• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.1-7
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• 2019

The first hospice care center in Korea dates back to the East West Infirmaries (Dongseodaebiwon in the Korean language) of the Goryeo period in the early 11th century. It has been 50 years since hospice care was introduced in Korea. Initially hospice care was provided in the private sector, including those with a religious background, and its development was slow. In the 1990s, related religious organizations and academic associations were established, and then, a full-swing growth phase was ushered in as the Korean government institutionalized hospice care in the early 2000s. As a result, enhanced quality of hospice care service could be provided, which meant better pain management and higher quality of life for late stage cancer patients and their families. Still, the nation lacked a realistic reimbursement system which was needed to for financial stability of the affected patients. However, the national health insurance scheme began to cover hospice palliative expenses in 2015. In 2016, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was legislated, allowing terminally-ill patients to refuse meaningless life-sustaining treatments. As the range of diseases subject to hospice palliative care was expanded, more challenges and issues need to be addressed by the service providers.

• Journal of IKEEE
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• v.23 no.3
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• pp.883-892
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• 2019

This study is the method which is adapted to control ankle joint movement for resolving the problem of gait imbalance in intervals where gait environments are changed and slope walking, as applying terrain-adaptive technique to intelligent above-knee prosthesis. In this development of above-knee prosthesis, to classify the gait modes is essential. For distinguishing the stance phases and the swing phase depending on roads, a machine learning which combines decision tree and random forest from knee angle data and inertial sensor data, is proposed and adapted. By using this method, the ankle movement state of the prosthesis is controlled. This study verifies whether the problem is resolved through butterfly diagram.

• Physical Therapy Korea
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• v.28 no.1
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• pp.77-83
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• 2021

Background: Although symmetry of spatio-temporal parameter and center of pressure (COP) shift during walking is associated with knee adduction moment, research on clinical association with knee osteoarthritis (OA)-related knee pain and functional scores is lacking. Objects: The aims were 1) to compare symmetry of gait parameters and COP-shift in patients with unilateral knee OA and pain and matched controls, and 2) to investigate the relationship between symmetry of gait parameters and COP-shift, and clinical measures. Methods: Female subjects (n = 16) had with unilateral radiological knee OA and pain. Healthy controls (n = 15) were age-matched to OA group. Symmetry of foot rotation, step length, stance and swing phase, lateral symmetry of COP and anterior/posterior symmetry of COP during walking was assessed. To assess the clinical variables, pain intensity, pain duration and function using Knee Osteoarthritis Outcome Survey (KOOS) subscales were collected. We compared symmetry between groups using Mann-Whitney U-test or independent t-test. Relationships between clinical measures and symmetry index measured using Spearman's correlation test. Statistical significance was set at α = 0.05. Results: Knee OA group showed significantly greater values of only lateral symmetry of COP (p < 0.01) than healthy group. Values of lateral symmetry of COP had moderate or strong correlation significantly with the intensity of knee pain, pain duration, and scores of all KOOS subscales (p < 0.01). Conclusion: Patients with unilateral knee OA and pain showed more asymmetry of lateral COP-shift during walking compared with matched healthy controls. In addition, larger asymmetry of lateral COP-shift has the moderate or strong association with worse of knee pain, worse in KOOS scores and longer duration of knee pain. Asymmetry of lateral COP-shift during walking may be one of the characteristics of unilateral knee OA as the compensatory strategy response to unilateral OA of the knee.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.80-89
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• 2013

■ Objectives The aim of study is to analyze the change of gait pattern by arm sling in a hemiplegic patient. ■ Methods We analyzed the change of gait pattern under three conditions using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) First, the patient didn't have arm sling on her upper limb, second, the patient have arm sling on her affected upper limb, third, patient have arm sling on her unaffected upper limb. ■ Results In terms of spatiotemporal gait values, swing phase, step time, step length of unaffected lower limb increased. Furthermore, stride time and stride length also increased when the patient had arm sling on her unaffected upper limb. In terms of displacement of Center of pressure(CoP), anterior/posterior position and lateral symmetry of CoP increased. Furthermore, lateral symmetry of decreased when the patient had arm sling on her affected upper limb. ■ Conclusion Arm sling applied on affected side would be advantage to gait improvement in hemiplegic patients.

• The Journal of Korea Robotics Society
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• v.19 no.2
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• pp.159-168
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• 2024

Lower limb amputees are increasing due to various reasons. It is difficult for lower limb amputees to walk without an assistive device such as a prosthetic leg. In this paper, an electronically controlled knee-type prosthetic leg with a 4-bar linkage structure for lower limb amputees was developed. The knee-type prosthetic leg has a 4-bar linkage structure and assists walking by using an integrated drive module. The torque is 90 Nm, the rotation speed is up to 120 deg, and it weight 1.9 kg, so it is lighter than a commercial prosthetic leg, so it can be used for a long time because there is less fatigue when walking. An integrated control board was developed by applying various sensors and microprocessor. The motor drive and encoder are built into the integrated drive module. The integrated control board and integrated drive module communicate using CAN. When a lower limb amputee wears a knee-type prosthetic leg and walks, it shows a shape similar to the swing phase graph of a normal people, and it is possible to walk naturally while walking.

• PNF and Movement
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• v.22 no.1
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• pp.31-41
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• 2024

Purpose: The purpose of this study is to compare lower extremity muscle activities and ankle joint angles between different foot strike patterns (forefoot strike, heelfoot strike) during stair ascent walking. Methods: The subjects of this study were 22 males who walked in each foot strike pattern on ascent stairs at a speed of 85 beats/min. During stair walking with the two types of foot strike patterns, the muscle activities of the rectus femoris, tibialis anterior, medial gastrocnemius, hamstring, and gluteus medius were measured. Additionally, ankle joint angles for inversion, eversion, dorsi flexion, and plantar flexion were recorded. Each participant underwent the experiment three times, with the foot strike pattern randomized. Results were averaged according to the foot strike pattern. Results: Significant differences in ankle angles were observed across all phases according to foot strike pattern. Muscle activities in the lower extremities showed significant differences in all phases except the swing 1 phase. Moreover, differences in foot movement trajectory were noted depending on the foot strike pattern. Conclusion: Walking on ascent stairs elicited differences in lower extremity muscle activities and ankle joint angles based on foot strike pattern. These findings can serve as foundational data for selecting a suitable foot strike pattern tailored to individual patient conditions when training patients in walking on ascent stairs.

• Korean Journal of Applied Biomechanics
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• v.34 no.2
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• pp.81-92
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• 2024

Objective: The purpose of this study was to analyze the impact acceleration, shock attenuation and biomechanical variables at various running speed. Method: 20 subjects (height: 176.15 ± 0.63 cm, weight: 70.95 ± 9.77 kg, age: 27.00 ± 4.65 yrs.) participated in this study. The subjects ran at four different speeds (2.5 m/s, 3.0 m/s, 3.5 m/s, 4.0 m/s). Three-dimensional accelerometers were attached to the distal tibia, sternum and head. Gait parameters, biomechanical variables (lower extremity joint angle, moment, power and ground reaction force) and acceleration variables (impact acceleration, shock attenuation) were calculated during the stance phase of the running. Repeated measures ANOVA was used with an alpha level of .05. Results: In gait parameters, decreased stance time, increasing stride length and stride frequency with increasing running speed. And at swing time 2.5 m/s and 4.0 m/s was decreased compared to 3.0 m/s and 3.5 m/s. Biomechanical variables statistically increased with increasing running speed except knee joint ROM, maximum ankle dorsiflexion moment, and maximum hip flexion moment. In acceleration variables as the running speed increased (2.5 m/s to 4.0 m/s), the impact acceleration on the distal tibia increased by more than twice, while the sternum and head increased by approximately 1.1 and 1.2 times, respectively. And shock attenuation (tibia to head) increased as the running speed increased. Conclusion: When running speed increases, the magnitude and increasing rate of sternum and head acceleration are lower compared to the proximal tibia, while shock attenuation increases. This suggests that limiting trunk movement and increasing lower limb movement effectively reduce impact from increased shock. However, to fully understand the body's mechanism for reducing shock, further studies are needed with accelerometers attached to more segments to examine their relationship with kinematic variables.

• Korean Journal of Applied Biomechanics
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• v.12 no.2
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• pp.159-177
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• 2002

The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle and the angular velocity of the air born phase and understand the control mechanism of the high-bar movement, the somersault, the double somersault, the double somersault with full twist. For this study seven well trained university gymnastic volunteered, Zatsiorky and Seluyanov(1983, 1985)'s sixteen segment system anatomical model was used for this study. For the movement analysis three dimensional cinematographical method(Arial Performance Analysis System : APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 5.1 graphical profromming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and angular velocity were defined. As a result of this study 1. As the rotation of the body increased in the air born phase the projection angle of the CM of the total increased, this resulted the increased of the max hight of the CM. 2. In three dimensional angular velocity the Z axis(vertical direction) projection angular velocity increased as the rotation of the body increased in the airborn phase, but the Y axis and the X axis projection angular velocity did not show significant differences. 3. As the rotation of the body increased in the air born phase the angular movement of the shoulder and the hip showed significant change. These movement act as the starter in the preparation phase. 4. The somersault angle, the twist angle, the tilt angle of the upper body related to the global reference frame in the releas phase the average somersault angle of the three types of high-bar movement was $57.7^{\circ}$, $38.8^{\circ}$, $39.7^{\circ}$, the average tilt angle was $-1.5^{\circ}$, $-5.4^{\circ}$, $-8.4^{\circ}$, the average twist angle was $13.4^{\circ}$, $10.6^{\circ}$, $23.3^{\circ}$. This result showed that the somersault with full twist had the largest movement.

• 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.