• 한국전문물리치료학회지
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• 제19권4호
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• pp.16-23
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• 2012

This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.49-53
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• 2010

Purpose: The purpose of this study was to investigate the plantar pressure distribution between the affected and unaffected side in adult hemiplegia during gait with the use of a quad-cane. Methods: Thirty-four stroke patients from 34 to 83 years of age were enrolled in this study, and in random order, all patients were asked to walk at their most comfortable speed three times along a walkway with the use of quad-cane over a period of three days. Plantar pressure distribution was measured with regard to foot contact pattern and center of pressure (CoP) trajectories during the stance phase, progressing from heel-strike to toe-off. The F-scan system was used to compare the foot pressure of the affected and unaffected sides. Results: A significant reduction in the total contact area, the width of fore foot (FF) and hind foot (HF), and anterior/posterior (AP) CoP trajectory of the affected side was found. However, contact pressure of the hind foot on the affected side during walking increased when compared to that on the unaffected side. Conclusion: We demonstrated that plantar pressure distribution on the affected side of adult hemiplegia patients was generally poorer than that on the unaffected side when these patients walked with cane assistance. However, the use of a quad-cane was shown to increase contact pressure of the hind foot on the affected side because weight can be borne on the affected side during heel-strike with use of the cane.

• The Journal of Korean Physical Therapy
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• 제27권2호
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• pp.124-127
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• 2015

Purpose: The emphasis on gait rehabilitation after stroke depends on training support through the lower limbs, balance of body mass over the changing base of support. However, muscle weakness, lack of control of lower limb, and poor balance can interfere with training after stroke. For this case study report, a wearable robot orthosis was applied to stroke patients in order to verify its actual applicability on balance and gait ability in the clinical field. Methods: Two stroke patients participated in the training using the wearable robot orthosis. Wearable robot orthosis provides patient-initiated active assistance contraction during training. Training includes weight shift training, standing up and sitting down, ground walking, and stair up and down Training was applied a total of 20 times, five times a week for 4 weeks, for 30 minutes a day. Gait ability was determined by Stance phase symmetry profile, Swing phase symmetry profile, and velocity using the GAITRite system. Balance ability was measured using the Biodex balance system. Results: Subjects 1, 2 showed improved gait and balance ability with mean individual improvement of 72.4% for velocity, 19.4% for stance phase symmetry profile, 9.6% for swing phase symmetry profile, and 13.6% for balance ability. Conclusion: Training utilizing a wearable robot orthosis can be useful for improvement of the gait and balance ability of stroke patients.

• 대한기계학회논문집A
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• 제41권8호
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• pp.771-782
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• 2017

본 논문은 노약자들의 발목근력보조를 위한 착용형 로봇에 대해서 서술하였다. 기존 착용형 로봇들은 보행 시 필요한 근력을 보조하기 위해 대부분 모터와 감속기를 사용하였다. 하지만 모터와 감속기의 조합은 무게가 무거울 뿐만 아니라 감속기 치차의 마찰때문에 실제 사람의 근육과 달리 강성과 토크를 동시에 제어하기 어려운 한계가 있다. 따라서 본 연구에서는 모터/감속기 조합보다 가볍고 안전하며 근력을 보조하는 힘을 충분히 발휘할 수 있는 Mckibben 공압 근육을 사용하였다. 발목의 피칭 모션에 이용되는 종아리 가자미근 및 앞정강근의 힘을 한 쌍의 공압 근육을 사용한 상극구동으로 보조하였으며, 상극구동제어를 위해 상극구동 모델 파라미터들을 실험적으로 도출하였다. 사용자의 보행의지를 판단하고자 발바닥에 부착된 압력변위센서로 압력과 압력중심위치를 측정하여 발바닥의 하중과 발목토크를 계산하였고, 이를 기반으로 공압 근육 관절의 강성과 토크를 동시에 제어하였다. 최종적으로, 트레드밀에서 근전도 신호를 측정하여 발목근력보조로봇의 성능을 실험적으로 입증하였다.

• 한국간호교육학회지
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• 제7권2호
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• 한국산업정보학회논문지
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• 제28권4호
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• pp.1-9
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• 2023

본 논문은 딥러닝을 통해 실시간으로 임베디드 기기에서 점자 블록을 인식하는 방법을 제안한다. 먼저 고성능 컴퓨터에서 점자 블록 인식을 위한 딥러닝 모델을 학습시키고, 임베디드 기기에 적용하기 위하여 학습 모델을 경량화 도구에 적용한다. 점자 블록의 보행 정보를 인식하기 위해 영상에서 점자블록과의 거리를 이용하여 경로를 판별하는 알고리즘을 사용한다. 임베디드 기기를 통해 촬영한 영상에서 YOLOv8 모델을 통해 점자 블록, 볼라드, 횡단보도를 검출한 후 점자블록 경로 판별 알고리즘을 거쳐 보행정보를 인식한다. 실시간으로 점자 블록을 검출하기 위해 모델 경량화 도구를 YOLOv8에 적용한다. YOLOv8 모델 가중치의 정밀도를 기존 32비트에서 8비트로 낮추고, TensorRT 최적화 엔진을 적용하여 모델의 최적화를 진행한다. 제안된 방법을 통해 경량화 된 모델을 기존 모델과 비교한 결과, 경로 인식 정확도는 99.05%로 기존 모델과 거의 차이가 없지만, 인식 속도는 기존 모델 대비 59% 단축되어 1초에 약 15개의 프레임을 처리할 수 있다.

• 임상간호연구
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• 제23권3호
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• pp.350-360
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• 2017

Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

• The Korean Journal of Pain
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• 제10권1호
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• pp.86-88
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• 1997

Regional sympathetic blockade is the most effective treatment for reflex sympathetic dystrophy (RSD). Radiofrequency thermocoagulation provides longer duration of pain relief than local anesthetics and less complication than chemical neurolytic agents for lumbar sympathectomy. Spinal cord stimulation (SCS) is thought to be an effective modality yieding good results in treating intractable neuropathic pain. Therefore RSD might be a good indication for SCS. We treated a patient with RSD who responded well to lumbar sympathetic blockade (LSB) with radiofrequency thermocoagulation and SCS. The patient had a left ankle sprain requiring a case for the lower leg for 2 weeks. The patient suffered increasing pain and swelling on the lower part of that leg. We thought to block the lumbar sympathetic chain utillzing radiofrequency thermocoagulation 2 days after LSB with local anesthetics. The results provided accepatable pain relief (VAS $8{\rightarrow}15$) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS $5{\rightarrow}13$) and patient could walk without assistance.

• 지역사회간호학회지
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• 제13권2호
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• pp.332-342
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• 2002

Purpose: The purpose of this study was to assess the level of activities of daily living (ADL) in a group of community dwelling elderly. Methods: The subjects were 100 low-income elderly registered in a public health center. The data were analyzed using the SPSS/PC program. Results: The results were as follows: 1. The basic ADLs of the subjects were scored at 7 levels, and the mean score was 6.24 out of 7 points. The subjects did not necessarily require help from others, but might have needed more times or instrumental assists to perform ADLs. The lowest ADL score was reported on walking up to the stairs (5.05), for which the subjects did not need physical assistance, but needed a certain degree of supervision. The highest score was reported on self eating (6.74), followed by bowel management (6.60). 2. The mean IADL score of the subjects was 1.77 out of 4 points. indicating that the subjects were very independent in performing IADLs, without help from others. 3. In relation to general characteristics, the level of ADLs of the subjects was significantly different by age (F=6.65, P=.000), main activities (F=6.36, P=.001), perceived health status (P=4.66, P=.012), educational background (F=4.64, P=.03), marital status(F=4.62, P=.005), and major household income (F=4.15, P=.002). 4. The subjects' level of IADLs in relation to their general characteristics was significantly different by perceived health status (F=8.08, P=.001), major activities (F=7.33, P=.000), age (F=6.18, P=.000), family context (F=3.53, P=.018), religion (F=3.10, P=.019), marital status(F=2.62, P=.055), and major household income (F=2.31, P=.049).

• Archives of Plastic Surgery
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• 제32권4호
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• pp.539-542
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• 2005

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.