• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.145-151
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• 2022

Purpose : Stroke patients exhibit abnormal walking patterns such as slow walking speed and asymmetrical walking values. The recovery of symmetrical walking in the stance phase using a treadmill means improvements in walking speed and asymmetrical walking. The purpose of this research was to investigate the effect of unilateral step treadmill training (USTT) on gait speed and the recovery of symmetrical walking in chronic stroke patients. Methods : Fifteen patients (11 men and 4 women) with chronic stroke participated in this study. The 10-meter walk test (10MWT) and GAITRite system were used to determine the intervention-related changes in gait speed and symmetrical walking values such as non-paretic step length (NSL), non-paretic step time (NST), paretic single-support time (PSST), step length asymmetry (SLA), and step time asymmetry (STA) after USTT. All participants completed USTT and underwent measurements at 3 different times: at pretest, posttest, and the follow-up test. Repeated-measures analysis of variance was used to compare walking speed and asymmetrical walking values. The statistical significance level was set at p<.05. Results : Walking speed by 10MWT (p<.05) showed significant improvements after USTT as follows: at pretest and posttest (p<.05), posttest and follow-up test (p<.05), and pretest and follow-up test (p<.05). Recovery of symmetrical walking patterns such as NSL (p<.05), NST (p<.05), and SLA (p<.05) were observed after USTT. However, no significant improvements were found in PSST (p>.05) and STA (p>.05) in symmetrical gait. Conclusion : This study suggests that USTT may have a positive effect on walking speed and symmetrical walking patterns in chronic stroke patients. Thus, this study contributes to the existing knowledge about the usefulness of USTT for the effective management of patients with chronic stroke. Further studies are needed to generalize these findings.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.31-39
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• 2013

■ Objectives The goal of this pilot study is to observe the change of gait pattern according to the clinical status in a patient with ataxic gait by cerebellar infarction. ■ Methods We measured the spatiotemporal gait parameters of a patient with ataxic gait four times, in which, first, the patient was not able to walk independently, second, able to walk independently, third, unable to walk independently by general tremor, and, last, able to walk independently after disappearing of general tremor. ■ Results When a patient with cerebellar ataxic gait was able to walk independently and the cerebellar tremor was disappeared, the change of gait pattern was that step and stride length decreased and total double support and stance phase increased. ■ Conclusion When different clinical characteristics were improved, the change of gait showed same pattern.

• Physical Therapy Korea
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• v.31 no.1
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• pp.40-47
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• 2024

Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities. Objects: To compare the FPD during SLSs between groups with pronated and normal feet. Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups. Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases. Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.3
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• pp.207-214
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• 2016

The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults ($32.3{\pm}2.7$ years old, $175.2{\pm}3.8cm$, $76.2{\pm}8.7kg$) participated. They wore knee brace or didn't wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM ($65.5{\pm}3.7^{\circ}$ vs. $60.5{\pm}3.5^{\circ}$, p < 0.05) of the angle and maximum flexion angles (stance: $31.9{\pm}4.6$ vs. $25.6{\pm}5.5$, swing: $76.7{\pm}3.1$ vs. $68.9{\pm}3.4$, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased ($22.4{\pm}2.6$ vs. $19.2{\pm}2.1$, p < 0.05) and maximum plantarflexion increased ($9.5{\pm}3.0$ vs. $15.7{\pm}2.2$, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased ($93.0{\pm}7.8$ vs, $84.7{\pm}4.9$, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: $25.1{\pm}6.7$ vs. $32.4{\pm}1.9$, between the knee and ankle joint during stance: $46.0{\pm}12.9$ vs. $80.1{\pm}31.1$, between the knee and ankle joint during swing: $34.5{\pm}4.1$ vs. $37.6{\pm}3.1$, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.

• Korean Journal of Applied Biomechanics
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• v.16 no.3
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• pp.149-163
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• 2006

The purpose of this study was to compare the lower extremity's joint and segment coupling patterns between forward and backward running in subjects who were twelve healthy males. Three-dimensional kinematic data were collected with Qualisys system while subjects ran to forward and backward. The thigh internal/external rotation and tibia internal/external rotation, thigh flexion/extension and tibia flexion/extension, tibia internal/external rotation and foot inversion/eversion, knee internal/external rotation and ankle inversion/eversion, knee flexion/extension and ankle inversion/eversion, knee flexion/extension and ankle flexion/extension, and knee flexion/extension and tibia internal/external rotation coupling patterns were determined using a vector coding technique. The comparison for each coupling between forward and backward running were conducted using a dependent, two-tailed t-test at a significant level of .05 for the mean of each of five stride regions, midstance(1l-30%), toe-off(31-50%), swing acceleration(51-70%), swing deceleration(71-90), and heel-strike(91-10%), respectively. 1. The knee flexion/extension and ankle flexion/extension coupling pattern of both foreward and backward running over the stride was converged on a complete coordination. However, the ankle flexion/extension to knee flexion/extension was relatively greater at heel-strike in backward running compared with forward running. At the swing deceleration, backward running was dominantly led by the ankle flexion/extension, but forward running done by the knee flexion/extension. 2. The knee flexion/extension and ankle inversion/eversion coupling pattern for both running was also converged on a complete coordination. At the mid-stance. the ankle movement in the frontal plane was large during forward running, but the knee movement in the sagital plane was large during backward running and vice versa at the swing deceleration. 3. The knee flexion/extension and tibia internal/external rotation coupling while forward and backward run was also centered on the angle of 45 degrees, which indicate a complete coordination. However, tibia internal/external rotation dominated the knee flexion/extension at heel strike phase in forward running and vice versa in backward running. It was diametrically opposed to the swing deceleration for each running. 4. Both running was governed by the ankle movement in the frontal plane across the stride cycle within the knee internal/external rotation and tibia internal/external rotation. The knee internal/external rotation of backward running was greater than that of forward running at the swing deceleration. 5. The tibia internal/external rotation in coupling between the tibia internal/external rotation and foot inversion/eversion was relatively great compared with the foot inversion/eversion over a stride for both running. At heel strike, the tibia internal/external rotation of backward running was shown greater than that of forward(p<.05). 6. The thigh internal/external rotation took the lead for both running in the thigh internal/external rotation and tibia internal/external rotation coupling. In comparison of phase, the thigh internal/external rotation movement at the swing acceleration phase in backward running worked greater in comparison with forward running(p<.05). However, it was greater at the swing deceleration in forward running(p<.05). 7. With the exception of the swing deceleration phase in forward running, the tibia flexion/extension surpassed the thigh flexion/extension across the stride cycle in both running. Analysis of the specific stride phases revealed the forward running had greater tibia flexion/extension movement at the heel strike than backward running(p<.05). In addition, the thigh flexion/extension and tibia flexion/extension coupling displayed almost coordination at the heel strike phase in backward running. On the other hand the thigh flexion/extension of forward running at the swing deceleration phase was greater than the tibia flexion/extension, but it was opposite from backward running. In summary, coupling which were the knee flexion/extension and ankle flexion/extension, the knee flexion/extension and ankle inversion/eversion, the knee internal/external rotation and ankle inversion/eversion, the tibia internal/external rotation and foot inversion/eversion, the thigh internal/external rotation and tibia internal/external rotation, and the thigh flexion/extension and tibia flexion/extension patterns were most similar across the strike cycle in both running, but it showed that coupling patterns in the specific stride phases were different from average point of view between two running types.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.76-82
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• 2009

Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.

• Physical Therapy Korea
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• v.17 no.3
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• pp.77-86
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• 2010

The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

• PNF and Movement
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• v.4 no.1
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• pp.45-50
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• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.241-250
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• 2022

Purpose : The purpose of this study was to investigate the effect of backward walking exercise on changes in the cervical angle and gait parameters in subjects with moderate forward head posture. Methods : Four subjects were selected for this study. In particular, subjects with an average of 43 subjects with moderate craniovertebral angles were selected as the criteria for subject selection. The exercise program consisted of a 5 minutes warm-up exercise, 20 minutes main exercise, and 5 minutes cool-down exercise. In the main exercise, the treadmill speed was 2.5 km/h for men, 2.0 km/h for women in the first week, from the 2nd week to the 4th week, it was increased by 0.5 km/h every week. Results : Craniovertebral angle increased by 2.06±2.46 ° before and after the backward walking exercise, and craniorotational angle decreased by -1.69±3.33 ° before and after exercise. As for the gait parameters, in the amount of change before and after the backward walking exercise, the left foot pressure was 4.58±5.70 % from front to back and the right foot pressure was 5.08±3.06 % from front to back. The left step length and right step length showed a change of -.33±4.43 cm and -2.08±7.26 cm, respectively. stride length showed a change of -2.59±11.18 cm. The left and right stance phase showed a change of -1.02±2.03 % and -1.23±1.54 %, respectively. The left and right swing phase showed changes of 1.02±2.03 % and 1.22±1.53 %, respectively. The left and right step times were -.01±.06 sec and -.02±.12 sec, respectively. The stride time showed a change of -.03±.18 sec. Conclusion : Changes in cervical angle and gait parameters were confirmed by performing backward walking exercise for subjects with moderate forward head posture for 4 weeks. Therefore, additional research should be conducted based on this case study.

• Korean Journal of Applied Biomechanics
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• v.25 no.1
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• pp.131-140
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• 2015

Purpose : The purpose of this study was to analyze the coordination of the trunk tilting angle and bilateral lower limbs according to the stirrups length during trot in equestrian. Methods : Participants selected as subject were consisted of adult male(n=7, mean age: $45.00{\pm}3.78yrs$, mean height: $172.50{\pm}2.44cm$, mean body mass: $76.95{\pm}4.40kg$, mean, mean leg length: $97.30{\pm}2.60cm$). They were divided into 3-types of stirrups lengths(67 cm, 72 cm, 77 cm) during trot. The variables analyzed were consisted of the trunk front-rear angle, lower limb joint(Right Left hip, knee, ankle), overall movement index(OMI) of the lower limbs(thigh, shank, foot) and asymmetry index(AI%) during trot. Results : The average angle in hip and knee joint showed more extended posture according to the increase of stirrups lengths and ankle angle showed more plantarflexion posture according to increase of stirrups length during 1 stride in trot. Also, average angle showed more extended posture in right hip and ankle joint than that of left. The angle of knee joint didn't show significant difference statistically between right and left. Also asymmetric index in average angle of hip, knee and ankle joint didn't show significant difference statistically in between lower limbs, but hip joint showed higher asymmetric index in stirrup length of 77 cm and ankle joint showed higher asymmetric index in stirrup length of 67 cm than that of the others respectively. The FR angle in trunk of horse-rider showed relative backward leaning motions at stirrup length of 67 cm and 77 cm than that of stirrup length of 72 cm during stance and swing phase. OMI in thigh, shank, and foot limbs didn't show significant difference statistically according to the stirrups length of right and left lower limbs, but left lower limbs showed higher index than that of right lower limb. Stirrup length of 72 cm in shank and foot limbs showed higher index than that of stirrup length of 67 cm and 77 cm. But stirrup length of 72 cm showed higher asymmetric index than that of stirrups length of 67 cm and 77 cm. Conclusions : When considering the above, 72 cm(ratio of lower limb 74.04%) stirrup lengths could be useful in posture correction and stabilization than 67cm(ratio of lower limb 68.69%) and 77 cm(ratio of lower limb 79.18%) stirrup lengths during trot in horse back riding.