• The Journal of Korean Physical Therapy
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• 제20권3호
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• pp.9-18
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• 2008

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.45-64
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• 2003

The purpose of this study was to examine the effects of the pelvic tilting exercise, pelvic tilting exercises with floor walking training, pelvic tilting exercises with treadmill walking training on quantitative gait function in patients with hemiplegia. Thirty patients with hemiplegia due to cerebrovascular disease participated in this study. Subjects were randomly assigned to one of pelvic tilting exercise group, pelvic tilting exercise with floor walking training group and pelvic tilting exercises with treadmill walking training group. The effects of each therapeutic method were evaluated by measurements of gait velocity, cadence, stride length, step length, base of support and foot angle using ink-foot prints. Data were analyzed statistically using paired t-test and one-way ANOVA. The results of this research are as followings : 1. After treatment, it turned out that pelvic tilting exercises with treadmill walking training has the most effect on gait velocity, cadence, stride length, step length and foot angle, which has significant difference in statistics (p<0.05). 2. Quantification of the gait velocity, cadence, both stride length and step length demonstrated a significant increase (p<0.05) after treatment in all groups when compared with values measured before treatment. The base of support and foot angle in affected side decreased significantly (p<0.05) after treatment in all groups when compared with values measured before treatment. 3. The lumbosacral angle noted a significant increase (p<0.05) after treatment in all groups, however, an ANOVA analysis did not reveal any differences between groups.

• 대한물리치료과학회지
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• 제7권1호
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• pp.367-375
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• 2000

The purpose of this study is to announce the present condition, walking training, and adaptable training of a limb amputated patient. The study is a successful report of the limb amputated patient through the medical treatment of the physical therapy. A cause of the limb amputated patient, a truck driver, was that the patient was hit by a train when the driver alight from the truck. Then, the driver was surgical operated on left AK (Above Knee) amputation and left AE (Above Elbow) amputation by orthopedics at the Young Dong Severance Hospital on Dec.7, 1996. Two weeks after the operation (Dec., 22, 1996), the patient was trained at the Yonsei Medical Center Physical Therapy Hospital for the walking and temper adjust training. It was possible to do a flat surface walking and a slope surface walking without helping due to the patients optimistic personal character and motivation. However, the patient struggled to a dull surface walking and his weak endurance. the patient has several problems when the patient wears artificial legs and hands, fears on fall down, and mentally worries on noise when he walks. It is necessary to approach for this problems by many fields of the helpers, such as Rehabilitation medical doctor, physical therapist, occupational therpist, artificial limbs makers, psychologists, and etc. Therefore, in order for recovering from the amputated parts function after the surgical operation, more approved reports have to be for the amputated patients due to increasing traffic accidents, industrial disaster, cancer, diabetes, obstacles of the peripheral nervous system, and etc.

• 한국지능시스템학회논문지
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• 제23권1호
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• pp.51-56
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• 2013

이족 보행 로봇을 실생활에 적용하기 위해서는 다양한 환경에서의 강인한 보행 뿐만 아니라, 현재 위치를 인식하여 목표 위치로의 경로를 생성하고, 경로를 추종하는 기능이 요구된다. 최근에 많이 사용되고 있는 RFID는 이동 로봇의 위치인식 및 경로 생성에 손쉽게 활용이 가능하다. 그러나 이족 로봇은 보행시에 불안정성을 내포하고 있어 주어진 경로에서 벗어나기 쉽다. 본 논문에서는 FSR(Force Sensing Resistor)센서, 자이로와 가속도 센서를 이용하여 이족 보행 로봇의 보행 안정화 방법을 제안하였다. 또한 양발에 RFID 센서를 장착하여 이족 보행 로봇의 위치 인식 후 경로를 추종하는 알고리즘을 제안하였다. 제안된 보행 안정화 알고리즘은 실제 제작된 이족 보행 로봇을 이용하여 비평탄 지형에서 실험하여 검증하였으며, 경로 추종 실험은 RFID센서를 로봇의 발바닥에 장착하여 평탄 지형에서 보행실험을 통해 검증하였다.

• 대한통합의학회지
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• 제7권4호
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• pp.119-130
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• 2019

Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.281-287
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• 1984

In search for a method of evaluating the cardiopulmonary function. 74 male and 33 female volunteers ages $18{\sim}25$ were subjected to this study The subjects walked on a treadmill at speed of 2,4,6 and 8km/hr with 0,5,10,15,20 and 25% grade of inclination, respectively, for a measurement of heart rate and oxygen-pulse. Heart rate was measured every 5 seconds at resting state and during walking by telemetric method using Heart Checker 108 System (Senoh Co., Japan). Oxygen concentration was measured by Douglas bag method collecting expired air for 5 minutes at rest, and for 2 minutes at the end of each walking exercise. Oxygen concentration in an expired air was analyzed with Orzat gas analyser and expressed in terms of STPD. Oxygen-pulse was defined as an amount of oxygen consumed at every heart at a cellular level. The followings were the results obtained from this study. 1. Mean values of oxygen-pulse at resting state was $3.1{\pm}0.11ml/beat$ in male and $2.5{\pm}0.87ml/beat$ in female, respectively. 2. Mean values of oxygen-pulse during treadmill walking were increased in proportion with the load of exercise, namely, the speed and grade of inclination, from minimum of 7.1ml/beat upto maximum of 18.2ml/beat in male and from minimum of 4.2ml/beat upto maximum of 12,7ml/beat in female. 3. Both linear and logarithmic regressional relationships between oxygen-pulse and speed of walking and grade of inclination were observed in both sexes. Predicted values of oxygen-pulse by logarithmic regressional formula on speed and on grade of inclination were better coincided with the measured values than those predicted by the linear regressional formula.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.976-986
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• 1996

연구배경: 호흡곤란은 심폐질환 환자의 가장 흔한 증상이며 호흡 장애 결과로 인한 운동 능력저하는 일상 생활을 불가능하게 한다.(daily disability) 운동시 산소 소모량은 운동 능력 평가의 기능적 척도이며 심폐기능 정도를 반영하는 가장 좋은 지표로 얄려져왔다. 그러나 운동 부하 검사는 장비가 비싸고 복잡하며 증상이 심하거나 노령층의 환자에는 수행에 많은 제약점이 따른다. 반면 걷기검사는 일상 생할과 비슷한 운동량으로 실시하여 특별한 장비가 필요없고 재현성이 높은 좋은 방법으로 알려져 있다. 따라서 호흡 곤란을 호소하는 환자에서 걷기검사를 시행하여 동맥혈검사 및 폐기능 검사, Modified Borg Scale(MBS), 최대 산소 흡수율(maximal oxygen uptake; 이하 VO2max) 간의 상관 관계 및 6분과 12분 걷기검사간의 상관 관계를 알아보고자 본 연구를 시행하였다. 방법: 호흡곤란을 주소로 내원한 37 명의 환자를 대상으로 COPD, 심혈관질환, 기관지 천식, 운동시 호흡곤란을 호소하였으나 정상 소견을 보인 네 군으로 분류하여 각각의 환자에서 안정 상태에서 폐기능 검사와 동맥혈 가스 분석을 실시하였다. 안정 시 MBS를 이용하여 호흡곤란 지수를 기록하고, 걷기검사를 실시하였다. 증상 제한적 최대 운용 검사(Symptorn-limited maximal exercise)는 자전거 타기 검사로 시행하였다. 결과: (1) 전체 환자에서 VO2max 은 COPD 및 심혈 관질환에서 다른 두군에 비해 유의하게 낮았으며 (p<0.05), 걷기검사 역시 현저히 낮았다. (2) 전체 환자에서 12분 걷기 검사는 VO2max, PaCO2, FVC(% predicted), FEV 1 (% predicted)과 상관관계가 있었으며, COPD 환자군에서는 걷기검사와 VO2max간에만 상관 관계가 있었다. (3) COPD 환자군에서 VO2max와 FEV1, FVC간의 상관관계가 가장 컸고, VO2 max와 걷기검사간에 유의한 상관관계가 있었으나 걷기검사와 FEV1 FVC간에는 상관관계가 없었다. (4) 6분 걷기검사와 12분 걷기검사는 매우 유의한 상관관계가 있었다(r=0.92, p<0.01). 결론: 걷기검사는 심폐기능을 반영하는 운동능력 평가의 간단한 방법으로 VO2max의 간접적인 지표로 유용하였으나 최대 운동 능력과는 다른 개념인 'daily disability'를 평가할 수 있는 방법이다. 또한 6분 걷기검사는 12분 걷기검사보다 환자의 부담은 줄이면서 심폐질환자의 폐기능 및 운동 기능 평가에 비슷한 결과를 보였다.

• 한국조경학회지
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• 제37권6호
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• pp.57-65
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• 2010

최근 전 세계적으로 앉아서 일하거나 여가시간을 보내는 생활습관(sedentary lifestyle)의 비율이 증가하면서 사람들의 체활동시간이 상당량 감소하였다. 이로 인해 비만 및 당뇨병과 같은 만성질환의 발병률이 증가하였고, 이를 해결하기 위한 대책으로써 누구나 쉽게 접근할 수 있다는 장점을 지닌 걷기활동이 사람들의 관심을 받고 있다. 본 연구의 목적은 사람들이 즐겁고 안전하게, 그리고 쾌적하게 생활할 수 있는 걷기 중심의 활동친화적 도시를 조성하여 일상생활 속에서 사람들의 걷기활동을 유도함으로써 감소되고 있는 현대인들의 신체활동량을 증진시키고자 하는데 있다. 이를 위해 진해시민들을 대상으로 걷기활동의 참여 및 정도를 결정하는데 영향을 끼치는 물리적 보행환경에 대한 만족도 조사를 실시하였고, 이러한 물리적 환경요인들이 보행만족도에 미치는 영향을 평가하기 위한 모형을 제시하였다. 연구의 결과를 요약하면 다음과 같다. 총 18개의 물리적 보행환경 지표를 선정하였고, 지표별 만족도 분석을 실시한 결과 횡단시설지표가 가장 높았고, 건물외관지표가 가장 낮게 나타났다. 요인분석은 1차, 2차로 진행되었으며, 1차에서는 18개 물리적 보행환경 지표에 대한 요인분석의 적절성을 검토하였다. 그 결과 2개의 지표가 제거되었고 나머지 16개의 지표가 2차 분석에 의해 4개의 요인으로 추출되었다. 각 요인의 공통성에 근거하여 4개의 요인을 각각 보도의 기능성, 차량의 영향, 쾌적성, 안전성으로 명명하였다. 다음으로 각 요인의 요인점수를 독립변수로, 보행만족도를 종속변수로 설정하여 다중선형회귀분석을 실시한 결과 4개의 독립변수 모두 보행만족도에 긍정적인 영향을 미치는 것으로 분석되었다. 요인별 기여도는 '보도의 기능', '쾌적성', '차량의 영향', '안전성' 순으로 높게 나타났으며, 특히 '보도의 기능'과 '쾌적성'의 영향이 다른 두 요인에 비해 상대적으로 매우 높은 것으로 분석되었다. 본 연구 결과는 향후 걷기 중심의 활동친화적 도시를 창출하는데 중요한 기초자료로 활용될 것으로 판단된다.

• 한국콘텐츠학회논문지
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• 제12권8호
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• pp.274-282
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• 2012

이 연구는 뇌졸중 환자를 대상으로 낙상예방을 위하여 가상현실 체험형 게임 운동(Nintendo-Wii Sport-NWS)과 요부안정화 운동을 실시하고 낙상관련 신체 심리 기능 변화를 측정하였다. 뇌졸중환자 30명을 대상으로 신체적 기능은 정적, 동적균형으로 측정하였고 심리적기능은 낙상효능감을 측정하여 운동 전과 운동 후, 각 운동군간을 비교분석하였다. 정적균형은 BBS, FRT, 동적균형은 TUG, 10m 보행검사, 낙상효능감은 낙상 효능감 지수로 측정되었다. 그 결과 두군 모두 신체 심리적기능에서 유의한 개선을 나타내었다. 그러나 BBS, FRT, 10m보행에서 요부안정화 운동군이 더 통계적으로 개선된 것으로 나타났으며 낙상효능감은 가상현실 체험형 게임 운동 군에서 더욱 개선된 것으로 나타났다. 결론적으로 가상현실 체험형 게임운동은 뇌졸중환자의 신체 심리적 기능 증진에 긍정적인 영향을 미친다.

• 한국운동역학회지
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• 제31권4호
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• pp.241-248
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• 2021

Objective: The purpose of this study was to investigate the difference in muscle strength, kinematics, and kinetics between injured and non-injured sides of the leg after Achilles Tendon Rupture surgery during walking and running. Method: The subjects (n=11; age = 30.63 ± 5.69 yrs; height = 172.00 ± 4.47 cm; mass = 77.00 ± 11.34 kg; time lapse from surgery = 29.81 ± 10.27 months) who experienced Achilles Tendon Rupture (ATR) surgery participated in this study. The walking and running trials were collected using infrared cameras (Oqus 300, Qualisys, Sweden, 100 Hz) on instrumented treadmill (Bertec, U.S.A., 1,000 Hz) and analyzed by using QTM (Qualisys Track Manager Ver. 2.15; Qualisys, U.S.A). The measured data were processed using Visual 3D (C-motion Inc., U.S.A.). The cutoff frequencies were set as 6 Hz and 12 Hz for walking and running kinematics respectively, while 100 Hz was used for force plate data. Results: In ATR group, muscle strength there were no difference between affected and unaffected sides (p> .05). In kinematic analysis, subjects showed greater ROM of knee joint flexion-extension in affected side compared to that of unaffected side during walking while smaller ROM of ankle dorsi-plantar and peak knee flexion were observed during running (p< .05). In kinetic analysis, subjects showed lower knee extension moment (running at 2.2 m/s) and positive ankle plantar-flexion power (running at 2.2 m/s, 3.3 m/s) in affected side compared to that of unaffected side (p< .05). This lower positive ankle joint power during a propulsive phase of running is related to slower ankle joint velocity in affected side of the subjects (p< .05). Conclusion: This study aimed to investigate the functional evaluation of the individuals after Achilles tendon rupture surgery through biomechanical analysis during walking and running trials. Based on the findings, greater reduction in dynamic joint function (i.e. lower positive ankle joint power) was found in the affected side of the leg compared to the unaffected side during running while there were no meaningful differences in ankle muscle strength and walking biomechanics. Therefore, before returning to daily life and sports activities, biomechanical analysis using more dynamic movements such as running and jumping trials followed by current clinical evaluations would be helpful in preventing Achilles tendon re-rupture or secondary injury.