• The Journal of Korean Physical Therapy
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• v.25 no.4
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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.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.247-253
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• 2012

The purpose of this study was to evaluate the effects of a visual flow speed's modulation-based VR(virtual reality) program on gait function in stroke patients. Thirty one stroke patients were randomly selected at Dep. of Rehabilitation medicine of M hospital in Seoul. We carried out the gait analysis by dividing them with four conditions : one condition had applied without the visual flow modulation-based VR and another had done three visual flow speed's modulation-based VR(0.25, 1, 2 times). The gait analysis was used with GaitRite system. The data were collected using gait velocity, cadence, stride length, step length, single support time, and double support time during treatment. The results were as follows. First, the slow visual flow(0.25 times)-based VR program on the condition was significant decrease gait velocity, cadence, stride length, step length and increase single support time, double support time(p<.05). Second, the fast visual flow(2 times)-based VR program on the condition was significant increase gait velocity, cadence, stride length, step length, single support time on paretic lower limb and decrease single support time on non-paretic lower limb, double support time(p<.05). Third, the normal visual flow(1 times)-based VR program on the condition was not significant differ gait velocity, cadence, stride length, step length, single support time, double support time. In conclusion, the visual flow speed's modulation-based VR program improves gait function in chronic stroke patients.

• PNF and Movement
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• v.15 no.2
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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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• v.14 no.1
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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.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.363-373
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• 2020

The purpose of this study was to improve the gait ability and quality of life of stroke patients by combining virtual reality technology and a visual feedback gait training program with entertainment elements. Ten stroke patients with circumduction gait were selected. The visual feedback treadmill gait training program using virtual reality technology and a force plate measurement system was conducted 30 minutes a day, 5 days a week, with 25 sessions in 5 weeks. To investigate the effects of this gait training program, evaluations using the joint range-of-motion test, muscle activity tests, Berg balance scale (BBS), gait analysis, and stroke-specific quality-of-life scale (SS-QOL) were performed before and after intervention. Statistically significant differences were found in the joint range of motion and muscle activity of the affected side from the initial swing phase to the mid-swing phase of the gait cycle, dynamic balance, gait function, and quality of life (p <0.05). The results of this study indicate that the gait training program improved the foot drop, muscle activity, dynamic balance, and gait ability of stroke patients with circumduction gait, thereby improving the quality of life of the patients. Therefore, we recommend the application of the visual feedback treadmill gait training program using virtual reality technology and a force plate measurement system to improve gait ability and quality of life of stroke patients with circumduction gait.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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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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• v.11 no.2
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3353-3357
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• 2010

The purpose of this study is to investigate the effect of visual rhythmic stimulation in gait ability and proprioception in chronic stroke patients. Twenty-one persons after six months post stroke participated in pre and post test control. The subjects were randomly assigned to a rhythmic visual stimulation(RVS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the proprioception test and gait characteristics by gait analysis. In gait characteristics, the walking speed, cadence and the TUG time were significantly different from RVS group. The proprioception were significantly different RVS and control group. This study showed that the RVS training increased better functional activity by postural adjustment and gait learning of chronic stroke patients than that of control group. And so, the RVS training of hemiplegic patients was very important to successive rehabilitation. A continuous examination of RVS training could be practical use of physical therapy with exercise.

• PNF and Movement
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• v.18 no.3
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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.