemiplegic gait

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가속도계를 이용한 편마비 환자의 보행 분석 알고리즘 개발 (Development of Gait Analysis Algorithm for Hemiplegic Patients based on Accelerometry)

  • 이재영;이경중;김영호;이성호;박시운
    • 전자공학회논문지SC
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    • 제41권4호
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    • pp.55-62
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    • 2004
  • 본 연구에서는 보행 가속도 신호를 측정할 수 있는 휴대용 무선 가속도 측정 시스템을 설계하고 편마비 환자로부터 획득된 데이터를 이용하여 보행 인자 계산과 보행의 규칙성 및 대칭성을 평가할 수 있는 보행 자동분석 알고리즘을 개발하였다. 휴대용 무선 가속도 측정 시스템은 2축 가속도계와 증폭기 및 16㎐ 저역 통과 필터로 구성된 아날로그 신호처리부(가속도 센서부)와 원칩 마이크로프로세서, EEPROM RF 송신부 및 수신부로 구성되어 있다. 보행 분석 알고리즘은 FFT 분석부, 필터 처리부 및 정점 검출부로 구성된다. 알고리즘 개발 및 평가를 위하여 8명의 편마비 환자가 실험군으로 또 다른 8명의 편마비 환자가 대조군으로 참여하였으며, 요추 3∼4번 위치에서 10m 동안의 보행 가속도 신호를 60㎐의 샘플링 주파수로 측정하였다. 보행자동분석 알고리즘에 의해 먼저 보행 구분점을 검출하고 좌우 발을 구분하였으며, 이 정보를 이용하여 보행 인자들을 계산하였다. 비디오 데이터와 보행 가속도 신호를 직접 관찰하여 얻은 정보와 비교하여 알고리즘의 성능을 평가한 결과 보행 구분점이 모두 정확히 검출되었으며 좌우 발 또한 모두 구분되었다. 향후 알고리즘의 신뢰성과 더 많은 보행 인자들을 계산할 수 있도록 성능을 향상시킴으로써 임상에서 편마비 환자의 재활치료 성과를 평가하는데 사용될 수 있을 것이다.

팔걸이가 편마비 환자의 보행에 미치는 영향 (The effect of arm sling during hemiplegic gait)

  • 이일석;임형문;최산호;오재건;성강경;이상관
    • 대한중풍순환신경학회지
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    • 제14권1호
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    • pp.80-89
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    • 2013
  • ■ Objectives The aim of study is to analyze the change of gait pattern by arm sling in a hemiplegic patient. ■ Methods We analyzed the change of gait pattern under three conditions using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) First, the patient didn't have arm sling on her upper limb, second, the patient have arm sling on her affected upper limb, third, patient have arm sling on her unaffected upper limb. ■ Results In terms of spatiotemporal gait values, swing phase, step time, step length of unaffected lower limb increased. Furthermore, stride time and stride length also increased when the patient had arm sling on her unaffected upper limb. In terms of displacement of Center of pressure(CoP), anterior/posterior position and lateral symmetry of CoP increased. Furthermore, lateral symmetry of decreased when the patient had arm sling on her affected upper limb. ■ Conclusion Arm sling applied on affected side would be advantage to gait improvement in hemiplegic patients.

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Spatiotemporal Gait Parameters That Predict Gait Function Based on Timed Up and Go Test Performance in the Hemiplegic Stroke Patients

  • Kim, Jeong-Soo;Kim, Jeong-Ah;Jeon, Hye-Seon;Yu, Kyung-Hoon
    • 한국전문물리치료학회지
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    • 제20권4호
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    • pp.40-46
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    • 2013
  • The purpose of this study was to determine which spatiotemporal gait parameters obtained during hemiplegic walking could be a predictive factor for the Timed Up and Go test (TUG). Two hundreds nine subjects who had suffered a stroke were recruited for this study. They were participated in two assessments; the TUG test and gait analysis. The relationship between the TUG test and spatiotemporal parameters was analyzed using Pearson's correlation coefficients. In addition, to predict the spatiotemporal gait parameters that correlated most with the TUG scores, we used multiple linear regression analyses (stepwise method). The results show that the normalized velocity was strongly correlated with the TUG performance (r=-.72, p<.001). Additionally, single support percentage (SSP), double support percentage (DSP), step time difference (STD), and step length difference (SLD) significantly were correlated with the TUG test. Normalized velocity, STD, DSP of affected side, and SSP of non-affected side explained 53%, 8%, 3%, 2%, of variance in the TUG test respectively. In conclusion, an increase in gait velocity and a decrease in STD would be effective indicators of improvement on the functional mobility in the stroke rehabilitation.

상호억제 기법에 의한 경직성 편마비 환자 보행의 공간적, 시간적 특성 변화 (Characteristics Change of Spatial and Temporal Parameters of Gait in Spastic Hemiplegic Patients by Reciprocal Inhibition)

  • 김종순;이현옥;안소윤;구봉오;배성수
    • The Journal of Korean Physical Therapy
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    • 제16권4호
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    • pp.59-79
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    • 2004
  • 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.

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Effects of Water Exercise on the Foot Pressure Distribution of a Female Adult with Hemiplegia: A Biomechanical Case Study

  • Lee, In-Woo;Kim, Jin-Ki;Yang, Jeong-Ok;Lee, Joong-Sook;Lee, Bom-Jin
    • 한국운동역학회지
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    • 제23권2호
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    • pp.179-187
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    • 2013
  • This case study was conducted to determine the effects of water exercise on the foot pressure distribution (FPD) of persons who have a hemiplegia. A 43-year old female with hemiplegia acquired at the age of 3 years was selected from a local disability program. A 12-week water exercise program (60 min. per session and twice a week) focusing on gait training was developed and implemented as the intervention of this study. A recent product of the Pedar-X (Novel, Germany) was used to measure the FPD of hemiplegic gait before and after the intervention. Variables considered in this study included the average pressure (AP), contact area (CA), maximum pressure (MP), ground reaction force (GRF), and center of pressure (COP). The data collected were analyzed via the descriptive statistics and qualitative analyses on the graphical presentations of the FPD. Results revealed that the AP and CA of the hemiplegic foot was considerably increased before and after the intervention. Similar results were also found in the MP and GRF. Additionally, the graphical route of the COP related to hemiplegic foot was changed in a positive way after the intervention. It can be concluded that water exercise may be beneficial to restore hemiplegic gait. Limitations related to measurement and generalizability are further discussed.

만성 편마비 환자의 발목에 적용한 능동운동을 동반한 관절가동술이 하지근력과 보행의 시공간적 변수에 미치는 영향 (Effects of Ankle Joint Mobilization With Movement on Lower Extremity Muscle Strength and Spatiotemporal Gait Parameters in Chronic Hemiplegic Patients)

  • 안창만;원종임
    • 한국전문물리치료학회지
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    • 제19권3호
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    • pp.20-30
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    • 2012
  • The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

고유수용성 신경근 촉진법 하지 패턴에 기초한 탄력밴드 훈련이 만성 편마비 환자의 보행에 미치는 영향 (The Effect of Elastic Theraband Exercise Based of PNF L/E Pattern on the Gait of the Chronic Hemiplegic Patients)

  • 김좌준;김광일;김도환;성용인;신승제
    • PNF and Movement
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    • 제5권2호
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    • pp.47-54
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    • 2007
  • Purpose : The purpose of this study were to determine the effect of a Elastic Theraband Exercise Based of PNF L/E pattern on the gait of the chronic Hemiplegic Patients. Methods : We selected the 20 chronic Hemiplegic Patients not given treatment now and divided them into two groups of both 10 Elastic Theraband group and 10 Self Exercise. The first group went through a Elastic Theraband Exercise Based of PNF L/E pattern 30 minutes a day, 5 times a week, for 6 weeks. Exercise used to blue elastic band which 2 patterns of PNF by 1) hip extension - abduction - internal rotation with knee extension. 2) hip flexion - adduction - external rotation with knee flexion. The latter group experienced Self Exercise, 30 minutes a day, 5 times a week, for 6 weeks. Firstly, we measured the absolute improvement of gait velocity(m/s), cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6). Data analysis was performed with using SPSS 12.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; Results : 1. There was a more significant improvement of Gait velocity(0.12m/s) Elastic Theraband group(p<.05). 2. There was a more significant improvement of cadence(9.40steps/min) Elastic Theraband group(p<.05). Conclusion : As we can see from above, the findings suggest that Elastic Theraband may be more effective than the Self Exercise for improving some gait parameters such as Gait velocity and Cadency. This conclusion also suggest that Elstic Theraband is more effective for the improvement of gait of chronic Hemiplegic Patients.

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편마비환자에게 플라스틱 단하지 보조기착용 전${\cdot}$후 선자세 균형과 동적 움직임에 미치는 효과 (The immediate effect standing balance and dynamic activity on barefoot, wearing SPAFO and wearing HPAFO in hemiplegic patients)

  • 임호용;박승규
    • The Journal of Korean Physical Therapy
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    • 제17권1호
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    • pp.96-107
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    • 2005
  • Objective: The purpose of this study were to investigate the standing balance, dynamic activity in hemiplegic patients according to the types of ankle-foot orthosis(AFO) and to determine the most effective type of AFO for gait training. Method: A prospective study was performed for 16 patients with hemiplegia who was able to walk independently. Static balance and dynamic activity were compared in two condition : 1) barefoot and SPAFO, 2) barefoot and HPAFO. Static balance and dynamic activity characteristics were evaluated by Active Balance while they were standing with in two condition AFO and barefoot. Results: There were significant difference in standing balance between barefoot and wearing SPAFO and HPAFO(p<0.05). There were significant difference in dynamic activity balance between barefoot and wearing SPAFO and HPAFO(p<0.05). There were significant difference in gait speed between barefoot and wearing SPAFO and HPAFO(p<0.05). Conclusion: This study showed that wearing SPAFO and HPAFO gave fair amount of improvement to balance and gait ability of hemiplegic patients.

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Effects of Gait Training Using Functional Electrical Stimulation on Stroke Patients' Balance and Gait Velocity

  • Kang, Kwon-Young;Choi, Wan-Suk;An, Ho-Jung;Koo, Ja-Pung;Lee, Joon-Hee;Yun, Young-Dae;Lee, Jung-Sook;Jung, Joung-Youl;Lee, Sang-Bin
    • 국제물리치료학회지
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    • 제2권2호
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    • pp.288-293
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    • 2011
  • The purpose of this study is to examine the effects of gait training using functional electrical stimulation on the improvement of hemiplegic patients' functions for balance and gait velocity. The subjects of the experiment were determined to be 10 each hemiplegic patients who had been diagnosed with stroke or brain damage six months or longer earlier assigned to an experimental group and a control group respectively. The subjects were evaluated before the experiment using Tetrax and 10M gait tests, received gait training five times a week for four weeks using functional electrical stimulation and were evaluated after the experiment in the same method as used in the evaluation before the experiment. In order to examine differences between the experimental group that received gait training using functional electrical stimulation and the control group that was treated by functional electrical stimulation and received gait training thereafter, differences between before and after the experiment were analyzed using paired sample t-tests and differences in changes after the experiment between the experimental group and the control group were analyzed using independent sample t-tests in order to compare the two groups with each other. Experimental results showed significant differences in weight bearing, balance and gait velocity between before and after the experiment in the experimental group(p<.05). In the control group, whereas weight bearing and gait velocity did not show any significant difference between before and after the experiment(p>.05), balance showed significant differences(p<.05). Weight bearing, balance and gait velocity change rates showed significant differences between the experimental group and the control group(p<.05). In conclusion, it was indicated that gait training using functional electrical stimulation is effective for enhancing stroke patients' weight bearing rates, balance abilities and gait velocity.

Effects of Treadmill Gait Training According to Different Inclination on Postural Balance in Patients with Chronic Stroke

  • Choi, Myeong Su;Lee, Jong Su;Kim, Kyoung;Kim, Young Mi
    • The Journal of Korean Physical Therapy
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    • 제30권6호
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    • pp.205-210
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    • 2018
  • Purpose: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. Methods: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: $0^{\circ}$ treadmill gait training (n=14), $5^{\circ}$ treadmill gait training (n=15), and $10^{\circ}$ treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. Results: This study showed that gait training on a treadmill at controlled inclinations of $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ positively influenced the stroke patients' standing balance. The $5^{\circ}$ and $10^{\circ}$ inclination gait training groups showed significantly more improvement than the $0^{\circ}$ inclination group. Conclusion: Gait training on a treadmill with inclinations of $0^{\circ}$, $5^{\circ}$, or $10^{\circ}$ can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, $5^{\circ}$ and $10^{\circ}$ inclination gait training offered more significant improvement than the $0^{\circ}$ inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.