• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.174-179
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• 2013

Purpose: Visual gait analysis plays a pivotal role in determining the important gait problem of patients. A few studies have been published and have received little attention regarding visual gait analysis on patients with orthopedic problems. The purposes of this study were to investigate the difference of reliability levels according to experience of clinical physical therapists. Methods: Thirty-five clinical physical therapists, 5 high experienced, 15 experienced, and 15 inexperienced, were recruited and individually evaluated these videotaped gait patterns of the participants, and filled up the structured gait analysis form. The gait of nine participants was videotaped. Reliability levels were calculated by the Intraclass Correlation Coefficients (ICC). Results: The inter-rater reliability of high experienced group (ICC=0.56; 95% CI: 0.50-0.62) was comparable to that of the experienced raters (ICC=0.48; 95% CI: 0.43-0.53) and inexperienced group (ICC=0.42; 95% CI: 0.38-0.46). High experienced group reached a higher inter-rater reliability level. The average intra-rater reliability of the high experienced group was 0.70 (ICCs ranging from 0.54 to 0.82). The experienced group reached an average intra-rater reliability of 0.61 (ICCs ranging from 0.47 to 0.81). The inexperienced group attained average ICC values of 0.53 (ICCs ranging from 0.30 to 0.74). Conclusion: Use of a structured gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis.

• 대한물리의학회지
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• 제7권4호
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• pp.411-421
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• 2012

PURPOSE: The purpose of this study was to investigate the effect of balance rehabilitation training with the visual cue deprivation on gait function in stroke patients in comparison with balance training without the visual cue deprivation. METHODS: Twenty two stroke patients participated in this study. Patients were randomly assigned to one of the two balance training program with and without the visual cue deprivation. Balance training session for each group lasted 50 minutes, 3 times a week for a total of 6 weeks. Gait function was measured with the Functional Gait Assessment (FGA), the self-selective comfortable gait speed (CGS), the maximal gait speed (MGS), and the Gait Analysis System. Temporal and spatial gait parameters of each evaluation were measured before and after the balance training program respectively. RESULTS: After the program, the visual cue deprivation group improved significantly in the FGA, the CGS, the gait velocity, the step time, the step length, the stride length, and the Functional Ambulation Performance (FAP) in comparison with the balance training group with the visual cue (p<.05). CONCLUSION: The gait function of the participants with the visual cue deprivation showed more improvement after the balance training program compared to the patients group without the visual cue deprivation, Therefore, the balance training program with the visual cue deprivation may be useful for rehabilitation of patients with chronic stroke.

• 한국산학기술학회논문지
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• 제13권1호
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• pp.247-253
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• 2012

본 연구는 시각흐름 속도에 따른 가상현실 프로그램이 뇌졸중 환자의 보행에 미치는 영향을 알아보고자 시행하였다. 연구 대상자는 서울시 소재 M재활전문병원에 입원 중인 뇌졸중 환자 중 무작위로 31명을 선정하였고 대상자는 가상현실 프로그램에 몰입하여 보행분석기 위에서 보행을 실시하였으며 가상현실 프로그램의 4가지 조건은 정상 보행과 0.25배, 1배, 2배의 시각흐름 속도변환 가상현실 프로그램으로 구성되었다. 중재동안 보행분석은 GaitRite보행분석시스템을 이용하여 보행 속도, 분속수, 활보장, 보장, 단하지지지 시간, 양하지지지 시간을 측정하였다. 그 결과 0.25배의 느린 시각흐름 가상현실 프로그램에서 연구 대상자는 보행속도, 분속수, 환측 활보장, 건측 활보장, 환측 보장, 건측 활보장이 통계적으로 유의하게 감소하였고(p<.05), 환측 단하지지지시간, 건측 단하지지지시간, 환측 양하 지지지시간, 건측 양하지지지시간이 통계적으로 유의하게 증가하였다(p<.05). 또한 2배의 빠른 시각흐름 가상현실 프로그램에서 연구 대상자는 보행속도, 분속수, 환측 활보장, 건측 활보장, 환측 보장, 건측 활보장, 환측 단하지지지시간이 유의하게 증가하였고(p<.05), 건측 단하지지지시간, 환측 양하지지지시간, 건측 양하지지지시간이 유의하게 감소하였다(p<.05). 따라서 가상현실 보행 프로그램의 적용 속도에 따라서 뇌졸중 환자의 보행 능력이 유의하게 차이를 나타낸다는 것을 알았다. 그러므로 뇌졸중 환자의 운동 프로그램을 계획할 때 보행 훈련 프로그램을 증가시킬 수 있는 다양한 훈련 프로그램이 요구된다.

• PNF and Movement
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• 제15권2호
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• pp.133-140
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• 2017

Purpose: This study compares the effects of treadmill gait training accompanied by visual feedback and general treadmill gait training on the gait and balance ability of patients with chronic stroke. Methods: A total of 11 patients with chronic stroke were randomly divided into either the treadmill gait training accompanied by visual feedback group (six patients) or the general treadmill gait training group (five patients). The gait and balance ability of the two groups were measured before and after the interventions using the functional reach test, the Timed Up and Go (TUG) test, Berg's balance test, and the Biodex balance test. The treadmill gait training accompanied by visual feedback group performed the exercise under the supervision of a therapist after first being provided with a hat and a goal that was devised for the purpose of providing visual feedback information. The interventions were applied to the respective groups for four weeks. For the statistical analysis, we conducted a Mann-Whitney test to compare the results between the two groups. Additionally, the Wilcoxon test was used to compare the results from before and after the intervention in each group. Results: The treadmill gait training accompanied by visual feedback group showed a significant difference in terms of the functional reach test after the intervention when compared to the general treadmill gait training group (p<0.05). Although there was no significant difference, the treadmill gait training accompanied by visual feedback group showed a larger improvement in the TUG test, Berg's balance test, and the Biodex balance test than the general treadmill gait training group (p>0.05). Conclusion: The results of this study suggest that treadmill gait training accompanied by visual feedback can be used as a beneficial intervention scheme for the recovery of the gait and balance ability of patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• 제14권1호
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• pp.75-88
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• 2002

The purpose of this study was to investigate the influence of anterior, posterior, and lateral pelvic tilt exercise upon the gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of this study was 24 men and women patients with hemiplegia. The patients, the subject of this study, were classified into 12 patients of treatment group applying pelvic tilt exercise using visual feedback and 12 patients of control group applying general pelvic tilt exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis (Boening, 1977) was used to analyze their gait, and ink foot-print was applied as on of measurement methods. To find out meaningful difference between control group and treatment group, this study carried out independent sample t-test for each item by utilizing SPSS/Win 10.0, compared changes in control group's and treatment group's gait characteristics before and after exercise as percentage, and applied paired t-test to conduct before-after test in same group. Statistical significance level was ${\alpha}$ < 0.05. The results of this study were as follows. As a result of independent sample t-test for control group's and treatment group's gait characteristics after exercise, it was not statistically significant so there was no meaningful difference between two groups. However, it was statistically significant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that pelvic tilt exercise using visual feedback for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general pelvic tilt exercise. In the future, studies on the effect of pelvic tilt exercise using visual feedback shall be continued based on more quantitative methods.

• 한국엔터테인먼트산업학회논문지
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• 제14권3호
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• pp.363-373
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• 2020

본 연구는 뇌졸중 환자에게 엔터테인먼트요소가 가미된 가상현실과 시각적 되먹임 보행 훈련 프로그램을 병행하여 보행능력과 삶의 질을 향상시키고자 하였다. 이에 휘돌림 보행을 하는 뇌졸중 환자 10명을 선정하여, 가상현실과 힘판을 통한 시각적 되먹임 트레드밀보행훈련을 일일 30분씩, 주5회, 5주간 총 25회 실시하였다. 이러한 보행훈련의 효과를 알아보기 위해 관절가동범위검사, 근활성도 검사, 버그 균형 척도(BBS), 보행분석, 삶의 질(SS-QOL) 평가를 중재 전·후 시행하였다. 본 연구결과, 보행 흔듦기 시기에 마비측 관절가동범위와 근활성도, 동적균형능력, 보행능력, 삶의 질이 중재 후 통계학적으로 유의하게 차이가 있었다(p<0.05). 본 연구결과를 통해 본 연구의 보행훈련이 휘돌림 보행을 하는 뇌졸중 환자의 발처짐, 근활성도, 동적 균형 및 보행능력을 향상시키고, 이로 인한 삶의 질도 개선하는 것을 알 수 있었다. 따라서 휘돌림 보행을 하는 뇌졸중 환자의 보행능력 향상과 삶의 질 개선을 통한 라이프케어증진을 위해 가상현실과 힘판을 통한 시각적 되먹임 트레드밀보행훈련 프로그램 적용을 권장한다.

• 대한물리의학회지
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• 제17권1호
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.215-223
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• 2022

Objective: This study was to resolve the limitations of the experimental environment and to solve the shortcomings of the method of measuring human gait characteristics using optical measuring instruments. Design: A cross-sectional study. Methods: Fifteen healthy adults without a history of orthopedic surgery on the lower extremities for the past 6 months were participated. They were analyzed gait variables using the smart guide and the 3D image analysis at the same time, and their results were compared. Visual-3D was used to calculate the analysis variables. Results: The reliability and validity of the data according to the two measuring instruments were found to be very high; gait speed(0.85), cycle time(0.99), stride time of both feet(0.98, 0.97) stride legnth of both feet(0.86, 0.88) stride per minute of both feet(0.99, 0.96), foot speed of both feet(0.90, 0.91), step time of both feet(0.77, 0.71), step per minute(0.72, 0.74), stance time of both feet(0.96, 0.97), swing time of both feet(0.93, 0.79), double step time(0.81), initial double step time(0.84) and terminal step time(0.76). Conclusions: In the case of the smart insole, which measures human gait variables using the pressure sensor and inertial sensor inserted in the insole, the reliability and validity of the measured data were found to be very high. It can be used as a device to replace 3D image analysis when measuring pathological gait.

• 한국산학기술학회논문지
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• 제11권9호
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• pp.3353-3357
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• 2010

본 연구는 만성 뇌졸중 환자를 대상으로 시각리듬자극(rhythmic visual stimulation, RVS)을 이용한 보행 운동을 적용하여 보행과 고유수용성감각에 미치는 효과를 알아보고자 하였다. 뇌졸중으로 6개월 이상 장애를 가진 21명이 연구에 참여하였고 실험군 10명과 대조군 11명으로 나누었다. 대조군은 14m의 보행로가 확보된 공간에서 준비운동 5분, 보행운동 20분, 정리운동 5분 씩 주 3회, 4주간 12회를 실시하였고, 실험군은 대조군의 운동프로그램과 같은 조건에서 보행운동시 시각리듬자극(RVS)을 추가적으로 적용하였다. 운동 전 후에 보행과 고유수용성감각을 측정하여 효과를 비교하였다. 통계처리 방법으로 실험 전?후 차이를 검증하기 위하여 Wilcoxon 부호 순위 검정을 실시하였고 대조군과의 차이 검증을 위하여 공분산분석 검정을 실시하였다. 모든 통계적 유의수준은 p<0.05로 하였다. 본 연구의 결과 시각리듬자극(RVS)이 적용된 실험군에서 보행속도와 분속수, Timed up and go test(TUG) 시간이 유의하게 증가하였고(p<.05), 고유수용성감각이 유의하게 증가하였다(p<.05). 결론적으로 시각리듬자극(RVS)을 이용한 보행운동이 만성 뇌졸중 환자의 보행과 고유수용성감각에 효과가 있는 것으로 나타났다. 향후 만성 뇌졸중 환자에게 음악적 요소인 시각리듬자극(RVS)이 정신적 육체적 기능을 상실한 뇌졸중 환자의 재활치료 프로그램에 적용하는 연구가 필요할 것으로 기대된다.

• PNF and Movement
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• 제18권3호
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• pp.383-392
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• 2020

Purpose: Balance and gait dysfunction caused by aging affect elderly individuals' independent life, which, in turn, can reduce their overall quality of life. The purpose of this study is to compare the differences in the vestibular function of healthy elderly and young adults based on the subjective visual vertical (SVV) test as well as to compare and analyze the gait ability between these two groups to study the differences and association between vestibular, dizziness, and balance ability. Methods: The subjects were 18 young and 16 elderly adults with no neurological or musculoskeletal damage. To evaluate vestibular function, a subjective visual vertical test was performed. To evaluate the gait function, the step time, step length, stride length, stance phase ratio, and swing phase ratio were measured. Balance was evaluated using the Berg Balance Scale (BBS), and dizziness was evaluated using a dizziness handicap inventory (DHI). Results: There were significant differences in the SVV, BBS, and DHI between the young and elderly adults (p < 0.05). The gait variables of the older adults were all significantly different (except for the swing phase ratio) than those of the young adults (p < 0.05). As the result of correlation analysis, the SVV values of the young adults showed a significant negative correlation with step length and stride length (p < 0.05), while the SVV values of the elderly adults only showed a significant positive correlation with the DHI (p < 0.05). Conclusion: The elderly appeared to show a decrease in vestibular function when compared to the young adults, and it is thought that walking and balance function declined, while dizziness increased. Moreover, it is believed that these results can be used as basic data for vestibular rehabilitation in the future.