• 대한물리의학회지
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• 제17권1호
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.36-43
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• 2007

Purpose: An objective analysis and observations were to be done on hemiplegia patients that are wearing a walking support device, Stroke shoes. Their improvements in walking pace, the reduction of distance between the two knee joint, the increase of curve angle of the knee joint and their steps and the reduction of ankle joint upon swing phase were analyzed using a 20 walking analyzer. Methods: An examination was carried out to see the patients' communication skill and independent walking and then let them walk with the Stroke shoes on to get results before and after wearing it. Simi Reality Motion Systems GmbH (Germany, 2007) was used to analyze the results regarding knee joint and ankle joint angle changes of sagitta plane and coronal plane, stepping distances, distances between the knees and walking pace. Results: 1. The articulation angle of ankle joint during swing phase decreased and knee joint has shown a statistically significant increase in such value(p<0.05). 2. Only knee joint showed a significant increase in articulation angle during heel strike(p<0.05). 3. Knee joint showed a significant increase in articulation angle during toe off(p<0.05). 4. The distance between the two knees as well as their foot steps significantly decreased compared with when Stroke shoes were not worn(p<0.05). 5. Stroke shoes with FES have shown positive effects on the patients in improving their walking styles overall. (p<0.05). Conclusion: There was an improvement in rotation walking pattern by a reduction in the distance between the knees after wearing Stroke shoes with FES. Plantar flexion reduced that occurred in ankle joint during walking and flexion angle increased in knee joint, both of which improved foot drop which was a major problem in hemiplegia patients. Also it is believed that the device will have some positive influences on knee joint stiffening paralysis to aid in improving inefficient walking phases.

• 한국간호교육학회지
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• 제14권1호
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• pp.20-29
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• 2008

Purpose: This research was conducted to compare the effects of a muscle strengthening exercise program on pain, straight leg raising ability, passive range of motion, independent walking time and satisfaction with total knee arthroplasty(TKA). Method: A nonequivalent control group posttest only design was used for this study. A total of 62 patients were randomly divided into the experimental group(31) and the control group (31). The experimental group received a 1-hour exercise intervention, while the control group received the usual care. Data was analyzed by t-test using the SPSS/WIN 11.0. Results: The experimental group showed significant improvement in pain score, straight leg raising ability, passive range of motion of knee joint, independent walking time, and the patient's satisfaction. Conclusion: The muscle strengthening exercise program was effective on decreasing pain and increasing mobility and satisfaction in patients with TKA.

• 제어로봇시스템학회논문지
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• 제12권9호
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• pp.926-934
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• 2006

This paper proposes intelligent control of a virtual walking machine that can generate infinite floor for various surfaces and can provide proprioceptive feedback of walking to a user. This machine allows users to participate in a life-like walking experience in virtual environments with various terrains. The controller of the machine is implemented hierarchically, at low-level for robust actuator control, at mid-level fur platform control to compensate the external forces by foot contact, and at high-level control for generating walking trajectory. The high level controller is suggested to generate continuous walking on an infinite floor for various terrains. For the high level control, each independent platform follows a man foot during the swing phase, while the other platform moves back during single stance phase. During double limb support, two platforms manipulate neutral positions to compensate the offset errors generated by velocity changes. This control can, therefore, satisfy natural walking conditions in any direction. Transition phase between the swing and the stance phases is detected by using simple switch sensor system, while human foot motions are sensed by careful calibration with a magnetic motion tracker attached to the shoe. Experimental results of walking simulations at level ground, slope, and stairs, show that with the proposed machine, a general person can walk naturally on various terrains with safety and without any considerable disturbances. This interface can be applied to various areas such as VR navigations, rehabilitation, and gait analysis.

• Journal of Korean Biological Nursing Science
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• 제20권3호
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• pp.141-149
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• 2018

Purpose: This study was conducted to examine the effects walking program with dance on gait, cognition, and risk of falls of elderly with dementia in a long-term care hospital. Methods: Subjects consisted of 42 elderly with dementia in a long-term care hospital (21 elderly with dementia in an experimental group and 21 elders with dementia in a control group). Data were collected from March 14 to April 30, 2016. Subjects in the experimental group performed walking program with dance (three times a week, 30-50 minutes session, 18 sessions). Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, independent t-test, paired t-test, repeated measures ANOVA with the SPSS/WIN 21.0. Results: The participants in the experimental group showed significantly increased scores of cadence (F= 8.36, p= .007) and improved scores of cognition (F= 9.95, p= .003) compared the control group. Conclusion: The findings indicate walking program with dance is recommend a regular exercise program to enhance the cadence associated with walking speed and cognitive function elderly.

• 대한통합의학회지
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• 제5권1호
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• pp.19-24
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• 2017

Purpose : The purpose of this study was to find out the difference motion of hip, knee and ankle joint during walking according to using walker on older people. Method : Korean older people of 34 subjects was participated in this study. Participants was measured joint motion on hip, knee and ankle joint during both conditions (walking with walker and without walker). The measured data were analyzed using independent t-test to investigate the difference of joint motion on the both condition. The statistical analyses were performed using Predictive Analytics Soft Ware (PASW) for windows(Ver. 19) and p-value less than .05 were considered significant for all cases. Result : The study showed that more joint motion on hip flexion and ankle pronation is increased by using walker. And hip extension, knee external rotation and ankle plantar flexion is decreased by using walker. Conclusion : This study suggest that using walker on older people was change the motion of the lower limb joint during walking. Therefore, It is necessary to develop a new walker that can reduce dependency and ensure stability on older people during walking.

• The Journal of Korean Physical Therapy
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• 제30권3호
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• pp.79-83
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• 2018

Purpose: The purpose of this study was to investigate the effects of combined training using proprioceptive neuromuscular facilitation (PNF) patterns and treadmills on the balance and walking ability of stroke patients. Methods: Twenty-three stroke patients were randomized into a control group (n=11), receiving only treadmill training and an experimental group (n=12) receiving combined training. The use of both PNF exercise and treadmill were implemented in the combined training. Interventions were performed 5 times a week for 6 weeks. Balance ability was measured by a timed up and go (TUG) test. Walking ability was measured by a 10-meter walk test (10MWT) and a 6-minute walk test (6MWT). A paired t-test was used to compare differences between pre- and post-intervention and independent t-tests were used to compare between groups. Results: Changes in TUG, 10MWT, and 6MWT before and after interventions were significantly different for both the experimental group and the control group (p<0.05). In addition, within-group changes in the TUG, 10MWT, and 6MWT were more effective in the experimental group than in the control group (p<0.05). Conclusion: Combined training using PNF techniques and treadmills may be useful in improving the balance and walking ability of stroke patients.

• 대한물리의학회지
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• 제12권3호
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• pp.99-104
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• 2017

PURPOSE: Gait disturbances in patients with hemiplegic stroke involve asymmetry of stance time. Step box training is used to supplement the limitations of stair walking training and increasing the torque value of the paralyzed lower leg's strength. This study aimed to investigate whether step-up training on unstable support could change walking ability in patients with chronic stroke. METHODS: Thirty stroke patients were randomly assigned to the step-up training group (experimental group), that performed training on an unstable surface, and the control group, that performed training on a stable surface. Walking speed, step length, and cadence were measured before and after training. Paired t-tests were used to compare pre- and post-intervention data, while the independent samples t-test was used to determine intergroup differences. Values of p < .05 were considered statistically significant. RESULTS: There was a significant difference in walking ability before versus after the intervention in both groups, although the experimental group showed greater differences than the control group (walking velocity by 8.1%; step length of the non-paralyzed side by 6.9%, respectively; p<.05). CONCLUSION: Step-up training might be more effective on an unstable surface than on a stable surface for increasing walking speed and step length of the non-paralyzed side.

• The Journal of Korean Physical Therapy
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• 제29권2호
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• pp.50-54
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• 2017

Purpose: This investigation aimed to determine the effects of treadmill training (TT) and high frequency chest wall oscillation (HFCWO) on pulmonary function and walking ability in stroke patients as well as propose an exercise program to improve cardiovascular function. Methods: Twenty hemiplegic stroke patients were randomized to either the control group (CG) (n=10) or the experimental group (EG), which received TT and HFCWO (n=10). Pulmonary function was quantitated using patient forced vital capacity (FVC) and forced expiratory volume at one second (FEV1) while walking speed was assessed by the 10m walking test (10MWT). Further, walking endurance was determined utilizing the 6-minute walk test (6MWT). Subjects of the EG performed the study protocol for 60 minutes, five times a week for six weeks; CG patients did not participate in regular exercise. To determine significance for the differences observed before and after exercise, within-group and between-group comparisons were conducted utilizing paired and independent t-tests, respectively, with the level of significance set at ${\alpha}=0.05$. Results: Within-groups, significant differences were observed in both FVC and FEV1 (p<0.01) following completion of the study protocol. Further, between-group comparisons demonstrated significant differences in both FVC (p<0.05) and FEV1 (p<0.01). Post-exercise, significant changes in the 10MWT and 6MWT score were observed between the EG and CG (p<0.01). Further, statistically significant differences were observed in 6MWT scores between-groups (p<0.05). Conclusion: The TT and HFCWO effectively improved pulmonary function and walking ability in subjects with stroke. The proposed program can be applied to stroke patients as a useful therapy.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.16-25
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• 2011

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.