• 제목/요약/키워드: asymmetric gait

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편마비 환자의 양쪽 하지 테이핑 적용이 균형 및 보행에 미치는 영향 (The effect on balance and gait when applying Kinesio Taping to the lower extremities of hemiplegic patients)

  • 박창희;배화숙;김혜영;박현순;박혜선;정병욱;최진석;서한경;박혜진;김명훈;김상엽;정대인;김찬규;양진홍;김현진
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.11-19
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    • 2011
  • Purpose: The purpose of this study is to understand the effect of balance and gait when simultaneous application of Kinesio Taping on the lower extremities is done to improve the pattern of hemiplegic patients asymmetric lower extremity. Methods: This study was performed with 7 patients who have hemiplegia symptoms due to stoke. The taping on the paralyzed side was done on tibialis anterior, gluteus medius, gluteus maximus and psoas major and the taping on the unparalyzed side was done on the calf muscle and quadriceps. Berg Balance Scale(BBS) and Time Up and Go Test(TUG) was used to assessment the balance and gait of the patient after the kinesio taping was done on the lower extremities. The results of the test was analyzed by Wilcoxon Signed Rank Test on SPSS(Ver. 10.1). Results: When the taping was done on the paralyzed side, there was a significant improvement of balance and gait in BBS and TUG. When the taping was done on the lower extremities, it showed significant improvement of balance and gait, compared to when the taping was only done on the paralyzed side, according to BBS and TUG. Conclusion: The result of this study shows that the simultaneous taping of the lower extremities of the hemiplegic patients improves balance and gait by improving the pattern of patients lower extremities.

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보행 시 비대칭성 가방 휴대가 족저압에 미치는 영향 (The Effects of Asymmetric Bag Carrying during Walking on Plantar Pressure)

  • 박수진;이중호;김진상
    • 대한물리의학회지
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    • 제7권4호
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    • pp.459-469
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    • 2012
  • PURPOSE: The purpose of the present study was to examine changes caused by asymmetric bag carrying methods to carry the bag with one shoulder only to plantar pressure during walking. METHODS: Twenty three normal adults without any gait problem participated in the present study. Experimental conditions used consisted of walking without carrying any bag(condition 1), walking wearing a bag on both shouders (condition 2), and walking wearing a bag on the right shoulder(condition 3) and the weight of the bag was set to 15% of each subject's body weight. All the subjects were instructed to participate in all experiments under these three conditions and plantar pressures were measured from the subjects' right and left feet using an F-scan system while the subjects were walking under the three conditions. To analyze the measured plantar pressure, the sole was divided into seven areas (Hallux, Toe, Met1, Met23, Met45, Mid foot and Heel) and maximum plantar pressures in individual areas were measured. RESULTS: The results of measurement of plantar pressures under three walking conditions did not show significant changes in any areas of the left and right feet except for the mid foot area of the right food. The asymmetry between the left and right feet was examined and the results showed significant differences only in area Met23 under condition 2 and did not show significant differences in any other areas. CONCLUSION: On comprehensively considering the results of the present study, it could be seen that asymmetric bag carrying did not have large effects on changes in plantar pressure during walking compared to symmetric carrying. The reason for this is considered to be posture adjusting mechanisms against load positions.

만성 뇌졸중 환자의 참여제한에 활동과 가족지지가 미치는 영향 (The Effects of Activity and Family Support on the Participation Restriction of Chronic Stroke Patients)

  • 김원호
    • 한국전문물리치료학회지
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    • 제19권1호
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    • pp.76-85
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    • 2012
  • The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.

파킨슨병 환자의 상지 스윙의 비대칭과 청각신호에 따른 보행 시 진폭에 미치는 영향 (Arm Swing Asymmetry and Effect of Auditory Cues on Amplitude in the Patients with Parkinson's Disease)

  • 손호희;김은정
    • 한국산학기술학회논문지
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    • 제14권1호
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    • pp.344-350
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    • 2013
  • 본 연구의 목적은 파킨슨병 환자의 청각 신호에 따른 보행 시, 상지 스윙의 비대칭과 진폭에 미치는 영향을 알아보기 위함이다. 연구의 대상자는 초기 파킨슨병으로 진단받은 14명의 환자로, 청각 신호(빠른 속도, 일반적인 속도, 느린 속도)를 무작위 순서로 제공하여 보행을 실시하였다. 청각 신호 속도는 전자 메트로놈을 이용하여 대상자의 자연스러운 보행 속도보다 ${\pm}20%$ 속도를 적용하였다. 각각의 속도에 따른 청각 신호를 적용한 보행을 실시하는 동안, 동작분석기를 사용하여 보행 시 상지 스윙의 운동학적 변수를 비교 분석하였다. 정상 속도의 보행 시 파킨슨병 환자의 양측 상지 스윙 진폭의 비교에서는 더 많은 영향을 받은 쪽(MAS)의 상지 스윙 진폭에서 유의한 감소가 나타났다(p<.05). 청각 신호 속도에 따른 보행 시의 비교에서는 빠른 속도의 청각 신호를 적용한 보행 시 상지 스윙의 유의한 증가가 나타났다(p<.05). 본 연구의 결과를 통해 파킨슨 환자의 보행 시 양측 상지 스윙의 비대칭을 확인할 수 있었으며 또한 보행 시 빠른 청각 신호를 적용하는 경우, 파킨슨병 환자의 상지 스윙을 증가시켜 자연스러운 보행양상을 유도할 수 있으므로 중재 시 필요에 따라 적절한 속도의 청각 신호를 적용하여 보행훈련에 적용할 수 있을 것으로 생각된다.

임신기간 중 계단의 단너비에 따른 임산부 양발 보행의 생체역학적 변화 (Biomechanical Alterations in Gait of Stair Decent with Different Treads during Pregnancy)

  • 하종규
    • 한국운동역학회지
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    • 제19권2호
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    • pp.205-215
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    • 2009
  • 계단 하강보행에서의 임산부 낙상은 임산부와 태아에게 치명적인 영향을 미친다. 이 연구는 임신기간 중 계단의 단 너비 변화에 따른 임산부 양발 보행의 생체역학적 변화를 구명하는 것이다. 이 실험을 위하여 건강한 임산부 9명이 참가하였고 Qualisys사의 Proreflex MCU-240 카메라 7대와 Kistler사의 Type 9286AA 지면반력기 2대를 설치하여 상호 동조하여 실험하였으며 연구변인은 Visual 3D(C-motion Inc., USA)를 사용하여 인체를 모델링 한 후 산출하였다. 임신기간이 경과됨에 분당 활보장수는 감소한 반면 활보장 주기는 증가하였으며 양발의 슬관절 모멘트 차이가 작아졌다. 그리고 단너비가 넓어질수록 속력과 활보장 길이가 증가하였다. 단너비에 따른 하지 관절모멘트는 각 관절마다 고유한 패턴을 보였으며 고관절 모멘트는 주로 양발의 비대칭성 패턴을 보였고 슬관절 및 족관절은 대칭적인 패턴을 보였다. 그리고 임신기간이 경과됨에 따라 좌 우측의 최대 최소 슬관절 모멘트의 차이가 작아졌다. 이러한 결과들은 임산부가 신체변화에 적응하면서 안전성의 최대화를 위하여 자신의 고유한 보행패턴을 생성하는 자기적응화 과정을 지속적으로 유지하면서 변화한다고 할 수 있다.

Comparison of Both Legs EMG Symmetry during Over-Ground Walking and Stair Walking in Stroke Patients

  • Jeong, Mu-Geun;Kim, Joong-Hwi
    • The Journal of Korean Physical Therapy
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    • 제27권4호
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    • pp.228-233
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    • 2015
  • Purpose: Gait is the most basic element when evaluating the quality of life with activities of daily living under ordinary life circumstances. Symmetrical use of the lower extremities requires complicated coordination of all limbs. Thus, this study examined asymmetry of muscle activity quadriceps femoris and tibialis anterior as a baseline for training during over-ground walking and stair walking of stroke patients. Methods: Subjects were 14 stroke patients included as one experimental group. Gait speed used in this study was determined by the subject. Low extremity paretic and non-paretic EMG was compared using the surface EMG system. Results: The low extremity EMG difference was statistically significant during over-ground walking and stair walking (p<0.05). The result of low extremity EMG substituted symmetry ratio formula was compared to EMG symmetry ratio in both legs during over-ground walking and stair walking. The average symmetry ratio of quadriceps femoris during over-ground walking was 0.65, and average symmetry ratio of quadriceps femoris during stair walking was 0.47, with significant difference (p<0.05). Conclusion: EMG data was higher in stair walking than over-ground walking. However, in the comparison of symmetry ratio, asymmetric EMG of quadriceps femoris was significantly increased during stair walking. These findings suggested that application of stair walking for strengthening of both legs can be positive, but the key factor is maintaining asymmetrical posture of both legs. Therefore, physical therapists should make an effort to reduce asymmetry of quadriceps femoris power during stair walking by stroke patients.

만성 요통 환자의 골반지표와 발의 생체역학적 특징 연구 (Study on Pelvic Parameters and Biomechanical Characteristics of Foot in Patients with Chronic Low Back Pain)

  • 공재철;문수정;조동찬;고연석;송용선;이정한
    • 동의생리병리학회지
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    • 제26권1호
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    • pp.81-87
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    • 2012
  • The structural and biomechanical characteristics of pelvic and foot are important factors of back pain, but it is still complicated to clearly explain the relationship among them. The purpose of this study was to find out the characteristic of pelvic parameters and biomechanics of foot in patients with low back pain. Thirty-three female subjects with chronic low back pain were enrolled and ODI and VAS score were measured for back pain index. All subjects were taken the X-ray examination for major pelvic parameters and foot scan analysis for foot pressure, gait angle, fore-foot/rear-foot peak pressure ratio and asymmetric index. Statistical analysis were performed to examine the inter-relation between the measurement. As a result, it was shown the positive interrelation between back pain and F/R ratio, but others were not shown the relationship related to low back pain. And there were correlations between the lumbo-pelvic structure and biomechanics of foot in some aspects, but the causal relationship between them are still indefinable. In order to get more information about structures and biomechanics related to low back pain, subsequent researches are needed.

Female Carriers of Duchenne Muscular Dystrophy

  • Cho, Yu Na;Choi, Young-Chul
    • Journal of Genetic Medicine
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    • 제10권2호
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    • pp.94-98
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    • 2013
  • Dystrophinopathy, caused by mutations in the DMD gene, presents with variable clinical phenotypes ranging from the severe Duchenne muscular dystrophy (DMD) to the milder Becker muscular dystrophy(BMD) forms. DMD is a recessive X-linked form of muscular dystrophy. Two-thirds of mothers of affected males are thought to be DMD carriers. Approximately 2.5-7.8% of female DMD carriers have muscle weakness and are categorized as manifesting DMD carriers. The symptoms of female carriers of DMD range from mild muscle weakness to severe gait problems. The most commonly presented symptom is mild proximal muscle weakness, which is often asymmetric and progressive, but shows variable clinical spectrum with BMD of more severe DMD-like phenotype. Atypical presentations in manifesting carriers are myalgia or cramps without limb weakness, isolated cardiomyopathy and camptocormia. Multiplex PCR and MLPA analysis are common techniques to identify mutations in the DMD gene. Relationship between X-chromosome inactivation and clinical severity is not clear. Female carriers of DMD are not less common, and they have an important role of birth of a male DMD.

계단보행 시 계단 너비가 지면반력 파라미터에 미치는 영향 -비대칭 지수 및 일관성 지수- (The Effect of Stair Depth on Ground Reaction Force Parameters - Asymmetric and Variability Indices -)

  • 윤석훈
    • 한국운동역학회지
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    • 제18권1호
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    • pp.169-178
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    • 2008
  • 본 연구는 계단 보행 중 연속적인 두 스텝의 3차원적 지면반력 파라미터를 제공하고, 계단의 너비에 따른 지면 반력 파라미터의 차이 및 비대칭성과 일관성을 규명하는데 있다. 10명의 성인 대상자가 본 실험에 참여하였으며, 각 10번의 평지, 상향 및 하향보행을 3가지의 다른 너비의 계단에서 실시하였다. 본 연구를 수행한 결과 다음과 같은 결론을 얻었다. 첫째, 계단의 너비는 대부분의 지면반력 파라미터들의 패턴이나 일관성, 비대칭지수에 영향을 미치지 않았다. 둘째, 평지 보행과 계단보행은 지면반력 파라미터의 패턴에서 큰 차이를 보였다. 평지보행과 상향보행은 Fz1, Fz2, 그리고 Fz3로 구성되는 "M" 형태를 보인 반면에 하향보행에서는 Fz2가 거의 없고 큰 Fz1과 작은 Fz3로 구성된 패턴을 보였다. 또한 계단 보행은 평지보행과 매우 다른 전 후 지면반력 패턴을 보였다. 즉 상향보행은 Fy1이 존재하지 않는 패턴을, 하향보행은 Fy2가 존재하나 매우 작은 크기를 보였다. 셋째, 계단보행의 수직 지면반력 파라미터들은 적용가능한 일관성 지수 및 비대칭 지수를 나타내었다.

Parry-Romberg syndrome with ipsilateral hemipons involvement presenting as monoplegic ataxia

  • Lee, Yun-Jin;Chung, Kee-Yang;Kang, Hoon-Chul;Kim, Heung Dong;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • 제58권9호
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    • pp.354-357
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    • 2015
  • Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the left leg. At 4 years of age, she presented with localized scleroderma over the right parietal region of her scalp; her face gradually became asymmetric as her right cheek atrophied. Brain magnetic resonance imaging revealed hemiatrophy of the face and skull base, and T2-weighted images showed increased signal in the right hemipons and hemicerebellar peduncle. Magnetic resonance angiography findings were unremarkable. She was treated with oral prednisolone, and her recurrent gait ataxia diminished within 2 months of the follow-up period. To the best of our knowledge, this is only the second case of PRS presenting with an abnormal involvement of the ipsilateral hemipons.