• 대한통합의학회지
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• 제9권2호
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• pp.23-33
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• 2021

Purpose : This study aimed to investigate the effects of dual-task training according to the variability of the walking environment on balance, gait, and function in patients with stroke. Methods : Twenty-five patients with stroke were randomly assigned to experimental group I (n=12) and experimental group II (n=13). Experimental group I and II performed obstacle and non-obstacle walking training, respectively, along with cognitive tasks for 21 minutes per session, 3 times a week for 6 weeks. Both groups received additional general physical therapy for 30 minutes per session. The functional reach test (FRT), gait analyzer (G-Walk), and functional independence measure (FIM) were used to evaluate balance, gait and function of pre- and post-interventions, respectively, while gait cadence, gait velocity, and stride length were evaluated using a gait analyzer. Results : In the within-group comparison of FRT, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait cadence, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait velocity, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of stride length, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). In within-group comparison of FIM scores, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). There was a significant difference in the change of FIM scores pre- and post-intervention (p<.05) in the between-group comparison. Conclusion : The results of this study show that dual-task training with cognitive tasks and walking training can improve the balance, gait and function of patients with stroke, and obstacle walking training is effective for improving functions including activities of daily living compared to non-obstacle walking training.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.285-288
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• 2022

장애물보행훈련이 뇌졸중 환자의 보행 및 균형에 미치는 효과를 확인하고자 장애물보행과 평지보행훈련 후 변화를 보기 위해 보행과 균형을 평가하였다. 훈련 전후 보행과 균형에서 장애물보행훈련을 한 실험군이 유의미한 차이를 보였고 평지보행을 한 대조군은 유의미한 차이를 보이지 않았으며 두 군간에는 유의미한 차이를 보였다.

• 대한물리치료과학회지
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• 제15권3호
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• pp.55-63
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• 2008

Background : The Purposes of this study were to understand difference between free walking and obstacle over walking through the naked eye and motion analysis device, and to review merits of obstacle walking training as item of functional assessment in clinical situations. Methods : All participants were male and performed 3 types of walking methods: free walking, obstacle over walking with low block(height=10cm, width=8cm), and obstacle over walking with high block(height=20cm, width=8cm). All walking were performed 3 trials respectively. Results : In the naked eye, initial contact with toes occurred more than heel strike in obstacle over walking, and the flexion angle of hip and knee were increased in obstacle over walking. On interpretations though motion analysis device, cadence, gait speed and weight accept were significant statistically(p<.05). Cadence and gait speed were decreased, and weight accept duration was increased in obstacle over walking. Rotation among three pelvic motions was significant statistically(p<.05), flexion among three hip motions was significant statistically(p<.05) and flexion among three ankle motions was significant statistically(p<.05). Rotation and flexion among three ankle motions was significant statistically(p<.05). Conclusion : Both the naked eye and interpretations of the device presented many difference between free walking and obstacle over walking. In overcrossing obstacles, many participants appeared walking strategy by perform initial contact with toes. Knee flexion was most significant statistically(p<.05) in obstacle over walking with 20cm block.

• 대한물리의학회지
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• 제7권1호
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• pp.125-135
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• 2012

Purpose : This study is designed to demonstrate the effects of circuit obstacle group gait training on walking ability and emotion in stroke patients. Methods : Twenty one patients with stroke were participated in this study. The subjects were divided into control group(n=10) and experimental group(n=11). Circuit obstacle group gait training consisted of walking around obstacles, walking over obstacles, walking up and down slopes and walking up and down stairs. Circuit obstacle group gait training was conducted five times per week, 1 hour per session, for 6 consecutive weeks. At pre-test and post-test, subjects were tested with 10 m walking test, timed up and go test, up and down 4 stairs test, depression and self esteem. Results : After 6 weeks of research, the experimental group showed statistically significant difference in all items when comparing prior to training and after training (p<.05), but the control group showed statistically significant difference in items other than depression and self esteem(p<.05). In the comparison between the two groups, the experimental group showed higher improvement than the control group in the 10 m walking test, timed up and go test, and up and down 4 stairs test, and there was statistically significant difference in decrease of degree in depression between the experimental group and control group(p<.05). Conclusion : This study have shown that circuit obstacle group gait training improves walking ability and emotion in stroke patients.

• PNF and Movement
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• 제21권1호
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• pp.119-128
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• 2023

Purpose: Obstacle crossing training is being used to improve the walking ability of stroke patients, but studies on which method is more effective when performing obstacle crossing training with an unaffected limb lead (OCT-ULL) and an affected limb lead (OCT-ALL) are not well known. As such, this study aims to compare the intervention effects of obstacle crossing training using unaffected limb leads (OCT-ULL) and obstacle crossing training using affected limb leads (OCT-ALL). Methods: In total, 25 patients with chronic stroke were studied and assigned randomly to the obstacle crossing training with unaffected limb leads (OCT-ULL) group or the obstacle crossing training with affected limb leads (OCT-ALL) group. A lower extremity strength test, balance and gait test, and fall efficacy test were conducted as preliminary tests, and all patients participated in the intervention for 30 minutes a day, five days a week for four weeks, and the same preliminary tests were conducted post-intervention. Results: Compared with the OCT-ALL group, the OCT-ULL group showed a significant improvement in the strength of the affected hip abductor muscle and in balance and gait, as well as in fall efficacy (p<.05). Conclusion: This study suggested that applying the OCT-ULL training method in the obstacle crossing training of stroke patients is more effective for improving balance and gait functions than OCT-ALL.

• 대한물리의학회지
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• 제9권1호
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• pp.69-74
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• 2014

PURPOSE: The aim of this study is to compare the spatio-temporal gait parameters between paretic and non-paretic limb while stepping over the different obstacle's heights in subjects with stroke. METHODS: Nine subjects with stroke were participated in this study. Subjects were asked to step over obstacles with a different height. 8 camera motion analysis system(Motion Analysis Corporation, Santa Rosa, USA) was used to measure spatio-temporal parameters. The two way repeated measurement ANOVA was used to compare spati-temporal gait parameters between paretic and non-paretic limbs while stepping over a different obstacle's height(0cm, 10cm, 20cm). RESULTS: Step width, velocity, single supoort time, and double support time were not different among obstacle's height(p>0.05) but stride length, step length, and cadence were significantly different(p>0.05). In stride length, cadence, and double support time, the interactions between obstacle's heights and limbs were not different(p>0.05) but it was significantly different in velocity, step length, and single support time(p<0.05). Velocity, stride length, cadence, and double support times were not different between paretic limb and non-paretic limb(p>0.05) but step length and single support times were significantly different between paretic limb and non-paretic limb(p<0.05). CONCLUSION: These results show that there are differences with spatio-temporal gait parameters among obstacle's heights and between paretic and non-paretic limb during obstacle crossing in subjects with stroke.

• 한국운동역학회지
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• 제17권4호
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• pp.141-148
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• 2007

Falls associated with tripping over an obstacle can be dangerous, yet little is known about the strategies used for stepping over obstacles in older Parkinson disease. The purpose of this study was to investigate the lower extremity muscle activity on the obstacle gait according to obstacle height in older Parkinson diseases. The obstacle gait of 7 older Parkinson disease was examined during a 5.0 m approach to, and while stepping over, obstacles of 0, 25, 52, and 152mm. Seven pairs of surface electrodes(Noraxon MyoResearch, USA) were attached to the right-hand side of the body to monitor the adductor longus(AL), gluteus medius(GME), gluteus maximus(GMA), biceps femoris(BF), rectus femoris(RF), gastrocnemius(GA), tibialis anterior(TA). Electromyography data were filtered using a 10Hz to 350 Hz Butterworth band-pass digital filter and normalized to the maximum value in the analyzed phases. A one-way ANOVA for repeated measures was employed for selected electromyography variables to analyze the differences of the height of four obstacles. The results showed significant differences between 0.0mm and 25, 52, and 152mm obstacle height in TA and GA activities during the second phase(swing phase). But the more increase obstacle height, the more not increase the muscle activities. This means that the Parkinson disease stepping over obstacle inefficiency. To prevent and reduce the frequency of falls, elderly Parkinson disease maintained and improved their balance, muscular strength, neuromuscular control and mobility.

• 한국운동역학회지
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• 제21권4호
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• pp.459-466
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• 2011

The purpose of this study was to analyze of obstacle gait using spatio-temporal and foot pressure variables in children with autism. Fifteen children with autism and fifteen age-matched controls participated in the study. Spatio-temporal and foot pressure variables was investigated using GAITRite pressure sensor system. Each footprint was divided into 12 equal trapezoids and after that the hindfoot, midfoot and forefoot analysis was developed. Independent t-test was applied to compare the gait variables between the groups. The results showed that the autism group were significantly decreased in velocity, cadence, cycle and swing time compared to the control group. The autism group were significantly increased in step width and toe out angle compared to the control group. The autism group were significantly increased at midfoot and forefoot of lateral part of footprint and forefoot of medial part of footprint in the peak time compared to the control group. The autism group were significantly increased at midfoot and hindfoot in $P^*t$, at midfoot in active area, and at hindfoot in peak pressure compared to the control group. In conclusion, the children with autism showed abnormal obstacle gait characteristics due to muscle hypotonia, muscle rigidity, akinesia, bradykinesia and postural control impairments.

• 한국운동역학회지
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• 제20권2호
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• pp.129-137
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• 2010

The purpose of this study is to investigate the effect of a 12-week aquatic exercise on obstacle gait in older women. Originally, 20 healthy female elderly participated this study but 12 of them completed the program. All participants were trained in the aquatic exercise program by an authorized trainer. They had come to the authors' lab three times during training period(0, 6, 12 weeks) and performed obstacle gait with three different height(0, 30, and 50% of leg length). After performed 3-Dimensional motion analysis following results were found. (1) For the CV, MVHC, TC, HC, statistically significances were shown in obstacle height. Although significant training effects were not shown, all variables showed typical patterns and it was considered as efficient motion to overcome the height obstacles. (2) The anterior-posterior and vertical GRF of support leg during support phase were revealed in height effect but in training one. However, differences between Peak 1 and Peak 2 in vertical GRF increased as training period increased. (3) Knee and hip resultant joint moments were affected by training but ankle resultant moments remained unchanged.

• 한국운동역학회지
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• 제18권2호
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• pp.11-17
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• 2008

파킨슨 환자들이 장애물에 걸려서 넘어지는 것은 위험한데, 아직까지 이와 관련된 연구는 미비한 실정이다. 본 연구의 목적은 장애물 보행을 성공적으로 수행한 5명을 대상으로, 4가지 높이(0, 2.5, 5.2, 15.2cm)의 장애물을 넘을 때 나타나는 보행 특성의 차이를 밝히는 것이다. 연구결과, 파킨슨 환자들은 장애물 높이가 높아질수록 장애물에 더 천천히 접근하였으며, 장애물의 높이가 높을수록 발이 장애물에 걸리지 않도록 더 높이 발을 들어 넘었다. 또한, 파킨슨 환자들은 장애물의 높이가 높을수록 더 안정되게 넘기 위해서 좌.우발 사이의 거리를 넓게 해서 넘었다. 파킨슨 환자들은 각 장애물별로 넘는 속도를 일정하게 하고, 장애물을 넘기 전 왼발 앞꿈치와 장애물과의 수평거리 및 장애물과 장애물을 넘은 오른발 뒷꿈치와의 수평거리에서 차이가 없이 장애물을 넘었다. 이와 같은 특성이 파킨슨 환자들이 장애물을 넘는 일반적인 전략인 것으로 판단된다. 결론적으로 파킨슨 환자들은 장애물을 천천히, 조심스럽게, 그리고 비효율적으로 넘는 것으로 나타났다.