• 대한한방내과학회지
• /
• 제37권5호
• /
• pp.763-769
• /
• 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.

• Physical Therapy Rehabilitation Science
• /
• 제9권3호
• /
• pp.155-164
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제9권1호
• /
• pp.127-145
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제17권4호
• /
• pp.633-650
• /
• 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.

• 한국산학기술학회논문지
• /
• 제12권12호
• /
• pp.5766-5772
• /
• 2011

본 연구는 아킬레스 건염 환자들과 정상인들을 대상으로 보행 선형지표와 고관절, 슬관절, 그리고 족관절의 모멘트 변화를 조사하여 아킬레스 건염에 의한 보행의 역학적 변화를 구명하고 아킬레스 건염을 예방하기 위한 예측인자들을 찾고자 실시되었다. 연구의 대상자는 아킬레스 건염 환자 20명과 비슷한 신체조건을 가진 건강한 정상인 20명이며, 대상자가 맨발 상태에서 힘판의 중앙 부분을 밟고 지나가도록 13 m의 거리를 편안한 속도로 5회 왕복하도록 하였다. 또한 대상자가 보행하는 동안 3차원 동작분석 장비를 이용하여 고관절, 슬관절, 그리고 족관절 모멘트를 산출하였다. 수집된 자료들을 SPSS 12.0 소프트웨어를 사용하여 분석하였다. 연구의 결과 아킬레스 건염 환자들의 고관절은 입각기 초기에 신전 모멘트가 감소하였고, 중후반에는 굴곡 모멘트가 감소하였다. 또한 슬관절에서는 입각기 초기부터 지속적인 굴곡 모멘트의 감소가 나타났으며 후기에는 신전 모멘트의 감소를 보였다. 그리고 족관절은 입각기 중반에 저측굴곡 모멘트가 감소하였으며 말기에는 배측 굴곡 모멘트가 감소하였다. 정상인과 비교해 아킬레스 건염 환자들에게서 보행의 역학적인 변화가 두드러지게 나타났으며, 임상에서는 아킬레스 건염 환자의 보행에 대한 변화를 세밀하게 파악하여 치료적 접근을 시도해야 할 것으로 보인다. 그리고 앞으로의 연구에서는 아킬레스 건염 환자에게서 나타나는 역학적인 변화에 대한 조사가 더 이루어져야 할 것이다.

• 한국운동역학회지
• /
• 제27권3호
• /
• pp.171-179
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제30권1호
• /
• pp.14-22
• /
• 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.

• 대한기계학회논문집A
• /
• 제41권10호
• /
• pp.991-996
• /
• 2017

인간의 보행에서 안정적인 디딤을 가능하게 하는 동작특성은 보행 일주기의 60%를 차지하는 긴 디딤국면이다. 본 연구에서는 이러한 보행패턴을 자전거의 크랭크 구동장치에 반영하여 직립자세에서 안정적으로 구동할 수 있는 자전거를 설계하고자 한다. 크랭크의 회전속도를 디딤국면에서는 느리게 되돌림국면에서는 빠르게 움직이도록 급속귀환 기구를 크랭크 구동시스템에 적용하였다. 이 급속귀환 크랭크기구의 설계변수를 정의하고 설계변수의 변화가 크랭크의 거동에 미치는 영향을 시뮬레이션 하였다. 또한 실험장치를 제작한 후 탑승자의 구동동작을 분석한 결과 보행패턴을 접목한 크랭크는 사용자 무게중심 안정화에 기여하는 것으로 나타났다. 향후 보행패턴을 접목한 크랭크는 서서 타는 자전거의 구동시스템에 접목 가능할 것으로 보인다.

• 한국콘텐츠학회논문지
• /
• 제11권12호
• /
• pp.317-325
• /
• 2011

본 연구의 목적은 소아마비, 하지 근력약화 등의 장애인이 사용하는 잠금형 보조기무릎관절을 대체하기 위하여, 4절 연쇄 방식의 입각기조절형 보조기무릎관절을 개발하는 것이다. 본 연구에서 개발한 4절 연쇄 보조기무릎관절은 기존의 입각기조절형 보조기무릎관절과 달리, 기하학적으로 잠금상태가 제어되어 전기제어 부품 등이 필요하지 않으며 부피를 최소화하였다. 평가를 위하여, 소아마비로 진단받고 잠금형 보조기무릎관절을 사용해온 소아마비자가 대상자로 참여하였다. 대상자의 걸음걸이를 3차원으로 분석한 결과, 4절 연쇄 보조기무릎관절을 착용했을 때 입각기 동안 무릎관절의 신전이 유지되고 유각기 동안 무릎관절이 굴곡되며 자연스러운 걸음걸이를 보여주었다.

• 제어로봇시스템학회논문지
• /
• 제17권8호
• /
• pp.814-823
• /
• 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.