• 한국전문물리치료학회지
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• 제23권4호
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• pp.27-37
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• 2016

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.

• 한국전문물리치료학회지
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• 제23권4호
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• pp.9-15
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• 2016

Background: Squatting is one of the best functional exercises to strengthen the quadriceps muscle in independent gait and activities of daily living. Although the use of a gym ball during squat exercise is the most common way of strengthening the vastus medialis oblique (VMO) muscle, published data on this subject are limited. Objects: The purpose of this study was to compare the sequential muscle activation of the VMO and vastus lateralis (VL) muscles during squat exercise using a gym ball at different knee flexion angles. Methods: Forty healthy adults were randomly divided into experimental (squat exercise using a gym ball) and control (squat exercise alone) groups, in which squats were performed at $45^{\circ}$ and $90^{\circ}$ knee flexion. Electromyographic (EMG) activity data were collected over 10 seconds under the 2 angles of knee flexion ($45^{\circ}$ and $90^{\circ}$). Results: There was significant group and time interaction effect for VMO and VL muscle activation at $45^{\circ}$ knee flexion. This was similarly demonstrated at $90^{\circ}$ knee flexion. No significant group main effect and time main effect for VMO and VL muscle activation were noted at $45^{\circ}$ knee flexion, respectively. In contrast, there was significant group main effect and time main effect for VMO and VL muscle activation at $90^{\circ}$ knee flexion. These significant differences were demonstrated through two-way analysis of variance over repeated measurements, suggesting that the EMG activity of the VMO muscle during squatting with a gym ball showed remarkable improvement compared to that of the VL muscle. Conclusion: This research suggests that squat exercise using a gym ball may be more beneficial in improving the activity of VMO than of the VL muscle at both $45^{\circ}$ and $90^{\circ}$ of knee flexion, respectively. We highly recommend squat exercises with a gym ball for selective strengthening of the VMO muscle in knee rehabilitation.

• 한국전문물리치료학회지
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• 제24권4호
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• pp.54-59
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• 2017

Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was $52.73{\pm}2.13%$ without a cane, $42.75{\pm}3.26%$ with a strong grip, and $43.00{\pm}2.55%$ with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects' centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

• PNF and Movement
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• 제14권3호
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• pp.219-229
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• 2016

Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.

• PNF and Movement
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• 제15권3호
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• pp.227-236
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• 2017

Purpose: The purpose of this study was to investigate the effects of coordinative locomotor training (CLT) on the foot pressure and balance of patients with scoliosis. Methods: This was a single-case A-B-A study involving two patients with scoliosis. The study was designed to perform repeated measurements as follows: 5 times at baseline (A), 10 times during intervention (B), and 5 times after intervention (A). The study period was 5 weeks, and the CLT program was divided into warm up, CLT program, and cool down stages, at 50 min per stage. For the primary outcome measure, Gait View AFA-50 was used to determine the foot pressure and balance ability. For the secondary outcome measure, the SRS-22 questionnaire was used to assess the quality of life of the patients with scoliosis. Descriptive statistics and visual analysis using graphs were used to compare the rates of change. Results: The results of this study showed that the foot pressure and balance ability of the two subjects improved during the intervention period and remained improved even during the baseline period. However, their quality of life did not change after the intervention. Conclusion: CLT may have a positive effect on foot pressure and balance ability in patients with scoliosis. Also, this body function improvement may have positive effects on the performance of daily activities which employ the upright position.

• 한국운동역학회지
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• 제25권3호
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• pp.257-263
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• 2015

Objective : The purpose of this study was to investigate the effect of genu valgum on the body mass index, movement of lower limb joints, and ground reaction force. Methods : Gait patterns of 30 college students with genu valgum were analyzed and the static Q angle of the femur was measured for selecting genu valgum of the subjects. To analyze the kinetic changes during walking, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. Results : As a result of measuring a relationship between genu valgum and Q-angle, as the Q-angle increases, it showed a genu valgum also increased. Body Mass Index showed a significant difference between the groups was higher in the genu valgum group.(p<.001). The analysis result showed that genu valgum had a significant effect on the internal rotation moment in the hip joint(p<.05). Also, genu valgum had a significant effect on the internal rotation moment of the knee joint(p<.05). The comparative analysis of the Medial-Lateral ground reaction force in the genu valgum group showed a tendency to increase the medial ground reaction force(p<.05). The vertical ground reaction forces of the middle of the stance phase(Fz0) showed a significant increase in genu valgum group(p<.05), in particular the results showed a decrease in the early stance phase(p<.001). Conclusion : In conclusion, the change in body mass is considered to be made by proactive regular exercise for improvement of the genu valgum. In addition, the prevention of the deformation caused by secondary of the genu valgum in this study may be used as an indicator of the position alignment rehabilitation for structural and functional improvements. Applying a therapeutic exercise program for the next lap will require changes in posture alignment.

• 제어로봇시스템학회논문지
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• 제12권9호
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• pp.926-934
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• 2006

This paper proposes intelligent control of a virtual walking machine that can generate infinite floor for various surfaces and can provide proprioceptive feedback of walking to a user. This machine allows users to participate in a life-like walking experience in virtual environments with various terrains. The controller of the machine is implemented hierarchically, at low-level for robust actuator control, at mid-level fur platform control to compensate the external forces by foot contact, and at high-level control for generating walking trajectory. The high level controller is suggested to generate continuous walking on an infinite floor for various terrains. For the high level control, each independent platform follows a man foot during the swing phase, while the other platform moves back during single stance phase. During double limb support, two platforms manipulate neutral positions to compensate the offset errors generated by velocity changes. This control can, therefore, satisfy natural walking conditions in any direction. Transition phase between the swing and the stance phases is detected by using simple switch sensor system, while human foot motions are sensed by careful calibration with a magnetic motion tracker attached to the shoe. Experimental results of walking simulations at level ground, slope, and stairs, show that with the proposed machine, a general person can walk naturally on various terrains with safety and without any considerable disturbances. This interface can be applied to various areas such as VR navigations, rehabilitation, and gait analysis.

• 한국운동역학회지
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• 제31권4호
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• pp.259-269
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• 2021

Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I² = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I² = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I² = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I² = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I² = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

• 한국융합학회논문지
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• 제12권12호
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• pp.419-425
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• 2021

본 연구의 목적은 건강한 성인을 대상으로 발목에 플로스밴드를 적용했을 때 발목의 기능적 관절가동범위와 보행능력에 미치는 효과를 검증하는 것이다. 총 20명이 실험에 참여했으며 무작위배정을 통해 발의 한쪽은 실험 측으로, 반대쪽은 대조 측으로 설정하였다. (중재 전, 후/ 실험 측과 대조 측) 두 가지 요인에 대해 분석하기 위하여 반복측정 이요인 분산분석 방법(two way-repated ANOVA)을 실시하였다. 유의수준은 0.05로 설정하였다. 연구결과 대조 측에 비하여 실험 측에서 WBLT와 발꿈치 딛기가 유의하게 증가하였다(p=.05). 중재 전, 후 검정에서 실험 측은 WBLT, 발꿈치 딛기, 발가락 떼기에서 유의한 증가를 보였다(p=.05). 대조 측은 발가락 떼기에서 유의한 증가를 보였다(p=.05). 따라서 본 연구에서 실시한 플로스밴드의 적용은 스포츠 및 재활 현장에서 기능적 관절가동범위를 증진시키고 보행능력을 향상시키는 데 도움을 줄 수 있을 것이다.

• 융합정보논문지
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• 제9권3호
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• pp.128-133
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• 2019

본 연구는 정상인에게 스마트 신발을 착용 시킨 후, 6분 보행검사와 일어나 걸어가기 검사를 실시하여 연구자가 측정한 데이터와 스마트 신발 센서 데이터가 동일 및 유사한지 확인 하고자 하였다. 정상 성인 남성 10명으로 진행을 하였으며 스마트 신발을 착용 한 후 6분 보행검사와 일어나 걸어가기 검사를 실시하여 데이터를 분석 하였다. 본 실험의 결과를 보았을 때 현재 센서의 정확도는 높은 편으로 보여 진다. 6분 보행검사의 거리에 차이가 나타난 것은 실제 30m 트랙에서 계산하지 않는 반환점도 거리를 측정하기 때문에 차이가 나타난 것으로 보인다. 이러한 관점에서 보았을 때 스마트 신발이 좀 더 정확한 거리를 측정 하였다고 볼 수가 있으며 추후 스마트 센서를 통한 다양한 검사가 가능 할 것으로 보여 진다.