• Title/Summary/Keyword: gait disorders

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The Influence of Wedged Insoles on Lower Extremity Joints during Gait (경사진 안창이 보행시 하지관절에 미치는 영향)

  • Kwon, Min-Jeong;Choi, Hwa-Soon;Chung, Min-K.;Na, Seok-Hee
    • Journal of the Ergonomics Society of Korea
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    • v.26 no.1
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    • pp.19-27
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    • 2007
  • Despite the widespread use of laterally wedged insoles for patients with knee osteoarthritis and medially wedged insoles for controlling rearfoot pronation, an understanding of the effects of wedged insoles was limited and sometimes controversial. The objective of this study was to evaluate the effect of wedged insoles on the kinematics and kinetics of normal gait. Ten male subjects without history of lower limb disorders were recruited. Each subject performed four gait cycles under each of seven conditions; shod with 5$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$, 8$^{\circ}$ and 15$^{\circ}$ laterally wedged insoles. In order to determine statistical differences among seven conditions, the measured temporal spatial variables, angular displacements, joint moments, and ground reaction forces were compared with a one-way analysis of variance. Some significant changes induced by wedged insoles were apparent in joint moments and ground reaction forces. The medially wedged insole increased the laterally directed ground reaction force and varus moments at the ankle force and varus moments at the ankle and the knee.

Validation of the Korean Translated Dynamic Gait Index in Community-Dwelling Elderly (지역사회에 거주하는 노인을 대상으로 한 한글판 동적보행지수의 타당성)

  • Park, So-Yeon;Hwang, Su-Jin
    • Physical Therapy Korea
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    • v.17 no.1
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    • pp.43-52
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    • 2010
  • The Dynamic Gait Index (DGI) was developed and widely used as a clinical tool to assess balance performance during gait. The purpose of this study was to validate the Korean translated DGI using Rasch analysis. A total of 105 community-dwelling elderly was participated in this study (age range = 65~95 years; mean = 78.0 years). The translated DGI showed sound item psychometric properties, and the 8 items were arranged in order of difficulty for the total participants. The most difficult item was 'Steps' and the easiest item was 'Level surface'. Also, each of the original 4 rating scale categories satisfied the Linacre's essential criteria suggestions for optimal rating scale category effectiveness. Although, thirty eight person (36.2%) showed the maximal high score, but the most of them was no history of fall in the preceding year. For subjects who has falling history, all of the person's ability was arranged within the item's difficulty. The 8-item Korean translated DGI can be used to measure gain in elderly person with balance disorders without compromising important clinical measurement characteristics in Korea.

Effects of Sling Exercise on Balance and Gait in Patients with Stroke: Meta-Analysis of Studies in Korea

  • Cho, Woonsu;Lee, Seongjin;Kim, Byeonggeun
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.3
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    • pp.2164-2172
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    • 2020
  • Background: Stroke patients have multiple disorders, but most have problems with balance and gait. Post-stroke rehabilitation exercise has been shown to be very important for functional recovery. Objectives: To systematically review and meta-analyze the effects of sling exercise (SE) on patients with stroke in studies published in Korea. Design: Meta-analysis. Methods: Five databases, namely, RISS, KISS, NDSL, DBpia and Earticle, were used to collect articles on vibration. Keywords such as "Stroke," "Hemiplegia," "Sling," and "Sling Exercise" were used in the search for published articles. Interventions and comparisons were SE and other exercise (OE). Outcome measures were berg balance scale (BBS) and timed up and go (TUG). Consequently, eight studies were selected in the second screening using meta-analyses. Results: Based on the results of the meta-analysis, SE was effective for BBS in the comparison of SE and OE [2.71, 95% CI (1.42, 4.01)]. It was effective for TUG in the comparison of SE and OE [-1.89, 95% CI (-3.01, -0.77)]. Conclusion: Based on eight limited studies, SE improved BBS and TUG over OE, suggesting improved stroke balance and gait. Therefore, more studies and large-scale sample randomized controlled trials are needed to confirm clinical application.

The Effect of Korean Medicine Treatment on Cerebral Infarction with Hemiplegia: A Case Report (아급성기 뇌경색 환자의 좌측 편마비에 대한 한의 치료 1례)

  • Oh, Ju-hyun;Sung, Jae-yeon;Seo, Hye-jin;Lee, Yu-ra;Song, Jin-young;Kong, Geon-sik;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.990-998
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    • 2019
  • Introduction: Stroke refers to a sudden brain disease that results in disorders in the anatomy of the brain. The cause is a sudden circulatory disorder of the cerebrovascular system that creates a consciousness disorder and hemiplegia. Despite aggressive treatment after the onset, stroke is a social problem because the patient has difficulty in recovering from sequelae that can include limb movement disorders, language disorders, and emotional disorders. In this study, we describe the effect of traditional Korean medicine treatment on the sequelae in a subacute cerebral infarction patient admitted to a Korean medical hospital. Case presentation: A 67-year-old male patient was diagnosed with cerebral infarction circa 2005, and his condition had not improved. Around March 15, 2018, he experienced the sudden onset of a cerebral infarction in his daily life. This was confirmed by a brain MRI, and he was hospitalized at other hospitals, but he showed no improvement. We conducted a manual muscle test (MMT) to evaluate the patient's exercise and strength. His gait level was measured to evaluate his degree of walking. He was treated with Bojungikgi-tang and acupuncture twice a day. After 34 days of inpatient treatment, the patient's exercise strength improved from Grade 2+~Grade 3 to Grade 3+ determined by the MMT, and his walking ability improved from Gait Level 3 to Gait Level 4. Conclusion: The findings of this study indicate that acupuncture and herbal medicine treatment can help treat patients with hemiplegia due to cerebral infarction.

A Case of Korean Medical Treatment on Advanced-Stage Multiple System Atrophy with Gait Disturbance (보행장애를 호소하는 말기 다계통 위축증 환자 한의 치험 1례)

  • Hwang, Ye-Chae;Lee, Hye-Jin;Choi, Jeong-Woo;Jeon, Gyu-Ri;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Seung-Yeon
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.22 no.1
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    • pp.31-44
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    • 2021
  • The purpose of this case report is to describe the effectiveness of Korean medicine in the treatment of gait disturbance in advanced stage multiple system atrophy-cerebellar type (MSA-C). This inpatient was treated with herbal medicine, acupuncture, pharmaco-acupuncture, moxibustion, cupping, and chuna therapy. The gait disturbance was assessed by Unified Multiple System Atrophy Rating Scale(UMSARS), Tinnetti test, and 16m walking spatial features. After treatment, UMSARS Part I score was enhanced, decreasing from 29 to 24, Part II score from 34 to 18. Tinetti test score increased from 7 to 20. Gait stride length increased and width decreased. This study suggests that Korean medical treatment could be an effective treatment for delaying the progress of gait disturbance in advanced-stage MSA-C patients.

Correlation Analysis Between Gait Pattern and Structural Features of Cerebral Cortex in Patients with Idiopathic Normal Pressure Hydrocephalus (특발정상압수두증 환자의 보행 패턴과 대뇌피질의 구조적인 특징의 상관관계 분석)

  • Yun, EunKyeong;Kang, Kyunghun;Yoon, Uicheul
    • Journal of Biomedical Engineering Research
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    • v.42 no.6
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    • pp.295-303
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    • 2021
  • Idiopathic normal-pressure hydrocephalus (INPH) is considered a potentially treatable neurological disorder by shunt surgery and characterized by a triad of symptoms including gait disturbance, cognitive impairment and urinary dysfunction. Although disorders of white matter are generally viewed as the principal pathological features of INPH, analysis of cortical features are important since the destruction of neural tracts could be associated with cortical structural changing. The aim of the study was to determine whether there was any relationship between gait parameter and structural features of cerebral cortex in INPH patients. Gait parameters were measured as follows: step width, toe in/out angle, coefficient of variation (CV) value of stride length, CV value of stride time. After obtaining individual brain MRI of patients with INPH and hemispheric cortical surfaces were automatically extracted from each MR volume, which reconstructed the inner and outer cortical surface. Then, cortical thickness, surface area, and volume were calculated from the cortical surface. As a result, step width was positively correlated with bilateral postcentral gyrus and left precentral gyrus, and toe in/out was positively correlated with left posterior parietal cortex and left insula. Also, the CV value of stride length showed positive correlation in the right superior frontal sulcus, left insula, and the CV value of stride time showed positive correlation in the right superior frontal sulcus. Unique parameter of cerebral cortical changes, as measured using MRI, might underline impairments in distinct gait parameters in patients with INPH.

Changes of Cervical Range of Motion and Pelvic Mobility during Gait in Subjects with Pain-related Temporomandibular Disorders (관자 아래턱 장애에 따른 목뼈 가동 범위 제한과 보행 시 골반 가동성의 변화 연구)

  • Yeo, Sang-Seok
    • PNF and Movement
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    • v.20 no.3
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    • pp.451-459
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    • 2022
  • Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

Forefoot disorders and conservative treatment

  • Park, Chul Hyun;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.92-98
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    • 2019
  • Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

A Case of Korean Medical Treatment on Multiple System Atrophy with Gait Disturbance (보행장애를 호소하는 다계통위축증 환자 1례)

  • Yim, Tae-bin;Jeon, Gyu-ri;Kim, Seo-young;Jeong, Hye-seon;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Ko, Chang-nam
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.821-829
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    • 2020
  • This case report describes the effects of Korean Medicine for the gait disturbance of Multiple System Atrophy (MSA). Korean Medicine that included chuna manual therapy, pharmaco-acupuncture, herbal medicine, acupuncture, electro-acupuncture, and moxibustion was administered for 23 days. During the hospitalization period, evaluations were performed using the Unified Multiple System Atrophy Rating Scale (UMSARS), Berg Balance Scale (BBS), and 20 m Round Timed Walking Test on day 1, day 15, and day 23. The UMSARS Part I score decreased from 11 to 5, Part II score from 11 to 9, and total score from 22 to 14, and the BBS score increased from 36 to 48. The 20 m Round Timed Walking Test score also improved. The width of the gait decreased from 65 to 40 cm, and the number of staggering incidents decreased from 6 times to 2 times. The findings of this case study suggest that Korean Medicine, including Chuna manual therapy, has potential benefits in MSA patients with gait disturbance.

A Kinetic Analysis of the Lower Extremity on the Normal and Abnormal Specificity of Walking on Stair for Twenties (이십대 청년의 정상 및 비정상 계단보행특성에 따른 하지의 운동역학적 분석)

  • Kim, Young-Ji;Lee, Young-Shin;Kim, Chang-Won
    • Korean Journal of Computational Design and Engineering
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    • v.16 no.6
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    • pp.391-396
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    • 2011
  • Gait is walking attitude and indicating state. The body's gait is a good mix in the center of body mechanics and exercises to wake up gently at the same time switch is a pass which is complicated at legs various joints. The shifting action what swing phase and stance phase rhythmic movement of body. One from piece moves with different dot. Especially plain walking and stair walking as a vehicle has been used frequently. Characteristics of the stair walking while the balanced the horizontal and vertical movement. Stair walking often takes place in everyday. It requires large range more than walking at plain in the moment and joint range of gait motion. And consistently applied to joints and various types of loads at legs joint may involve joint disorders. In this study, spastic cerebral palsy existing artificial limbs for disabled people when developing calibration equinus deformity patients induce muscle pain when walking on stairs independently, to reduce the research. Comparing the characteristics of the walking up the stairs for analysis patellofemoral joint pain as a result it is to provide engineering data.