• Title/Summary/Keyword: Stance Phase

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Case Study of the Immediate Gait Improvement in a Post-Stroke Gait Disturbance Patient Equipped with a Weighted Vest (중량조끼를 착용한 뇌졸중으로 인한 보행장애 환자의 즉각적인 보행 개선 효과 1례)

  • Kim, Cheol-hyun;Hong, Hae-jin;Lee, Sang-kwan
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.763-769
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    • 2016
  • Objective: To confirm the immediate gait improvement in a post-stroke gait disturbance patient equipped with a weighted vest. Methods: We selected a patient who was able to walk without another’s help or with tools. The selected patient had an unstable gait because she had only started an independent gait within the past week, so we thought that a weighted vest could be very helpful for her. We first collected gait parameters using a treadmill gait analysis system while the patient walked on the treadmill without the weighted vest. After a 10-minute break, gait parameters were collected again while the patient walked on the treadmill while wearing the weighted vest. The gait parameters we collected included step length (cm), stance phase (%), swing phase (%), SW/ST, and gait line length (mm). For objective evaluation of gait improvement, we calculated the ratio of gait parameters of the right and left limbs. Results: The gait of the post-stroke patient was more symmetrical when wearing the weighted vest than without the weighted vest. Without the weighted vest, her step length ratio was 0.78, stance phase ratio was 0.88, swing phase ratio was 1.50, SW/ST ratio was 1.70, and gait line length ratio was 0.91. With the weighted vest, her step length ratio was 0.88, stance phase ratio was 0.90, swing phase ratio was 1.38, SW/ST ratio was 1.54, and gait line length ratio was 0.98. No side effects were observed due to the weighted vest.

Correlation among triceps surae muscle structure, balance, and gait in persons with stroke

  • Park, Hye-Kang;Yu, Ki-Gon;Shin, Jang-Hoon;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.9 no.3
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    • pp.155-164
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    • 2020
  • Objective: This study aimed to compare muscle structure, balance, and gait parameters between healthy adults and persons with stroke and to analyze the correlation among these variables. Design: Cross-sectional study. Methods: Twenty persons with stroke (11 male, 9 female) and twenty healthy participants (9 male, 11 female) were included. Ultrasound images of the triceps surae and the tibialis anterior were acquired in sitting resting, sitting co-contraction, and standing resting positions and also during the functional reach test (FRT) and single leg anterior reaching test (SLART). Muscle thickness and fascicle length were measured. Spatiotemporal parameters of gait were measured using a pressure walkway. Gait speed, cadence, step length, stride length, stance time, and swing time were measured. Results: Changes in percent fascicle length were significantly greater in the gastrocnemius and soleus (SOL) muscles of healthy adults in the sitting co-contraction position (p<0.05). The percent fascicle length of the SOL in FRT and SLART were significantly greater in healthy adults (p<0.05). The mid-stance phase of stroke patients was shorter than healthy adults (p<0.05). A negative correlation was observed between percent fascicle length of the SOL in the sitting co-contraction position and the proportion of the mid-stance phase (p<0.05). Conclusions: The function of the triceps surae is affected in persons with stroke when compared with healthy adults. This can lead to difficulty in performing tasks that involve forward transfer of weight. If the triceps surae is not sufficiently secured, the possibility of compensation in the stance phase increases during gait.

Three-Dimensional Video Analysis of the Gate Patterns in Normal Children and Hemiplegic Children with Cerebral Palsy (정상아와 편마비 뇌성마비아의 삼차원 보행분석)

  • Lee Jin-Hee;Bae Sung-Soo;Kim Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.127-145
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    • 1997
  • The purpose of this study wa9 to analyse the gait patterns of two female children with hemiplegic cerebral palsy by using the three-dimensional video motion analysis technique. Case 1 has mild spastic hemiplegia on the right side while Case 3 has moderate spastic hemiplegia on the left side. A group of 10, normal female children of the same age(7-8 years old) were selected as the control group for comparison. Time and distance variables as well as the Center of Mass displacement, and the pelvic and joint motions in three anatomical planes were analysed for this purpose. The following observations were made through the analysis : Case 1 revealed an asymmetrical gait pattern in which the step length of the unaffected side was shorter than that of the affected side, which wan a result of the effort to minimize loading on the affected leg by shortening the swing phase of the unaffected leg. Case 1 scored similar phase ratios, cadence and walking velocity to the normal group. A slight posterior tilt of the pelvis was observed throughout the gait cycle. Less hip and knee flexion than the normal group was observed, and demonstrated hyperextension of the knee in the terminal stance phase. The main problem in case 1 originated from the insufficient dorsiflexion of the affected foot during the swing phase. Therefore, Case 1 has difficulty with foot clearance in the swing phase. Usually, this is compensated for by using exessive hip abduction and medial rotation in conjuction with trunk elevation as well as increased vortical displacement of the center of mass. Case 1 revealed a foot-flat initial contact pattern. Case 2 was characterized by a consistent retraction ef the affected aide of the body througout the gait cycle, As a result, an asymmetrical gait pattern with increased stance phase ratios of the unaffected side was observed. In spite of this the step lengths of both sieds were similar. Case 2 scored lower cadence and walking speed than the normal group with lower gait stability. The main problem in Case 2 originated from an excessive plantaflexion of the affected foot which, in turn, rebutted in high hip and knee flexion. Hyperextension of the knee was observed at mid-stance, and execessive anterior tilt of the pelvis throughout the gait cycle was noticed. A gait pattern with high hip abduction and medial circumduction was maintained for the stability in the stance phase and foot clearance in the swing phase. Case 2 revealed a forefoot-contact initial contact pattern.

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The 3-D Motion Analysis of Kinematic Variety on Lower Extremity during Ramp Ascent at Different Inclinations (정상인의 오름 경사로 보행 시 경사각에 따른 하지 관절의 삼차원적 동작 분석)

  • Han, Jin-Tae;Lee, Jong-Dae;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.633-650
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    • 2005
  • The aim of this study was to investigate the kinematics of young adults during ascent ramp climbing at different inclinations. Twenty-three subjects ascended a four step at four different inclinations(level, $8^{\circ},\;16^{\circ},\;24^{\circ}$). The 3-D kinematics was analysed by a camera-based falcon system. Groups difference was tested with one -way ANOVA and SNK test. The different kinematic patterns of ramp ascent were analysed and compared to level walking patterns. The kinematics of ramp walking could be clearly distinguished from the kinematics of level walking. In sagittal plane, Ankle joint was more dorsiflexed at initial contact and Max. dorsiflex. during stance phase with $16^{\circ},\;24^{\circ}$ inclination and more plantarflexed at toe off and Max. plantarflex. during swing phase with $24^{\circ}$(p<.001). Knee joint was more flexed at initial contact with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was more flexed at initial contact and Max. flex. during swing phase with $16^{\circ},\;24^{\circ}$ inclination and at toe off with $24^{\circ}$(p<.001) and was more extended at Max. ext. during stance phase with $24^{\circ}$(p<.05). In frontal plane, ankle joint was more everted at Max. eversion. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Knee joint was more increased at Max. varus. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was not differentiated with different inclinations. In horizontal plane, all joints were not differentiated with different inclinations. Conclusionally, In ascent ramp walking, the different gait pattern generally occurred at over $16^{\circ}$ on the ascending ramp in sagittal and frontal plane. These results suggest that there is a certain inclination angle or angular range where subjects do switch between a level walking and a ascent ramp walking gait pattern. This shows their motor control strategy between level and ascent ramp walking. Further studies are necessary to confirm and detect the ascent ramp gait patterns.

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A Study on the Change of Gait Temporal Parameter and Ankle Joint Moment in Patients with Achilles Tendinitis (아킬레스 건염 환자의 보행 시 고관절, 슬관절 및 족관절 모멘트의 변화에 대한 연구)

  • Yu, Jae-Ho;Lee, Gyu-Chang;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5766-5772
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    • 2011
  • This study was to investigate the change of gait temporal parameter and ankle joint moment between patients with achilles tendinitis and healthy people. Thus, the purpose of this study is to clarify biomechanical change of gait in patients with achilles tendinitis and to find risk factor for prevention of achilles tendinitis. We recruited 20 patients with an achilles tendinitis and 20 healthy people. While subjects shuttled 5 times on 13 m distance with comfortable pace, we examined gait function marker with three-dimensional gait analysis system. All subject outstepped center of forceplate during gait and calculated ankle joint moment using software. Obtained data was analyzed using SPSS 12.0 software. In results, we confirmed that patients with achilles tendinitis showed reduction of extension moment in early initial phase and reduction of flexion moment in mid-stance on hip joint. and reduction of flexion moment in early initial phase and reduction of extension moment in late phase on knee joint. And we identified that patients with achilles tendinitis showed reduction of dorsiflexion moment in early stance phase, maximal plantarflexion moment in mid stance phase, and dorsiflexion moment in late stance phase. Thus, there are biomechanical changes on gait in patients with achilles tendinitis compared to healthy people. And, in clinical settings, they should focus on changes of gait in patients with achilles tendinitis. Further study will be undertaken for the biomechanical changes of patietns with achilles tendinitis.

Analysis of Kinematics and Kinetics According to Skill Level and Sex in Double-under Jump Rope Technique

  • Kim, Dae Young;Jang, Kyeong Hui;Lee, Myeoung Gon;Son, Min Ji;Kim, You Kyung;Kim, Jin Hee;Youm, Chang Hong
    • Korean Journal of Applied Biomechanics
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    • v.27 no.3
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    • pp.171-179
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    • 2017
  • Objective: The purpose of this study was to perform a kinematic and kinetic analysis of double-under jump rope technique according to skill level and sex. Method: Participants comprised a skilled group of 16 (9 males, 7 females), and an unskilled group of 16 with 6 months or less of experience (9 males, 7 females). Five consecutive double-under successes were regarded as 1 trial, and all participants were asked to complete 3 successful trials. The data for these 3 trials were averaged and analyzed after collecting the stable third jump in each trial. The variables used in the analysis included phase duration, total duration, flight time, vertical toe height, stance width, vertical center of mass displacement, and right lower limb ankle, knee, and hip joint angles in the sagittal plane during all events. Results: The skilled group had a shorter phase and total duration and a shorter flight time than the unskilled group. The vertical center of mass displacement and ankle dorsiflexion angle were significantly smaller in the skilled group. The male group had a shorter phase duration than the female group. The vertical toe height was greater, the stance width was smaller, and the ankle and hip flexion angles were smaller in the male group. Conclusion: Variables that can be used to distinguish between skill levels are phase and total duration, flight time, vertical center of mass displacement, and ankle dorsiflexion angle. Differences between sexes in double-under jump rope technique may be related to lower limb flexion angle control.

Pelvic, Hip, and Knee Kinematics of Stair Climbing in People with Genu Varum

  • Chae, Yun Won;Park, Seol;Park, Ji Won
    • The Journal of Korean Physical Therapy
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    • v.30 no.1
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    • pp.14-22
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    • 2018
  • Purpose: This study examined the effects of the lower limb alignment on the pelvis, hip, and knee kinematics in people with genu varum during stair walking. Methods: Forty subjects were enrolled in this study. People who had intercondylar distance ${\geq}4cm$ were classified in the genu varum group, and people who had intercondylar distance <4cm and intermalleolar distance <4cm were placed in the control group. 3D motion analysis was used to collect the pelvis, hip, and knee kinematic data while subjects were walking stairs with three steps. Results: During stair ascent, the genu varum group had decreased pelvic lateral tilt and hip adduction at the early stance phase and decreased pelvic lateral tilt at the swing phase compared to the control group. At the same time, they had decreased minimal hip adduction ROM at the early stance and decreased maximum pelvic lateral tilt ROM and minimum hip rotation ROM at the swing phase. During stair descent, the genu varum group had decreased pelvic lateral tilt at the early stance and decreased pelvic lateral tilt and pelvic rotation at the swing phase. In addition, they had decreased pelvic frontal ROM during single limb support and increased knee sagittal ROM during the whole gait cycle. Conclusion: This study suggests that a genu varum deformity could affect the pelvis, hip and knee kinematics. In addition, the biomechanical risk factors that could result in the articular impairments by the excessive loads from lower limb malalignment were identified.

Design of Crank Drive System Based on Gait Pattern for Stand-up Bicycle (보행패턴을 접목한 직립주행 자전거용 크랭크 구동장치의 거동분석)

  • Hyeong, Joonho;Roh, Jongryun;Kim, Sayup
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.41 no.10
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    • pp.991-996
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    • 2017
  • Gait stability is partly characterized by an extended stance phase that comprises 60 of the gait % cycle. In this study, a gait pattern was employed for a crank drive system that allows for stable lower limb kinematics during stand-up cycling. A quick return mechanism was applied to the crank system to allow for a slow rotation of the crank during the stance phase and for a quick return during the swing phase. Design parameters for the quick return crank mechanism were defined, and kinematic simulations were performed to understand the behavior of the mechanism. To evaluate the design, an experimental instrument was fabricated, and the cycling motion was analyzed. The results indicated that this new drive system can stabilize the center of mass of the user. This study can contribute to the development of a stand-up bicycle that allows for more comfortable leg kinematics.

Development of 4-Bar Linkage Orthotic Knee Joint (4절 연쇄 보조기무릎관절의 개발)

  • Kim, Jang-Hwan;Yi, Jin-Bock
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.317-325
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    • 2011
  • This study aims to develop the stance-control typed 4-bar linkage orthotic knee joint that replace the locked orthotic knee joint for the disabled with poliomyelitis and muscle weakness of lower limb. Unlike the existing stance-control orthotic knee joint, there are no needs of electric power, connecting circuit, bulky compomnets, etc, because this 4-bar linkage orthotic knee joint is controled by geometric locking. To evaluate the 4-bar linkage orthotic knee joint, a subject participated in this study who has been diagnosed with lower limb poliomyelitis and have used locked type orthotic knee joint. In the results of analysis of subject's gait using 3-dimentional motion analysis system, this 4-bar linkage orthotic knee joint provide the stability during stance phase and knee flexion during swing phase.

A Novel Kinematic Design of a Knee Orthosis to Allow Independent Actuations During Swing and Stance Phases (회전기 및 착지기 분리 구동을 가능케 하는 새로운 무릎 보장구의 기구부 설계)

  • Pyo, Sang-Hun;Kim, Gab-Soon;Yoon, Jung-Won
    • Journal of Institute of Control, Robotics and Systems
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    • v.17 no.8
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    • pp.814-823
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    • 2011
  • Nowadays many neurological diseases such as stroke and Parkinson diseases are continually increasing. Orthotic devices as well as exoskeletons have been widely developed for supporting movement assistance and therapy of patients. Robotic knee orthosis can compensate stiff-knee gait of the paralyzed limb and can provide patients consistent assistance at wearable environments. With keeping a robotic orthosis wearable, however, it is not easy to develop a compact and safe actuator with fast rotation and high torque for consistent supports of patients during walking. In this paper, we propose a novel kinematic model for a robotic knee orthosis to drive a knee joint with independent actuation during swing and stance phases, which can allow an actuator with fast rotation to control swing motions and an actuator with high torque to control stance motions, respectively. The suggested kinematic model is composed of a hamstring device with a slide-crank mechanism, a quadriceps device with five-bar/six-bar links, and a patella device for knee covering. The quadriceps device operates in five-bar links with 2-dof motions during swing phase and is changed to six-bar links during stance phase by the contact motion to the patella device. The hamstring device operates in a slider-crank mechanism for entire gait cycle. The kinematics and velocity/force relations are analyzed for the quadriceps and hamstring devices. Finally, the adequate actuators for the suggested kinematic model are designed based on normal gait requirements. The suggested kinematic model will allow a robotic knee orthosis to use compact and light actuators with full support during walking.