Kinematic Effects of Newly Designed Knee-Ankle-Foot Orthosis With Oil Damper Unit on Gait in People With Hemiparesis
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- 한국전문물리치료학회지
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- 제20권1호
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- pp.64-73
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- 2013
The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio,
본 연구는 배드민턴 드라이브 동작의 원리와 현상을 이해함은 물론 운동 시 정확한 동작을 유도하여 상해예방 및 기술향상을 기할 수 있도록 기초자료를 제공하고자 하였다. 라헤드의 이동변위는 모든 연구대상자들에게서 비슷한 패턴으로 나타났지만 다소 차이가 나타난 이유로는 신장, 상완과 전완의 길이, 스윙괘적의 개인적인 성향의 등 외부적인 요인에 의한 결과로 사료된다. 국면별 상지관절의 각도를 살펴보면 어깨 관절, 팔꿈치 관절, 손목 관절의 각도는 드라이브 동작을 수행함에 있어 서로 유기적인 관계로 얽혀 있으며 근위에서 원위로 힘의 전달을 한다는 분절 순서이론도 뒷받침하고 있다. 상지관절의 각속도는 연구대상자 모두에서 임팩트 이후 팔로우스루 동작에서도 크게 나타났는데 이는 배드민턴과 같은 라운동에서 팔로우스루의 중요도를 나타내는 것을 의미한다. 이 팔로우스루 동작은 자세의 안정성 유지, 동작의 자세교정, 관절의 상해예방이라는 측면에서 라운동 시 중요요소로 작용하고 있음을 보여주고 있다. 종합해보면 분절의 순서이론에 따른 스윙이 이루어져야 효율적인 동작을 할 수가 있을 것으로 판단된다.
본 연구의 목적은 트레드밀 보행 시, gait dynamics 측면에서 보행의 속도 변화와 인지과제 수행 시 보행 변인의 가변성(variability)을 알아보고자 하는 것이다. 실험은 인지과제의 동시수행 유/무에 따른 5가지 속도(선호속도의 80%, 90%, 100%, 110% and 120%)에 의한 보행 실험으로 구성되었다. 인지과제의 종류는 학습기능이 없는 인지과제(2-back task)를 수행하였다. 인지과제는 피험자의 트레드밀 보행 시, 3m 앞에 놓여진 스크린에 주어지고 무선마우스를 통해 응답하는 형태로 구성되었다. 실험의 모든 과정은 3차원 동작분석기를 통해 동작데이터를 획득하였다. 이를 통해, 5가지 보행 시간 변인과 3가지 공간 변인을 추출하였다. gait dynamics 측면의 분석을 위해, 가변성의 크기를 살펴볼 수 있는 방법인 분산계수(coefficient of variance)와 변동량의 구조적 자기 유사성을 추론할 수 있는 detrended fluctuation analysis (DFA)를 사용하였다. 그 결과 보행 속도 변화에 따라 보행 변인의 평균값과 분산계수에서 통계적 유의한 차이가 발생하였고, 인지과제의 수행 유/무에 따라서는 DFA에서 통계적인 차이가 발생하였다. 이는 인지과제의 수행에 의해 보행의 발생과 조절 능력에 영향을 끼쳤다고 추론할 수 있다. 본 연구 결과를 명백히 하기 위해 더 많은 수의 피험자 실험과 추가 실험이 필요할 것이다.
목적: 아킬레스 동종건을 이용한 관절경적 후방십자인대 재건술을 시행한 환자군에 대해 임상적 결과를 평가하고 보행분석을 시행하고자 하였다. 대상 및 방법: 2004년 3월에서 2005년 3월 까지 후방십자인대 손상에 대해 신선 동결 아킬레스 동종건을 이용한 관절경적 재건술을 시행 받은 환자들 중, 저자들이 지시한 재활 프로그램에 순응한 12명의 환자를 대상으로 하였다. 모든 환자에서 수술후 추시 36개월에 임상적 결과 평가와 보행분석을 시행하였다. 임상적 결과는 관절 운동 범위, Lysholm knee score, Tegner Activity Score, IKDC score, 후방 전위 검사, Telos stress arthrometer를 이용한 후방 전위를 측정하여 평가하였고 보행검사는 3차원적 보행분석기를 이용하여 분석하였다. 결과: 모든 임상적 결과 평가 항목에 있어서 술 전과 비교하여 후방십자인대 재건술 후 통계학적으로 유의한 만족할 만한 결과를 보였다. 보행분석 결과 환측과 건측 슬관절에 굴곡각 및 내반각의 약간의 차이를 보였지만 통계적으로 유의성을 보이지 않았으며, 전반적으로 양쪽 슬관절의 유의한 보행의 차이는 관찰되지 않았다. 결론: 후방십자인대 손상 슬관절에서 관절경적 재건술을 시행한 환자 중 재활프로그램에 순응한 환자를 대상으로 평가한 결과 술 전과 비교하여 의미있게 증가된 임상적 결과와 건측과 비교하여 차이를 보이지 않는 보행분석 결과를 얻은바 후방십자인대 재건시 체계적이고 엄격한 재활치료가 중요할 것으로 사료된다.
There are many types of walking exercise. We have choice the way according to the walking exercise purpose. Nordic walking(NW) is one of walking types with nordic poles. Also, power walking(PW) has motion of large swing the arm in walking, and dumbbell walking(DW) way is walking with 3-pound dumbbell. This study compared the physiological response(heart rate, energy expenditure) of general walking(GW) to another types(nordic, power, and 3-pound hand weights walking way). Seven apparently male health volunteers between the ages 19 and 24 years participated. Each complete a treadmill test. The tests were assigned randomly, as submaximal walking trials on separate days. Each walking trial was conducted on a level treadmill, for 40 minutes(3-5mile/hour 5min warm-up, 6mile/hour speed for 15min walking and 7mile/hour speed for 15min Jogging exercise, and 5-3mile/hour cool down 5min), at an same pace. Heart rate in beats per minute(bpm), and energy expenditure in kcal per minute(kcal/min) were recorded each minute. Results between trials were compared using repeated measures analysis of variance and Tukey's post hoc tests. In slow walking, it was found that walking with 3-pound hand weight way resulted in and average of (
Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left
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.
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.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70