• 한국정밀공학회지
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• 제24권7호
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• pp.133-138
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• 2007

It is important to understand the characteristics of amputee gait to develop more advanced prostheses. The aim of this study was quantitatively to analyze the stair climbing task for the above-knee amputee with a prosthesis and to predict muscle forces and joint moments at musculoskeletal joints by dynamic analysis. The three-dimensional musculoskeletal model of lower extremities was constructed by gait analysis and transformation software for one above-knee amputee and ten healthy people. The measured ground reaction forces and kinematical data of each joint by gait analysis were used as input data during inverse dynamic analysis. Lastly, dynamic analysis of above-knee amputee during stair climbing were performed using musculoskeletal models. The results showed that summed muscle farces of hip extensor of amputated leg were greater than those of sound leg but the opposite results were revealed at hip abductor and knee flexor of amputated leg. We could also find that the higher moments at hip and knee joint of sound leg were needed to overcome the flexion moment caused by body weight and amputated leg. In conclusion, dynamic analysis using musculoskeletal models may be a useful mean to predict muscle forces and joint moments for specific motion tasks related to rehacilitation therapy..

• PNF and Movement
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• 제15권1호
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• pp.105-113
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• 2017

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

• International Journal of Precision Engineering and Manufacturing
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• 제9권1호
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• pp.30-33
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• 2008

Understanding the characteristics of amputee gait is key in developing more advanced prostheses. The aim of this study was to quantitatively analyze a stair-climbing task for transfemoral amputees with a prosthesis and to predict the muscle forces and joint moments at musculoskeletal joints using a dynamic analysis. A three-dimensional musculoskeletal model of the lower extremities was constructed from a gait analysis using transformation software for two transfemoral amputees and ten healthy people. The measured ground reaction forces and kinematical data of each joint from the gait analysis were used as input data for an inverse dynamic analysis. Dynamic analyses of an transfemoral amputee climbing stairs were performed using musculoskeletal models. The results showed that the summed muscle forces of the hip extensor of an amputated leg were greater than those of a sound leg. The opposite was true at the hip abductor and knee flexor of an amputated leg. We also found that higher moments at the hip and knee joints of the sound leg were required to overcome the flexion moment caused by the body weight and amputated leg. Dynamic analyses using musculoskeletal models may be a useful means to predict muscle forces and joint moments for specific motion tasks related to rehabilitation therapy.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.111-119
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• 2005

The purpose of this study was to compare the differences of hip and thigh muscle activities between subjects with increased and decreased femoral anteversion during stair ascent. Twelve healthy female volunteers participated in this study. The subjects were divided into two groups (group 1 with increased anteversion of the hip, group 2 with decreased anteversion of the hip). This study analyzed differences in each mean peak gluteus maximus (GM), gluteus medius (GD) and tensor fascia lata (TLF) EMG amplitude: composite mean peak hip muscles (GM, GD, TFL) EMG amplitude ratios and in each mean peak vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (HM) and semitendinosus (HL) EMG amplitude: composite thigh muscles (VMO, VL, HM, HL) EMG amplitude ratios among subjects with decreased or increased relative femoral anteversion. EMG ratios were compared in the stance and swing phase of stair ascent. Group 1 showed an increased standardized mean GM and GD EMG amplitude and decreased standardized mean TFL to composite mean hip muscles EMG amplitude ratios in stair ascent during both stance and swing phase. Also, group 1 showed an increased standardized mean HL EMG amplitude and decreased standardized mean VL and HM to composite mean thigh muscles EMG amplitude ratios in stair ascent during both stance and swing phases. There was no statistically significant difference in vastus medialis oblique between subjects with increased or decreased relative femoral anteversion. In order to provide rehabilitation professionals with a clearer picture of the specific requirements of the stair climbing task, further research must be expanded to include a wider range of age groups that represent the general public, such as including middle-aged healthy persons.

• 재활치료과학
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• 제2권2호
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• pp.47-59
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• 2013

목적 : 뇌졸중 환자를 대상으로 과제 지향적 훈련을 집단과 개별로 실시하게 하여 상지 기능, 인지 기능과 일상생활 수행력에 미치는 영향을 알아보고자 실시하였다. 연구방법 : 2012년 6월부터 11월까지 약 5개월간 A병원에 입원하여 뇌졸중 진단을 받은 사람 중에 재활치료를 받은 환자를 대상으로 하였다. 과제 훈련군과 개별 훈련군은 각각 13명씩 무작위 배정 하였다. 두 군 모두 동일한 내용의 과제 지향 훈련을 1일 30분씩 3주간 시행하도록 하였다. 결과 : 훈련 전 두 군의 상지 기능과 인지 기능은 유의한 차이를 보이지 않았다. 훈련 전 일상생활 영역에서 목욕하기(p<.001), 식사하기, 개인위생과 총점(p<.05)이 집단 훈련군에서 더 높은 것으로 나타났고 훈련 후 상지 기능은 개별 훈련군에서 유의하게 높았다(p<.001). 두 그룹 모두 훈련 전후 상지 기능 식사하기, 개인위생,목욕하기, 옷 입기, 용변처리, 이동, 보행, 계단, 총점(p<.05)에 유의한 향상이 있었다. 두 그룹의 훈련 전후 변화량 비교에서 개별 훈련군이 상지 기능(p<.001)과 일상생활 영역에서 식사하기와 총점에서 더 유의한 향상을 나타냈다(p<.05). 결론 : 과제 지향적 훈련을 시행 시 집단 훈련군과 개별 훈련군 모두 상지기능, 일상생활 수행력에 향상을 가져오며, 특히 상지 기능의 향상이 클 경우에 더 높은 일상생활 수행력의 변화를 가져 올 수 있다. 앞으로 보다 많은 환자를 대상으로 장기간에 걸친 종단적인 사례 연구가 필요하다.

• 지역사회간호학회지
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• 제9권2호
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• pp.280-290
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• 1998

This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).