• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.297-302
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• 2013

Purpose: This study was conducted in order to investigate the kinematic gait parameter of lower extremities with different gait conditions (level walking, stair, ramp) in hemiplegic patients. Methods: Ten hemiplegic patients participated in this study and kinematic data were measured using a 3D motion analysis system (LUKOtronic AS202, Lutz-kovacs-Electronics, Innsbruk, Austria). Statistical analysis was performed using one-way repeated measure of ANOVA in order to determine the difference of lower extremity angle at each gait phase with different gait conditions. Results: Affected degree of ankle joint in the heel strike phase showed significant difference between level walking and climbing stairs, and toe off phase showed significant difference between level walking and climbing stairs, ramps, and climbing stairs. Affected degree of knee joint showed no significant difference in all attempts. Affected degree of hip joint in the toe off phase showed significant difference between level walking, ramps and stairs, and climbing ramps. Swing phase showed significant difference between sides for level walking and stairs, climbing ramps. Affected ankle joint of heel strike and toe off, and affected hip joint of toe off and the maximum angle of swing phase in the angle was increased. Unaffected side of the ankle joint, knee joint, and hip joint showed a significant increase in walking phase. Conclusion: These findings indicate that compared with level walking, different results were obtained for joint angle of lower extremity when climbing stairs and ramps. In hemiplegia patient's climbing ramps, stairs, more movement was observed not only for the non-affected side but also the ankle joint of the affected side and hip joint. According to these findings of hemiplegic patients when climbing stairs or ramps, more joint motion was observed not only on the unaffected side but also on the affected side compared with flat walking.

• 한국운동역학회지
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• 제18권4호
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• pp.59-65
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• 2008

본 연구는 일상생활에서 흔히 접하게 되는 시설물 중 낙상의 위험이 큰 계단과 경사로 오르기 동안 젊은 성인과 노인들의 압력중심이동 경로와 족저압 변화에 대해 알아보았다. 측정도구는 MatScan system(Tekscan, USA)을 사용하였다. 보행 조건(평지 보행, 계단 오르기, 경사로 오르기)에 따른 족저 영역별 족저압의 차이를 알아보기 위해 일원배치분산분석(One-way ANOVA)을 사용하였다. 압력중심 이동경로는 젊은 성인의 경우 평지 보행과 비교해 계단 오르기에서 조금 짧아졌으며 전족부에서는 외전하는 경향이 나타났다. 경사로 오르기에서는 대체적으로 내전되는 경향이 나타났고 특히 입각기 말기에 엄지발가락으로 압력중심이 이동하였다. 노인의 경우 평지 보행과 비교해 계단 오르기에서 압력중심 이동 경로가 짧아졌으며 앞뒤로 이동이 많았으며 전족부에서는 외전되었다. 경사로 오르기에서는 압력중심이 좌우로 이동하는 경향이 나타났다. 족저 영역별 최고 족저압은 젊은 성인의 경우 평지보행과 비교해 경사로 오르기 에서 2-3번째 중족골두 영역과 후족부 영역의 최고 족저압이 유의하게 감소하였다. 노인의 경우 첫 번째 중족골두 영역은 계단 오르기에서 최고 족저압이 증가하고 경사로 오르기에서 최고 족저압이 감소하였고, 두 번째 중족관절 영역과 후족부 영역은 평지 보행과 비교해 경사로 오르기에서 최고 족저압이 감소하였다. 같은 기울기의 계단과 경사로 오르기 동안 최고 족저압은 대체적으로 경사로 오르기에서 변화가 크게 나타났다.

• The Journal of Korean Physical Therapy
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• 제21권1호
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• pp.35-40
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• 2009

Purpose: The purpose of this study was to investigate change of muscle activities during level walking, stairs and ramp climbing in old adults. Methods: Twelve old adults were recruited and agreed this study. Muscle activity was measured by MP150 system (BIOPAC System Inc., Santa Barbara, USA). Statistical analysis was used one-way ANOVA to know the difference according to gait conditions (level walking, stairs and ramp ascending) Results: In stance phase, muscle activities of low extremities with old adults were generally significant difference in ramp ascending. In swing phase, rectus femoris and biceps femoris activity in old adults generally more increased during stairs ascending and tibialis anterior and gastrocnemius activity in old adults generally increased during ramp ascending. Conclusion: These results indicate that stair and ramp climbing is different muscle recruit pattern to level walking.

• The Journal of Korean Physical Therapy
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• 제24권4호
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• pp.247-252
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• 2012

Purpose: The purpose of this study was to investigate the change of muscle activities during level walking, stairs and ramp climbing in hemiplegic patients. Methods: Eight hemiplegic patients were recruited and agreed to participate in this study. Muscle activity was measured by MP100 system (BIOPAC System Inc., Santa Barbara, CA, USA). Statistical analysis was used as a one-way repeated measure of ANOVA to know the difference according to the gait conditions (level walking, stairs and ramp ascending). Results: In the swing phase, muscle activity of rectus femoris muscle, with the side lower extremities affected, were generally significantly different in the stair and ramp ascending. In addition, biceps femoris muscle with unaffected side lower extremity was generally significantly different in the ramp ascending. In the swing phase, muscle activity of tibialis anterior muscle with unaffected side lower extremities was generally showed a significant difference in the ramp ascending. In the stance phase, climbing stairs and ramps showed an increase in the muscle activities. Further, climbing the stairs increased muscle activities of the gastrocnemius muscle. Conclusion: These findings indicate that compared with the level walking climbing stairs, ramps and muscle activities of lower extremity during each showed different results. It can be seen that in accordance with the terms of gait are different muscles group recruitment.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.478-487
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• 2022

Objective: This study was conducted to analyze the effect of wearable complex muscle support system on energy efficiency during walking in elderly. Design: Cross sectional study Methods: Twenty healthy elderly participated in this study. All subjects performed a 6 minuteswalk test(6MWT) and stair climbing test in dual, slack and no suit conditions. In each condition, oxygen consumption(VO₂), metabolic equivalents(METs), energy expenditure measures(EEm), physiological cost index(PCI), walking velocity and heartrate were measured. Through repeated measured ANOVA, it was investigated whether there was a statistically significant difference in the measurement results between the three conditions. Results: In over-ground walking, VO₂, METs and EEm showed significant differences between no suit and slack conditions(p<0.05). In stair climbing, VO₂ showed significant difference between slack and dual conditions(p<0.05). Also, METs and EEm showed significant differences between no suit and slack, and between slack and dual conditions(p<0.05). Conclusions: Wearing the wearable complex muscle support system for elderly does not have much benefit in energy metabolism efficiency in over-ground, but there is a benefit in stair walking.

• 한국전문물리치료학회지
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• 제20권3호
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• pp.89-99
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• 2013

The purposes of this study were: 1) to show the item difficulty hierarchy of walking/moving construct of the International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM), 2) to evaluate the item-level psychometrics for model fit, 3) to describe the relevant physical activity defined by level of activity intensity expressed as Metabolic Equivalent of Tasks (MET), and 4) to explore what extent the empirical activity hierarchy of the ICF-AM is linked to the conceptual model based on the level of energy expenditure described as MET. One hundred and eight participants with lower extremity impairments were examined for the present study. A newly created activity measure, the ICF-AM using an item response theory (IRT) model and computer adaptive testing (CAT) method, has a construct on walking/moving construct. Based on the ICF category of walking and moving, the instrument comprised items corresponding to: walking short distances, walking long distances, walking on different surfaces, walking around objects, climbing, and running. The item difficulty hierarchy was created using Winstep software for 20 items. The Rasch analyses (1-parameter IRT model) were performed on participants with lower extremity injuries who completed the paper and pencil version of walking/moving construct of the ICF-AM. The classification of physical activity can also be performed by the use of METs that is often preferred to determine the level of physical activity. The empirical item hierarchy of walking, climbing, running activities of the ICF-AM instrument was similar to the conceptual activity hierarchy based on the METs. The empirically derived item difficulty hierarchy of the ICF-AM may be useful in developing MET-based activity measure questionnaires. In addition to convenience of applying items to questionnaires, implications of the finding could lead to the use of CAT method without sacrificing the objectivity of physiologic measures.

• 한국컴퓨터정보학회논문지
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• 제24권1호
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• pp.159-166
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• 2019

Recently, the advanced development of smart devices has increased the interest in health-care, and many people are paying more attentions to disease prevention than disease treatment. Among these prevention methods, the bare body movement has received much attention, and especially walking exercise is attracting much attention because it is enjoyable without any restrictions on place and time. Walking exercise is generally divided into two types: walking on the ground and climbing the stairs. Walking up the stairs consumes much more calories compared to walking on the ground. These walking exercises have the advantage that they can be easily performed by male and female without special equipments or economic considerations. However, there is a lack of applications and systems that accurately determine such walking and stair walking and measure momentum according to stair walking. In this paper, we designed and implemented a real-time walking status analysis system using smartwatch's, pedometer, smartphone's barometer and beacons.

• Physical Therapy Rehabilitation Science
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• 제13권2호
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• pp.152-162
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• 2024

Objective: This study was conducted to analyze the effect of wearable Electromyography-controlled functional electrical stimulation (EMG-controlled FES) System on Gait Function and cardiopulmonary metabolic efficiency during walking in older adults. Design: Cross-section study Methods: Total 22 older adult participants suitable to selection criteria of this study participated in this study. The EMG-controlled FES System, which functions as a wearable physical activity assist FES system was used. All participations performed randomly assigned two conditions (Non-FES assist [NFA], FES assist [FA]) of walking. In all conditions, spatio-temporal parameters and kinematics and kinetics parameters during walking was collected via 3D motion capture system and 6 minutes walking test (6MWT) and metabolic cost during walking and stairs climbing was collected via a portable metabolic device (COSMED K5, COSMED Srl, Roma, Italy). Results: In Spatio-temporal parameters aspects, The EMG-controlled FES system significantly improved gait functions measurements of older adults with sarcopenia at walking in comparison to the NFA condition (P<0.05). Hip, knee and ankle joint range of motion increased at walking in FA condition compared to the NFA condition (P<0.05). In the FA condition, moment and ground reaction force was changed like normal gait during walking of older adults in comparison to the NFA condition (P<0.05). The EMG-controlled FES system significantly reduced net cardiopulmonary metabolic energy cost, net energy expenditure measurement at stairs climbing (P<0.05). Conclusions: This study demonstrated that EMG-controlled FES is a potentially useful gait-assist system for improving gait function by making joint range of motion and moment properly.

• 한국운동역학회지
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• 제19권3호
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• pp.435-448
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• 2009

본 연구는 노인의 계단과 경사로 오르기와 평지보행 동안 하지의 운동학적 변화를 분석하는 것이었다. 건강한 노인 14명(남:10, 녀:4)이 실험에 참여하였으며 측정도구는 삼차원동작분석기인 Vicon system(Vicon, Oxford Metrics, England)을 사용하였다. 보행주기 각 시점에서 하지 관절의 각도 변화를 보행 조건(평지, 계단, 경사로)에 따라 알아보기 위해 일요인 반복측정 분산분석(one-way repeated measure of ANOVA)을 사용하였다. 전후면상에서 골반은 평지 보행에서 보행 주기 동안 전방굴곡이 나타났으며 계단과 경사로 오르기에서 전방굴곡이 증가하였다. 고관절과 슬관절는 모두 평지보행과 비교해 계단 오르기에서 굴곡이 더 증가하였다. 족관절은 평지보행과 비교해 경사로 오르기에서 굴곡이 더 증가하였다. 좌우면상에서 보행 주기 동안 평지보행과 비교해 계단 오르기에서 골반이 크게 올라갔으며 고관절도 계단 오르기에서 내전과 외전의 변화가 크게 나타났다. 또한 슬관절도 계단 오르기에서 내반이 증가하였고 족관절 역시 계단 오르기에서 내번이 증가하였다. 수평면상에서 보행 주기 동안 골반은 평지 보행과 비교해 계단과 경사로 오르기에서는 내회전이 대체로 증가하였고 고관절은 계단과 경사로 오르기에서 내회전이 증가하였으나 통계적으로 유의한 차이는 없었다. 슬관절은 계단 오르기에서 대체적으로 내회전이 증가하였고 족관절은 계단 오르기에서 대체적으로 외회전이 증가하였다. 이러한 결과는 노인의 계단과 경사로 오르기는 평지 보행과 비교해 하지의 운동학적 보행 변수들을 크게 변화시키는 것을 알 수 있었다.

• 한국전문물리치료학회지
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• 제13권3호
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• pp.67-74
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• 2006

The purpose of this study was to investigate the effects of walking aid on hemiplegic gait of chronic stroke patients. Twelve stroke patients participated in this study. Physiological cost index (PCI), gait speed, and climbing stairs with and without walking aid were measured and analyzed. The results showed that walking with walking aid significantly improved gait speed and reduced physiological cost index and time needed to climb stair (height 7 cm) in comparison with a walking without walking aid. In conclusion, walking aid may improve the speed and efficiency of hemiplegic gait in chronic stroke patients.