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Leg Length Discrepancy to Influence on Kinematic Changes of the Pelvis and the Hip during Gait

  • Yong, MinSik;Park, SoHyun
    • The Journal of Korean Physical Therapy
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    • 제31권6호
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    • pp.368-371
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of leg length discrepancy on kinematic changes of the pelvis and hip during gait. Methods: A total of ten healthy women with no history of neurological, musculoskeletal surgery or injuries, or pain in the lower limbs were recruited. They were assigned to two groups; the experimental group (LLD) consisting of five subjects leg length discrepancy of 10mm to 18mm and the control group (CON) consisting of five subjects leg length discrepancy of<10 mm. All participants were instructed to perform three walking trials for further analysis by using the Cortex 3.0 software program. Independent T-test and Mann-Whitney test were used to examine the effects of mild LLD on kinematic changes of the pelvis and hip during gait. Results: Angles of hip flexion, hip abduction, pelvic obliquity, and pelvic tilt in the experimental group were not significantly different compared to those of the control group. Conclusion: Mild leg length discrepancy induces kinematic changes in the lower limbs, including decreased hip flexion, increased hip abduction, and increased pelvic obliquity in the shorter limb, and increased hip adduction and increased pelvic obliquity in the longer limb. However, those changes were not significant.

기능적 전기 자극을 적용한 전동식 보행 훈련이 편마비 환자의 보행에 미치는 영향 (Effectiveness of Gait Training Using an Electromechanical Gait Trainer Combined With Simultaneous Functional Electrical Stimulation in Chronic Stroke Patients)

  • 안승헌;이윤미;양경희
    • The Journal of Korean Physical Therapy
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    • 제20권1호
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    • pp.41-47
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    • 2008
  • Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

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참장공이 악력 증가에 미치는 영향 (Effect of Qigong(Zhan zhuang gong) on Grip Strength Improvement)

  • 조문형;황의형;장인수;양창섭;강준원
    • 한방재활의학과학회지
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    • 제21권4호
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    • pp.219-226
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    • 2011
  • Objectives: The aim of this pilot study is to investigate qigong as a trailing method to treat diseases and improve the quality of life. Methods: We used a controlled clinical study in this research qigong group(n=34) practiced the zhan zhuang gong for 2 minutes. Control group(n=33) did low intensity walking for 2 minutes. Changes of grip strength, heat rate and rating of perceieved exertion were measured before and after treatment. Paired t-tests and independent t-tests were applied for statistical analysis. Results: Qigong group showed significant improvement in grip strength(p<0.05), whereas the control group showed insignificant changes(p<0.05). Both groups demonstrate significant changes in heart rate(p<0.05). In rating of perceieved exertion, significant difference showed between groups(p<0.05). Conclusions: The zhan zhuang gong, a kind of qigong improved grip strength by 2 minutes of practice. We may conclude that zhan zhuang gong could be a method of improving physical strength.

Physical Activities and Health-related Quality of Life of Individuals Post Stroke

  • Choi, Young-eun;Kim, Ji-hye
    • 대한물리의학회지
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    • 제10권2호
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    • pp.47-54
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    • 2015
  • PURPOSE: The purpose of this study is to examine the relationship between the physical activities of individuals post-stroke and their HRQL, as well as to determine whether their functional abilities contribute to their amounts of physical activity. METHODS: The study's subjects included 90 individuals post-stroke. Their amounts of physical activity were measured using the International Physical Activity Questionnaire (IPAQ), and their HRQL was measured using the Medical Outcomes Study 36-Item Short-form Health Survey (SF-36). In addition, the functional abilities of the subjects were measured. For the measures of physical activities and the HRQL, Pearson's correlation coefficients were used to identify the strengths of the associations between the measures. A hierarchical linear regression model was used to determine whether physical activities had independent impacts on the HRQL. RESULTS: This study found that the physical activities performed by the subjects affected the SF-36 physical component score (PCS) (12%). However, the physical activities and the SF-36 mental component score (MCS) showed no statistically significant relationship, whereas functional abilities and physical activities had a statistically significant relationship (r = .57~.86, p<.001). CONCLUSION: The present study identified a correlation between physical activity and the PCS. Therefore, individuals post-stroke should be encouraged to carry out more physical activities, including more frequent walking activities.

Relationship of Cognitive Functions and Physical Activities in Persons with Chronic Stroke

  • 우영근
    • PNF and Movement
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    • 제10권4호
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    • pp.1-7
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    • 2012
  • Purpose : The purpose of this study was to evaluate the relationship between physical performance, such as gait and postural control, and cognition on as assessed by clinical tools in individuals with chronic hemiparetic stroke. Methods : Twenty-six patients who had hemiparetic stroke participated in this study, and were evaluated four common clinical measurements, including the Berg balance scale (BBS), 10 meter walk test (10MWT), 6 minute walking test (6MWT), and Montreal cognitive assessment (MoCA). Multiple regression analysis was used BBS score, 10MWT, and 6MWT as the dependent variables; MoCA score, post-stroke duration, age, and affected side as independent variables. Results : In the regression equation of the BBS score, the correlation coefficient (r) was 0.875, the coefficient of determination (R2) was 0.786, and the MoCA score was the most important variable for determining the BBS score. In the regression equation for the 10MWT, ther was 0.888, the R2 was 0.999, and the MoCA score was the most important variable for determining 10MWT. Finally, the r was 0.777, the R2 was 0.998, and the MoCA score was the most important variable for determining 6MWT in the regression equation of the 6MWT. Conclusion : The results show that cognitive abilities affect gait proficiencies in individuals with chronic hemiparetic stroke. Therefore, these results suggest that cognitive tests are necessary for examining and evaluating the abilities of postural control and gait performance for chronic stroke patients in research and clinical environments.

Gait Recovery Characteristic According to the Injury Aspect of Descending Motor Pathway in a Chronic Stroke Patient: a Case Study

  • Sang Seok Yeo
    • The Journal of Korean Physical Therapy
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    • 제34권6호
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    • pp.326-331
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    • 2022
  • Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

보행 관련 뇌파의 신호원 추정을 위한 비통합 데이터 분석 방법 (A non-merging data analysis method to localize brain source for gait-related EEG)

  • 송민수;정지욱;지인혁;추준욱
    • 전기전자학회논문지
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    • 제25권4호
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    • pp.679-688
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    • 2021
  • 보행능력은 의학적으로 다양한 뇌신경계 질환에서 사용되는 평가 지표이다. 보행에 관련된 뇌 활성화를 측정하고 분석하는 방법으로 뇌파 데이터에 대해 독립성분을 추출한 뒤 신호원 추정 및 시간-주파수 분석이 주로 사용된다. 기존의 트레드밀 기반 보행 뇌파 분석은 분할 측정한 뒤, 데이터를 병합하여 신호 전처리, 독립성분분석 및 신호원 추정을 수행하고 피험자 간 군집화를 통하여 대표 성분 클러스터들을 추출한다. 본 연구에서는 보행 뇌파에 대하여 데이터 통합 없이 각각의 분할 측정된 데이터에 대하여 개별적으로 신호 전처리, 독립성분분석 및 신호원 추정을 수행하고 모든 피험자로부터 추정된 독립성분에 대하여 피험자 간 군집화를 수행하는 새로운 방법을 제안한다. 데이터 통합이 독립성분 군집화 및 시간-주파수 분석에 미치는 영향을 조사하기 위해 기존의 통합 데이터에 기반한 두 가지 분석 방법과 본 연구에서 제안하는 데이터 통합이 없는 분석 방법을 비교하였다. 그 결과, 통합 데이터 방법들에서는 각각 2개씩의 성분 클러스터를 도출하였으나 제안하는 방법을 통해 4개의 성분 클러스터를 도출, 적은 피험자 수에도 불구하고 세분화된 보행 뇌 신호 성분 클러스터를 도출할 수 있었음을 확인하였다.

혈액투석 환자의 신체 활동 증가가 건강관련 삶의 질과 영양섭취에 미치는 영향 (Effects of Ingressed Physical Activity in Hemodialysis Patients on Health-related Quality of Life and Nutritional Intake)

  • 박영주
    • 한국콘텐츠학회논문지
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    • 제20권11호
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    • pp.511-524
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    • 2020
  • 연구목적은 혈액투석환자를 위한 혈액투석 중 자전거운동과 걷기운동을 개발하여 적용하고, 혈액투석환자의 신체 활동량이 건강관련 삶의 질과 영양섭취에 미치는 영향을 확인하기 위함이다. 연구방법은 혈액투석환자에게 적용한 유산소 운동 프로그램의 효과를 확인하기 위한 비동등성 대조군 전·후 실험연구이다. 연구대상자는 중재군과 대조군에 각각 30명이 배정되어 총 60명이었다. 운동중재는 두 종류의 유산소 운동이 포함되어 있으며, 총 8주간 진행되었다. 첫 번째 운동은 일주일에 세 번씩 혈액투석 중 수행되는 자전거운동이었고 두 번째 운동은 일주일에 최대 7 일 동안 실시되는 걷기운동이었다. 통계분석은 기술통계, 독립표본 t-test, 𝑥2-test와 Mann-Whitney U test를 사용하였다. 영양섭취는 CAN-2.0을 사용하여 평가하였다. 연구결과는 중재군이 중재 후 신체활동량 점수가 유의하게 높았으며, 신체적 건강관련 삶의 질도 중재 후 유의하게 개선되었다. 그러나 영양섭취는 중재 전 후 유의한 차이가 없었다. 비록 그룹 간의 차이는 없었지만, 총 칼로리 섭취는 중재 후에 중재군이 대조군보다 높은 것으로 나타났다. 신체적 건강관련 삶의 질은 동물성 단백질, 망간, 셀레늄과 비타민 C와 유의한 상관관계가 있었다. 본 연구는 혈액투석 중 자전거운동과 걷기운동은 신체활동량과 신체적 건강관련 삶의 질을 향상시키는데 효과적인 것으로 나타났다. 따라서, 본 연구결과는 혈액투석환자의 운동증진을 위한 지침으로 사용될 수 있을 것이다.

기능적 과제를 통한 다관절 관절위치감각 훈련이 뇌졸중 환자의 관절위치감각, 균형, 보행능력에 미치는 효과 (The Effects of Multi Joint-Joint Position Sense Training Using Functional Task on Joint Position Sense, Balance, Walking Ability in Patients With Post-Stroke Hemiplegia)

  • 고경희;최종덕;김미선
    • 한국전문물리치료학회지
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    • 제22권3호
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    • pp.33-40
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    • 2015
  • The purpose of this study was to investigate the effect of multi joint-joint position sense (MJ-JPS) training on joint position sense, balance, and gait ability in stroke patients. A total of 18 stroke patients participated in the study. The subjects were allocated randomly into two groups: an experimental group and a control group. Participants in the experimental group received MJ-JPS training (10 min) and conventional treatment (20 min), but participants in the control group only received conventional treatment (30 min). Both groups received training for five times per week for six weeks. MJ-JPS is a training method used to increase proprioception in the lower extremities; as such, it is used, to position the lower extremities in a given space. MJ-JPS measurement was captured via video using a Image J program to calculate the error distance. Balance ability was measured using Timed Up and Go (TUG) and the Berg Balance Scale (BBS). Gait ability was measured with a 10 m walking test (10MWT) and by climbing four flights of stairs. The Shapiro-Wilk test was used to assess normalization. Within-group differences were analyzed using the paired t-test. Between-group differences were analyzed using the independent t-test. The experimental group showed a significant decrease in error distance (MJ-JPS) compared to the control group (p<.05). Both groups showed a significant difference in their BBS and 10MWT results (p<.05). The experimental group showed a significant decrease in their TUG and climbing results (p<.05), but the control group results for those two tasks were not found to be significant (p>.05). There was significant difference in MJ-JPS and by climbing four flights of stairs on variation of pre and post test in between groups (p<.05), but TUG and BBS and 10MWT was no significantly (p>.05). We suggest that the MJ-JPS training proposed in this study be used as an intervention to help improve the functional activity of the lower extremities in stroke patients.

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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