The purpose of this study was to investigate the variations in gait parameters according to arm slings used in healthy adults. Twenty healthy adults (9 males, 11 females) participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. They were randomly assigned conditions: without an arm sling, a care sling, a Harris hemi arm sling, a CVA sling, and a Rolyan humeral cuff sling. The following gait parameters were analyzed: the temporo-spatial parameters of gait velocity, swing phase, single support, cadence. In the comparison of parameters in each trial, step length was statistically significantly changed(p=.002). The right step length was significantly decreased in the Harris hemi arm sling and increased in the Rolyan humeral cuff sling when compared with no sling. This study found that several different types arm slings varied gait pattern in healthy adults.
Journal of the Korean Society of Physical Medicine
/
v.15
no.4
/
pp.163-174
/
2020
PURPOSE: This study examined the effects of Robot Tilt-table Training (RTT) on the lower extremity strength, balance, gait, and satisfaction with rehabilitation, in patients with subacute stroke (less than six months after stroke onset), and requiring intensive rehabilitation. METHODS: A total of 29 subacute stroke patients were divided into an RTT group (n = 14) and a Body Weight Support Treadmill Training (BWSTT) group (n = 15). The mean age of patients was 62 years. RTT and BWSTT were performed for four weeks, three times a week, for 30 minutes. Isometric strength of the lower extremities before and after intervention was compared by measuring the maximal voluntary isometric contraction of the lower extremity muscles. To compare the balance function, the center of pressure (COP) path-length and COP velocity were measured. Timed Up & Go test (TUG) and 10 Meter Walking Test (10 MWT) were evaluated to compare the gait function. A satisfaction with rehabilitation survey was conducted for subjective evaluation of the subject's satisfaction with the rehabilitation training imparted. RESULTS: In the intra-group comparison, both groups showed significant improvement in lower extremity strength, balance, gait, and satisfaction with rehabilitation, by comparing the parameters before and after the intervention (p < .05). Comparison of the amount of change between groups revealed significant improvement for all parameters in the RTT group, except for the 10 MWT (p < .05). CONCLUSION: Both groups are effective for all variables, but the RTT group showed enhanced efficacy for variables such as lower extremity strength, balance, gait, and satisfaction with rehabilitation, as compared to the BWSTT group.
The aim of this study was to evaluate the effects of mental practice to improve on gait and quality of life in stroke patients. Participants were randomly allocated to two groups: experimental(n=10) and control (n=10). Both groups received neural development treatment training for 6 sessions 1 hour per week during 6 weeks. Experimental group practiced additional mental practice for 3 session 10 minutes per week 6 weeks. Results were evaluated by spatial-temporal parameter, 10m walk test, and quality of life. There were significantly increased by mental practice in outcomes of the gait performance from the gait velocity, cadence, double support, single support, 10m walk test. There were significantly increased by mental practice in outcomes of stroke impact scale from the strength, social participants, and stroke recovery. In conclusion, the mental practice improves gait performance and quality of life in stroke patients. The results suggest that mental practice training is feasible and suitable to stroke patients.
Background: This research was conducted to understand balance training in trunk control, balance, and walking in stroke patients. Design: Randomized controlled trial. Methods: The subjects included 40 stroke patients, of whom 20 undertook balance training using visual information and the other 20 undertook balance training using balance boards. Using visual feedback, the balance training group used a training program within the static balanced evaluation tool, while the balance training group trained using a balance board. All subjects underwent 20 mins of neurodevelopmental treatment, and both target groups underwent 10 mins each of balance training by using either visual feedback or a balance board. The treatment period lasted a total of 4 weeks, twice a day. Trunk control before and after training was evaluated with the Trunk Impairment Scale. Balance capability was assessed by the Berg Balance Scale, Functional Reach Test, Timed Up and Go test, and Static balance measurement tool. Walking capacity was measured using gait measuring equipment, and cadence and velocity were measured. Results: Both groups showed a significant improvement in their interstitial control, balance, and gait ability after the experiments compared to before the experiments (p<0.05). The difference between the two groups was not significant. The visual feedback balance training group showed a more substantial improvement than the balance board training group. Conclusion: In this study, we found that the balance training combined with visual feedback contributes to improving trunk control, balance, and gait in patients with hemiplegia due to stroke. In addition to this, I believe that balanced training combined with visual feedback can be used as a training method when considering patients who lack interstitial control, balance, and gait ability.
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.
Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Ki-Jong;Kim, Myoung-Kwon
Journal of Magnetics
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v.19
no.2
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pp.181-184
/
2014
The aim of the present study was to examine whether motor imagery (MI) practice in conjunction with repetitive transcranial magnetic stimulation (rTMS) applied to stroke patients could improve theirgait ability. This study was conducted with 29 subjects diagnosed with hemiparesis due to stroke.The experimental group consisted of 15 members who were performed MI practice in conjunction with repetitive transcranial magnetic stimulation, while the control group consisted of 14 members who were performed MI practice and sham therapy. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes. The experimental group was instructed to perform rTMS and the control group was instructed to apply sham stimulation for 15 minutes. Gait analysis was performed using a three-dimensional motion capture system, which is a real-time tracking device that delivers data via infrared reflective markers using six cameras. Results showed that the velocity, step length, and cadence of both groups were significantly improved after the practice (p<0.05). Significant differences were found between the groups in velocity and cadence (p<0.05) as well as with respect to the change rate (p<0.05) after practice. The results showed that MI practice in conjunction with rTMS is more effective in improving gait ability than MI practice alone.
To simulate an actual slip to measure floor slipperiness, slip resistance testers simulate slip in only forward direction because forward slip in the landing phase was found to be the most important factor for loss of balance. Backward slip in the take off phase was possible but was excluded in the friction test protocol because it was not dangerous. However, backward slip was tested in the friction test protocol without any theoretical background of the significance in generating dangerous slips and falls and was proven to be as good as forward slip in measuring floor slipperiness. Therefore, this study was designed to investigate the significance of backward slip in generating dangerous slips and falls with different combinations of floor and shoe sole. The results showed different tendency of backward slip in take off phase being significant in generating dangerous slips and falls because backward slip in the takeoff phase affected gait pattern disturbances seriously. resulted in dangerous falls. Fast toe velocity increased the severity of backward slip and confirmed the significance of backward slip in generating dangerous slips and falls. As a result, this study recommends the utilization of backward slip in the measurement of floor slipperiness.
Purpose: Hallux valgus (HV) is one of the most common chronic foot disorders, occurring when the first toe deviates laterally toward the other toe. HV impairs muscle strength and affects gait function (postural sway and gait speed). Thus, this study aims to investigate using the FDM system the effect of wearing braces on gait while wearing a virtual reality (VR) device. Methods: This study was conducted on 28 healthy adults with HV of 15 degrees or more. To compare differences in walking, depending on whether a toe brace can be worn, the subject walked without wearing anything, walked after wearing the VR device, and walked after wearing the VR device and the toe brace, and the FDM system was used for the gait ability measurement analysis. Results: As a result of a one-way repeated analysis of variance, the walking speed-related variables (cadence, velocity, etc.) in the HV group were higher during comfortable walking. In addition, walking while wearing a VR device and walking while wearing a VR device and a toe brace demonstrated more significant values in terms of six gait parameters (double stance phase, loading response, stage, stage, stage, and stage). The maximum pressure of the forefoot was significantly reduced when walking while wearing a VR device and a toe brace compared to comfortable walking, but in all variables, there was no statistically significant difference between walking while wearing a VR device and walking while wearing a VR device and a toe brace. Conclusion: Orthosis with a VR device during gait (OVG) and gait with a VR device (GVR) affect gait in HV patients. However, there was no significant difference between GVR and OVG. Thus, it is necessary to conduct experiments on various HV angles and increase the duration of wearing the toe brace.
Purpose: The aim of this study was to ascertain the effects of the lower extremity muscle strengthening exercise on balance and ambulation of children with cerebral palsy. Methods: 10 subjects who participated in this research undertook the 12-week the lower extremity muscle strengthening exercise program, which consisted of a series of mat exercises and sling exercises. The statistical significances were examined by using Wilcoxon signed-rank test, a non-parametric test, for evaluating the improvement of balance and ambulation of the subjects. In order to evaluate the correlation among the variables, Pearson's correlation coefficients were also calculated. In all statistical analyses the significance level was selected as ${\alpha}$=0.05. Results: Berg balance scale(BBS) was significantly increased after the intervention(p<.05). Percentage weight bearing(PWB) was decreased after the intervention, but there was no significant difference. Time up and go test(TUG) value was significantly decreased(p<.05). Gait velocities was increased after the intervention, but there was no significance. Stride length, step lengths of the affected side and the sound side were significantly increased after the intervention(p<.05). In the correlation analyses of the measures before the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). In the correlation analyses of the measures after the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). BBS revealed significant positive correlations to stride length, step lengths of the sound side and the affected side(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). Conclusion: Based upon the outcomes as above, it is likely that the muscle strength exercises have substantial effects on balance and ambulation of children with cerebral palsy. Thus various lower extremity muscle strengthening exercise programs are required to be studied and developed in order to contribute to functional improvements of children with cerebral palsy.
Purpose: The aim of the current study was to examine the effects of hinged ankle-foot orthosis (HAFO) on walking function in children with spastic diplegic cerebral palsy (CP). Methods: Thirty-two children (mean age: $6.79{\pm}0.35years$, age range: 5-7 years) who were diagnosed with spastic diplegic cerebral palsy participated in the study. Each subject typically walked through 10 meters of a gait platform with markers on the subject's proper body segments and underwent 3-D motion analysis system with and without hinged ankle-foot orthosis. The HAFOs were all custom-made for individual CP children and had plantarflexion stop at $0^{\circ}C$ with no dorsiflexion stop. The interventions were conducted over three trials in each group, and measurements were performed on each subject by one examiner in three trials. 3-D motion analysis system was used to measure gait parameters such as walking velocity, cadence, step-length, step-width, stride-length, and double support period in two conditions. Results: The walking velocity, cadence, step-length, and stride-length were significantly greater for the HAFO condition as compared to the no HAFO condition (p<0.05). However, no significant difference in step-width and double support period was observed between two conditions. Conclusion: These findings suggest that using the HAFO during walking would suggest positive evidence for improving the spatiotemporal parameters of gait in children with spastic diplegic cerebral palsy.
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