• PNF and Movement
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• 제20권2호
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• pp.167-177
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• 2022

Purpose: Pes planus is a common foot deformity that involves the loss of the medial longitudinal arch. The medial longitudinal arch deformity is usually asymptomatic; however, it can lead to an increased risk of pain and injury. Low-Dye taping is designed to treat plantar heel pain and pes planus. However, low-Dye taping is relatively complex, and a considerable amount of time is required to apply the tape correctly. The purpose of this study was to compare the acute effect of two different types of taping (low-Dye taping and modified Mulligan taping) on arch reformation, plantar pressure, and gait characteristics in participants with asymptomatic flexible pes planus. Methods: Twenty subjects (9 males and 11 females; mean age = 21.95 years) with asymptomatic flexible pes planus voluntarily participated in this study. Arch reformation was evaluated using navicular height measurements. Changes in plantar pressure distribution were measured using BioRecue equipment. Gait parameters were measured using spatiotemporal data collected during consecutive gait cycles using a G-WALK device. One-way analysis of variance was used to compare the three different conditions (i.e., bare foot, low-Dye taping, and modified Mulligan taping) for each variable. Results: Navicular height was significantly increased in subjects who underwent the two types of taping compared to those who experienced the bare foot condition. The plantar pressure was significantly shifted to the posterolateral area after modified Mulligan taping compared with the bare foot condition. There were no significant differences in the gait parameters. Conclusion: The findings of this study indicate that modified Mulligan taping has a similar effect to low-Dye taping, and modified Mulligan taping is a simpler method than low-Dye taping.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제33권1호
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• pp.34-39
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• 2021

Purpose: The purpose of this study was to verify the effectiveness of repetitive sit to stand training to improve knee extensor strength and walking ability of total knee replacement patients. Methods: In this study, 12 patients with total knee replacement patients were recruited from a rehabilitation hospital. They were divided into two groups: a repetitive sit to stand group (n=6) and a control group (n=6). They all received 30 minutes of continuous passive motion (CPM). After that, the repetitive sit to stand group performed repetitive sit to stand training, and the control group performed resistance exercise for 15 minutes five times a week for 2 weeks. After 2 weeks of training, knee extensor strength and spatiotemporal gait parameters were measured. Knee extensor strength was measured by Biodex system 3, walking ability was measured by Biodex gait trainer 2. Paired t test was performed to verify the difference between before and after intervention within the group, and analysis of covariance was used to verify the differences between the two groups. Results: After the training periods, the repetitive sit to stand group showed a significant improvement in knee extensor muscle strength, walking speed, step length of the operated side, and step length of the non-operated side (p<0.05). Conclusion: The results of this study showed that repetitive sit to stand training was more effective in improving knee extensor muscle strength and walking ability. Therefore, to strengthen knee extensor muscles and improve the walking ability of total knee replacement patients, it is necessary to consider repetitive sit to stand training.

• 인간행동과 음악연구
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• 제12권2호
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• pp.19-36
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• 2015

본 연구는 외상성 뇌손상 청소년을 대상으로 리듬청각자극(RAS) 적용 시 선율의 유무에 따른 보행 훈련 효과를 비교하고, 보행인자의 변화를 알아보고자 시행하였다. 이를 위해 3명의 외상성 뇌손상 청소년을 대상으로 사전 사후 평가를 제외한 총 8회의 보행훈련을 진행하였다. 회기별 중재 시 선율 유무에 따른 보행 속도 차이를 비교하였고, 훈련 효과에 따른 시공간적 지표 및 운동 형상학적 지표 변화 비교를 위해 VICON 370 Motion Analysis System을 사용하여 보행 지표를 측정하였다. 연구 결과 RAS 보행 훈련 시 제공한 음악 자극 형태에 따라 보행 속도에 미치는 유의미한 영향이 없으므로, 선율의 사용 유무는 보행 훈련 효과와 직접적인 관련이 없음을 알 수 있었다. 또한 사전사후 검사 결과, RAS 보행 훈련 후 분속수, 보행 속도, 활보장, 활보장 시간, 보행 대칭성이 공통적으로 개선되었으며, 대상자 모두 공통적으로 고관절 및 슬관절의 움직임에서 필요 이상의 과도한 굴곡이나 신전이 감소함에 따라 양측의 비대칭성 감소 및 움직임의 안정성이 증가한 모습을 보였다. 리듬 적용과 리듬 자극에 선율을 반영한 음악 자극 적용에 따른 보행 속도 간 차이를 비교한 본 연구 결과는 운동기능을 위한 RAS 적용 시, 일정한 간격의 리듬자극에 의한 리듬-운동 동조화가 핵심 기제로 작용함을 시사한다. 또한, 본 연구는 외상성 뇌손상 청소년을 대상으로 RAS 보행 훈련을 통한 보행 기능뿐만 아니라 보행 패턴의 개선을 살펴본 것에 의의가 있다.

• 한국전문물리치료학회지
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• 제11권1호
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• pp.53-67
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• 2004

This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• The Journal of Korean Physical Therapy
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• 제27권1호
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• pp.43-49
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• 2015

Purpose: The aim of the current study was to examine the effects of hinged ankle-foot orthosis (HAFO) on walking function in children with spastic diplegic cerebral palsy (CP). Methods: Thirty-two children (mean age: $6.79{\pm}0.35years$, age range: 5-7 years) who were diagnosed with spastic diplegic cerebral palsy participated in the study. Each subject typically walked through 10 meters of a gait platform with markers on the subject's proper body segments and underwent 3-D motion analysis system with and without hinged ankle-foot orthosis. The HAFOs were all custom-made for individual CP children and had plantarflexion stop at $0^{\circ}C$ with no dorsiflexion stop. The interventions were conducted over three trials in each group, and measurements were performed on each subject by one examiner in three trials. 3-D motion analysis system was used to measure gait parameters such as walking velocity, cadence, step-length, step-width, stride-length, and double support period in two conditions. Results: The walking velocity, cadence, step-length, and stride-length were significantly greater for the HAFO condition as compared to the no HAFO condition (p<0.05). However, no significant difference in step-width and double support period was observed between two conditions. Conclusion: These findings suggest that using the HAFO during walking would suggest positive evidence for improving the spatiotemporal parameters of gait in children with spastic diplegic cerebral palsy.

• 한국운동역학회지
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• 제28권1호
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• pp.19-27
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• 2018

Objective: This study aimed to analyze the effects of freezing of gait on spatiotemporal variables, ground reaction forces (GRFs), and joint moments during the sit-to-walk task at the preferred and maximum speeds in patients with Parkinson's disease (PD). Method: The subjects were classified by a neurologist into 12 freezers, 12 non-freezers, and 12 controls. Sit-to-walk parameters were measured during three repetitions of the task in a random order at the preferred and maximum possible speeds. Results: In the sit-to-walk task at the preferred speed, the freezers and non-freezers exhibited a higher peak anterior-posterior GRF (p<0.001) in the sit-to-stand phase and lower step velocity (p<0.001), step length (p<0.001), and peak anterior-posterior GRF (p<0.001) in the first-step phase than the controls. The freezers had higher peak anterior-posterior GRF (p<0.001) and peak moment of the hip joint (p=0.008) in the sit-to-stand phase than the non-freezers. In the sit-to-walk phase at the maximum speed, the freezers and non-freezers had lower peak moment of the hip joint (p=0.008) in the sit-to-stand phase than the controls. The freezers and non-freezers displayed lower step velocity (p<0.001) and peak anterior-posterior GRF (p<0.001) in the first-step phase than the controls. The freezers showed higher peak moments of the hip joint in the sit-to-stand phase than the non-freezers (p=0.008). Conclusion: The PD patients had reduced control ability in sit-to-stand motions for efficient performance of the sit-to-walk task and reduced performance in the sit-to-walk task. Furthermore, the freezers displayed reduced control ability in the sit-to-stand task. Finally, the PD patients exhibited a lower ability to control dynamic stability with changes in speed than the controls.

• 디지털융복합연구
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• 제15권4호
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• pp.529-536
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• 2017

본 연구의 목적은 마비측 다리에 나선형 방향으로 테이핑을 적용하여 뇌졸중 환자의 보행능력에 미치는 즉각적인 효과를 알아보고자 하였다. 뇌졸중 환자 42명을 각각 실험군(나선형 테이핑군) 21명과 대조군(넙다리네갈래근 테이핑군)21명으로 나누어 테이핑을 부착하였다. 두 집단 모두 10m 보행 검사(10 meter walk test)와 동적 보행 지수(Dynamic Gait Index; DGI), 가속도계(Accelerometer)를 이용한 시 공간적 보행변수 중 보행율(cadence), 속도(speed), 마비측 보행주기(gait cycle duration), 마비측 디딤기(stance phase duration), 마비측 양발 지기기(double support duration)를 측정하였다. 연구 결과 중재 전과 중재 후 두 집단 모두 10m 보행과 DGI 그리고 보행율, 보행속도에서 유의한 증가를 보였고 마비측 디딤기, 마비측 보행주기, 마비측 양발지지기에서 증가 및 감소하였지만 유의한 차이가 없었다. 두 집단간 변화량 차이는 유의한 차이가 없었다. 테이핑을 통한 뇌졸중 환자의 보행능력 변화에서 두 방법 모두 보행능력에 증가함을 알 수 있었다. 하지만 나선형 테이핑은 테이핑 절단 횟수가 적고 비교적 쉽게 적용이 가능하므로 가정에서 적용 시 보다 쉽게 적용할 수 있는 방법일 것이다.

• 대한한방내과학회지
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• 제42권2호
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• pp.75-85
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• 2021

Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.