• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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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.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.10a
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• pp.285-288
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• 2022

Objectives : This study aimed to determine whether Variability of Walking Environment Training can improve gait and balance in stroke patients. Methods : Twenty-four stroke patients are randomly assigned to experimental group 1 (n=8), experimental group 2 (n=8) and control group (n=8). Experimental group 1 performed unexpected obstacle walking training, experimental group 2 performed fixed obstacle walking training and control group performed non obstacle walking training for 12 minutes per session, 5 times a week for 4 weeks. The gait analyzer G-walk were evaluated using gait cadence, gait velocity, and stride length, balance was evaluated using FES-K and BBS. Results : In within-group comparison of gait cadence, gait velocity and stride length of change, the experimental 1,2 groups showed significant improvements post intervention (p<.05) but control group showed no significant improvement. In between-groups comparison there was significant difference in the change of gait cadence, gait velocity and stride length pre and post intervention. In within-group comparison of FES-K and BBS scores, the experimental 1,2 groups showed significant improvements post intervention (p<.05) but control group showed no significant improvement. In between-groups comparison there was significant difference in the change of FES-K and BBS scores pre and post intervention (p<.05).

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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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.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.1
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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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• v.21 no.1
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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.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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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.

• Korean Journal of Applied Biomechanics
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• v.17 no.4
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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.

• Korean Journal of Applied Biomechanics
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• v.21 no.4
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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.

• Korean Journal of Applied Biomechanics
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• v.20 no.2
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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.

• Korean Journal of Applied Biomechanics
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• v.18 no.2
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• pp.11-17
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• 2008

Falls associated with tripping over an obstacle can be dangerous, yet little is known about the strategies used for stepping over obstacles by Parkinson's patients. The purpose of this study was to investigate stepping over gait characteristics according to obstacle height in Parkinson's patients. The gait of 7 Parkinson's patients was examined during a 5.0 m approach to, and while stepping over, obstacles of 0, 2.5, 5.2, and 15.2 cm. Only five Parkinson's patients were able to clear all obstacles successfully; as such, only their data were analyzed. A one-way ANOVA for repeated measures was employed for selected kinematic variables to analyze the differences of the height of four obstacles. The results showed significant differences between obstacle height and: approaching speed (AS), foot clearance from the obstacle(FC), and step width (SW). The results showed no significant differences between obstacle height and: crossing speed (CS), toe distance (TD), and heel distance (HD). This strategy tends to reduce the risk of toe contact with the obstacle. Parkinson's patients were stepping over the obstacle slowly, stably and inefficiently.