• 대한의용생체공학회:의공학회지
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• 제32권2호
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.11-21
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• 2002

The purpose of this study was to find the effect of rear foot wedge angle on peak plantar pressures on the forefoot during walking. Twenty normal healthy subjects (10 female, 10 male) were recruited. Peak plantar pressure was measured using pressure distribution platforms (MatScan system) in medial forefoot (under the first, second metatarsal head) and lateral forefoot (under the third, fourth, fifth metatarsal head). The subjects walked at the comfortable velocity under seven conditions; bare footed, $5^{\circ}$, $10^{\circ}$ and $15^{\circ}$ wedges under the medial and lateral sides of the hindfoot. The three averaged peak plantar pressures were collected at each condition at stance and toe off phases. The results showed that a significant increase in lateral forefoot plantar peak pressure investigated in the medial wedge and a significant decrease in lateral forefoot plantar peak pressure investigated in lateral wedge at stance phase (p<.05). These results suggest that rear foot wedge may be useful to modify the peak plantar pressure on the forefoot.

• 대한물리치료과학회지
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• 제27권3호
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• pp.25-34
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• 2020

Background: Gait analysis is an important measurement for health professionals to assess gait patterns related to functional limitations due to neurological or orthopedic conditions. The purpose of this study was to investigate the reliability of the newly developed portable gait analysis system (PGAS). Design: Cross-sectional design. Test-retest study. Methods: The PGAS study was based on a wearable sensor, and measurement of gait kinematic parameters, such as gait velocity, cadence, step length and stride length, and joint angle (hip, knee, and ankle) in stance and swing phases. The results were compared with a motion capture system (MCS). Twenty healthy individuals were applied to the MCS and PGAS simultaneously during gait performance. Results: The test-retest reliability of the PGAS showed good repeatability in gait parameters with mean intra-class correlation coefficients (ICCs) ranging from 0.840 to 0.992, and joint angles in stance and swing phase from 0.907 to 0.988. The acceptable test-retest ICC was observed for the gait parameters (0.809 to 0.961), and joint angles (0.800 to 0.977). Conclusion: The results of this study indicated that the developed PGAS showed good grades of repeatability for gait kinematic data along with acceptable ICCs compared with the results from the MCS. The gait kinematic parameters in healthy subjects can be used as standard values for adopting this PGAS.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.105-112
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• 2022

Objective: Nonspecific low back pain (NS-LBP) causes pain and disability, affecting the neuromuscular system and altering gait patterns. The purpose of this study is to investigate the effect of improvement of low back pain symptoms through physical therapy on foot pressure and spatiotemporal gait parameters. Design: A pilot study. Methods: Participants received manual therapy and supervised therapeutic exercise, which consisted of 12 sessions for 6 weeks. Participants were assessed for pain intensity (a numeric pain rating scale), disability index (oswestry disability index), and spatiotemporal gait parameters before and after intervention. Wilcoxon signed rank test was used to analyze the before-and-after differences in a single group. Results: All seven NS-LBP patients completed the study without dropout. After six weeks of physical therapy, the numeric pain rating scale and oswestry disability index showed significant improvement (Z= -2.388, P=0.017). There was no significant improvement in both static and dynamic conditions in foot pressure (P>0.05). However, in the spatiotemporal gait parameters, there were significant differences in all variables except the right stance phase and left mid stance (P<0.05). Conclusions: In our pilot study, 12 sessions of physical therapy in NS-LBP patients improved gait quilty in spatiotemporal gait parameters. Similarly, it has resulted in clinically positive improvements in pain and disability.

• 대한물리의학회지
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• 제4권3호
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• pp.193-200
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• 2009

Purpose：In this study is to verify the effects postural control training based on Bobath approach for body schema and visual perception on Middle Cerebral Artery(MCA) Infarcts. Methods：The subject was a 46 years old man with MCA infaction, lives in B city. An AB design for a single-subject research was used for this study. The procedures consisted of 1 time of baseline phase(A), 20 times of treatment phase(B). We applied the Bobath approach at the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. Results：With this treatment, the majority of body schema and visual perception and postural control was improved in treatment phase compared with in baseline phase. Therefore, this study supported the effectiveness of postural control training based on Bobath approach for body sechma and visual perception of hemiplegia. Conculusion：This study is integrated postural control training with Bobath approach that are widespread for hemiplegia and measured outcomes based on individualized therapy goals. Consequently the study is suggested the meaning of quality effectiveness of Bobath approach.

• 재활복지공학회논문지
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• 제6권2호
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• pp.23-30
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• 2012

본 연구에서는 로드셀 센서를 활용하여 편바미 환자의 환측에 부하되는 체중부하에 따른 청각적 피드백을 적용한 대칭 보행유도와 보행패턴 분석이 가능한 무선 보행훈련 시스템을 개발하였다. 또한 개발된 시스템의 유효성을 검증하기 위해 정상인군 및 편마비군 대상자에게 수행한 임상실험을 진행하였으며, 각 대상군마다 피드백 적용 후 보행 속도와 체중 부하량, 그리고 보행 시 입각기비율과 분속수가 증가하였음을 확인하였다. 연구 결과를 토대로 편마비 환자 뿐만 아니라 대칭적 체중부하가 요구되는 다양한 하지 질환자들에 대한 임상실험을 확대하고 장기간 훈련의 효과를 관찰한다면, 본 연구에서 개발된 청각적 대칭 체중부하 피드백 보행 시스템은 다양한 패턴 분석과 함께 보행 향상을 위한 기기 적용이 가능할 것으로 기대된다.

• 대한인간공학회지
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• 제35권5호
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• pp.319-341
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• 2016

Objective:This research analyzed the lower-limb motion in kinetic and kinematic way while walking on various terrains to develop Foot-Ground Contact Detection (FGCD) algorithm using the Inertial Measurement Unit (IMU). Background: To estimate the location of human in GPS-denied environments, it is well known that the lower-limb kinematics based on IMU sensors, and pressure insoles are very useful. IMU is mainly used to solve the lower-limb kinematics, and pressure insole are mainly used to detect the foot-ground contacts in stance phase. However, the use of multiple sensors are not desirable in most cases. Therefore, only IMU based FGCD can be an efficient method. Method: Orientation and acceleration of lower-limb of 10 participants were measured using IMU while walking on flat ground, ascending and descending slope and stairs. And the inertial information showing significant changes at the Heel strike (HS), Full contact (FC), Heel off (HO) and Toe off (TO) was analyzed. Results: The results confirm that pitch angle, rate of pitch angle of foot and shank, and acceleration in x, z directions of the foot are useful in detecting the four different contacts in five different walking terrain. Conclusion: IMU based FGCD Algorithm considering all walking terrain possible in daily life was successfully developed based on all IMU output signals showing significant changes at the four steps of stance phase. Application: The information of the contact between foot and ground can be used for solving lower-limb kinematics to estimating an individual's location and walking speed.

• 대한정형도수물리치료학회지
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• 제23권1호
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• pp.63-72
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• 2017

Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.

• 국제물리치료학회지
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• 제1권2호
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• pp.120-125
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• 2010

The purpose of this study was to compare the effects of treadmill walking in underwater and overground which affects gait and physical function of people who have had a stroke. Twenty people after a stroke who have become hemiplegic over 6 months were participated. Participants were divided into two groups: underwater treadmill group(UTG) and overground treadmill group(OTG). The intervention was done 4 times per weeks for 6 weeks and 1 session lasted for 30 minutes. Gait and physical function elements were measured at baseline, at the middle(3 weeks) and at the end of the intervention(6 weeks). For the elements of gait, walking velocity, affected stance phase, affected weight bearing were assessed. For the elements of physical function, Short Form 8(SF-8) health survey was used. The result of this study showed that both groups improved similarly in walking velocity. However participants in UTG improved more than those in OTG in affected stance phase(p<.05), affected weight bearing(p<.05) and emotional aspect(p<.001). Based on the results of this study, it can be suggested that treadmill walking both in underwater and on the ground can be effective in improving hemiplegic gait and physical function of people who have had a stroke. The result also suggest that the underwater treadmill exercise can be more effective than overground treadmill in restoration of gait in people after stroke.

• 한국운동역학회지
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• 제25권3호
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• pp.257-263
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• 2015

Objective : The purpose of this study was to investigate the effect of genu valgum on the body mass index, movement of lower limb joints, and ground reaction force. Methods : Gait patterns of 30 college students with genu valgum were analyzed and the static Q angle of the femur was measured for selecting genu valgum of the subjects. To analyze the kinetic changes during walking, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. Results : As a result of measuring a relationship between genu valgum and Q-angle, as the Q-angle increases, it showed a genu valgum also increased. Body Mass Index showed a significant difference between the groups was higher in the genu valgum group.(p<.001). The analysis result showed that genu valgum had a significant effect on the internal rotation moment in the hip joint(p<.05). Also, genu valgum had a significant effect on the internal rotation moment of the knee joint(p<.05). The comparative analysis of the Medial-Lateral ground reaction force in the genu valgum group showed a tendency to increase the medial ground reaction force(p<.05). The vertical ground reaction forces of the middle of the stance phase(Fz0) showed a significant increase in genu valgum group(p<.05), in particular the results showed a decrease in the early stance phase(p<.001). Conclusion : In conclusion, the change in body mass is considered to be made by proactive regular exercise for improvement of the genu valgum. In addition, the prevention of the deformation caused by secondary of the genu valgum in this study may be used as an indicator of the position alignment rehabilitation for structural and functional improvements. Applying a therapeutic exercise program for the next lap will require changes in posture alignment.