• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.250-260
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• 2024

Objective: This study aimed to explore the effects of balance training using fully immersive VR devices on the balance and walking abilities of stroke patients. Design: Randomized controlled trial Methods: This study involved 54 stroke patients divided into three groups: VRT(VR and traditional physical therapy), VR(VR only), and TPT(traditional physical therapy only). Interventions were administered twice daily for 30 minutes over eight weeks. Outcome measures included the Berg Balance Scale, Timed Up and Go Test, 10-meter walk test, gait analysis, and Activities-specific Balance Confidence Scale. Results: The VRT and VR groups showed significant effects on spatiotemporal variables and confidence compared to the TPT group (p<0.05). Specifically, the VR group demonstrated superior effects in TUG, 10MWT, velocity, stride length, single-leg support, and ABC compared to the other two groups (p<0.05). Conclusions: Fully immersive VR balance training had a positive impact on balance, walking, and confidence in chronic stroke patients. Traditional physical therapy alone showed limited effectiveness, highlighting the potential of VR-based interventions in stroke rehabilitation. These findings underscore the importance of integrating VR technology into clinical practice to enhance outcomes for stroke survivors.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.5 no.1
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• pp.47-52
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• 2011

The functional loot orthoses, when wearing shoes, are in the direct contact with bottom of foots to improve and recover the correctness of abnormal lower limb musculoskeletal imbalance and the primary role of foot and also, it can act to keep the balance and weight of body and support the weakened region, so that it is very helpful to keep body balance for the standing position. In this paper, it was researched that foot orthoses which is accommodable for the function of impact absorption including the gait stability affect on the balanced performances of body in according to the formation and the material of foot part. Taking into account the balanced performances by using the sway velocity, the estimation and comparison of the effects on the balanced performances by each formation and material for foot orthoses was evaluated into significant values(p<0.006) in only the eye-opening posture with Firm state, In this posture, the static process performed by each foot formation reveals in order of normal foot(p<0.010), flat foot(p<0.000) and hollow foot(p<0.003) and then, on the base of each formation of foot part, the result that analyze the effects of the materials of foot orthoses on the balance performance appeared showing that soft materials is more effective on the normal foot and, on the other hand, rigid materials is more effective in balancing on flat foot and hollow foot.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.115-126
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• 2016

Objective: The purpose of this study was to investigate plantar foot pressure and static balance according to the type of insole in the elderly. Methods: Thirteen elderly (mean age: $67.08{\pm}2.25years$, mean height: $159.63{\pm}9.64cm$, mean body weight: $61.48{\pm}9.06kg$) who had no previous injury experience in the lower limbs and a normal gait pattern participated in this study. Three models of insoles of the normal, 3D, and triangle types were selected for the test. The Pedar-X system and Pedar-X insoles, 3.3 km/h of walking speed, and a compilation of 20 steps walking stages were used to analyze foot-pressure distribution. Static balance test was conducted using Gaitview AFA-50, and balance (opening eyes, closing eyes) was inspected for 20 s. One-way ANOVA was conducted to test the significance of the results with the three insoles. p-value of less than .05 was considered statistically significant. Results: The mean foot pressure under the forefoot regions was the lowest with the 3D insole during treadmill walking (p<.05). The mean value under the midfoot was the highest with the 3D insole (left: p<.05, right: p<.01). The mean value under the rearfoot was the lowest with the 3D insole (p<.001). The maximum foot pressure value under the foot regions was the lowest on both sides of the forefoot with the 3D insole. A statistically significant difference was seen only in the left foot (p<.01). The maximum value under the midfoot was the highest with the 3D insole (p<.001). No statistically significant difference was detected on the values under the rearfoot. In the case of vertical ground reaction force (GRF), statistically significant difference was seen only in the left side rearfoot (p<.01). However, static balance values (ENV, REC, RMS, Total Length, Sway velocity, and Length/ENV) did not show significant differences by the type of insole. Conclusion: These results show that functional insoles can decrease plantar pressure and GRF under the forefoot and rearfoot. Moreover, functional insoles can dislodge the overload of the rearfoot and forefoot to the midfoot. However, functional insoles do not affect the static balance in the elderly.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.1
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• pp.47-57
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• 2016

In this paper, we measured human body signals in order to verify a active harness system that we developed for gait and balance training. The experimental procedure was validated by tests with 20 healthy male subjects. They conducted motions of Activities of Daily Living(ADL)(Normal Walking, Stand-to-Sit, Sit-to-Stand, Stair Walking Up, and Stair Walking Down) according to body weight support rates (0%, 30%, 50% of subjects' body weight). The effectiveness of the active harness system is verified by using the results of foot pressure distribution. In normal walking, the decrease of fore-foot pressure, lateral soleus muscle and biceps femoris muscle were remarkable. The result of stand-to-sit results motion indicated that the rear-foot pressure and tibialis anterior muscle activities exceptionally decreased according to body weight support. The stair walking down show the marked drop of fore-foot pressure and rectus femoris muscle activities. The sit-to-stand and stair walking up activities were inadequate about the effect of body weight support because the velocity of body weight support system was slower than male's activity.

• Safety and Health at Work
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• v.3 no.1
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• pp.22-30
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• 2012

Objectives: To challenge the problem of slipperiness, various slipmeters have been developed to assess slip hazard. The performance of in-situ slipmeter is, however, still unclear under the various floor conditions. The main objectives of this study were to evaluate the performance of three kinds of slipmeters under real conditions, and to find their dynamic and kinematic characteristics, which were compared with gait test results. Methods: Four common restaurant floor materials were tested under five contaminants. Slipmeters and human gaits were measured by high speed camera and force plate to find and compare their dynamic and kinematic characteristics. Results: The contact pressures and built-up ratio were below those of subjects. The sliding velocity of British Pendulum Tester was above those of subjects, while those of BOT-3000 and English XL were below those of subjects. From the three meters, the English XL showed the highest overall correlation coefficient (r = 0.964) between slip index and $R_a$, while the rest did not show statistical significance with surface roughness parameters ($R_a$, $R_z$). The English XL only showed statistical significance (p < 0.01) between slip index and contaminants. The static coefficient of friction obtained with the BOT-3000 showed good consistency and repeatability (CV < 0.1) as compared to the results for the BPT (CV > 0.2) and English XL (CV < 0.2). Conclusion: It is unclear whether surface roughness can be a reliable and objective indicator of the friction coefficient under real floor conditions, and the viscosity of contaminants can affect the friction coefficient of the same floors. Therefore, to evaluate slipperiness, the performance of the slipmeters needed to improve.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.99-104
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• 2017

PURPOSE: Gait disturbances in patients with hemiplegic stroke involve asymmetry of stance time. Step box training is used to supplement the limitations of stair walking training and increasing the torque value of the paralyzed lower leg's strength. This study aimed to investigate whether step-up training on unstable support could change walking ability in patients with chronic stroke. METHODS: Thirty stroke patients were randomly assigned to the step-up training group (experimental group), that performed training on an unstable surface, and the control group, that performed training on a stable surface. Walking speed, step length, and cadence were measured before and after training. Paired t-tests were used to compare pre- and post-intervention data, while the independent samples t-test was used to determine intergroup differences. Values of p < .05 were considered statistically significant. RESULTS: There was a significant difference in walking ability before versus after the intervention in both groups, although the experimental group showed greater differences than the control group (walking velocity by 8.1%; step length of the non-paralyzed side by 6.9%, respectively; p<.05). CONCLUSION: Step-up training might be more effective on an unstable surface than on a stable surface for increasing walking speed and step length of the non-paralyzed side.

• PNF and Movement
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• v.18 no.2
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• pp.215-222
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• 2020

Purpose: The study investigated the effect on chronic stroke patients' balance of a weight shift to the affected side using an insole on the less affected side during treadmill walking training. Methods: The subjects were 7 patients who had been diagnosed with stroke 6-24 months prior to the study. In each case, an insole was applied on the patient's less affected side during treadmill walking training. Each training session lasted 30 minutes and was undertaken 5 times per week for 4 weeks. Biorescue equipment that measures shifts in center of pressure was used to assess balance ability as measured by the Korea-Berg balance scale (K-BBS) before and after each training intervention. The Wilcoxon signed-rank test was used to evaluate within-group effects. Results: The results revealed statistically significant before and after differences in area, pressure, length, and mean velocity of the balance test and on K-BBS (p < 0.05). Conclusion: In chronic stroke patients, using an insole to adjust the height of the shoe on the less affected side is an effective means of increasing weight-shifting on the paralyzed side during treadmill gait training.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.15-22
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• 2012

Purpose : We investigated the effects of the combined use of FES and over ground walking with partial body-weight support (PBWS) on walking function and balance control in people with chronic strokes. Methods : Twenty-seven people who were ambulatory after chronic strokes were evaluated. The exercise's intervention consisted of the combined use of FES and over ground walking with PBWS and general exercise groups. The FES + PBWS group and general exercise group consisted on a-20-minute session per day, 3 times a week during a 4 week period. The evaluation was carried out before, after, and two weeks after the exercise intervention. Outcome measures were a 6 Minute Walk Test, 6-Meter walk Test, Timed Up and Go Test, and a Balance Test, measured before and after the exercise interventions at a-2 week follow up. Results : The endurance was significantly increased in both the FES+PBWS group and general exercise group (p<0.05). Significant increase on the gait velocity was observed in both the FES+PBWS group and general exercise group (p<0.05). The TUG was significantly different in both the FES + PBWS group and general exercise group (p<0.05). However there were no differences in both the between-group & interaction. The stability index was significantly different in both the FES + PBWS group and general exercise group (p<0.05). Conclusion : In conclusion, the combined use of FES and over ground walking with PBWS led to an improvement in walking function and balance control. Thus, it is possible to combine the use of FES and over ground walking with PBWS for physical therapy intervention to improve walking function and balance control. It is suggested to apply this intervention in the clinical field.

• Journal of Institute of Control, Robotics and Systems
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• v.12 no.9
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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.

• Physical Therapy Korea
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• v.12 no.2
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• pp.58-72
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• 2005

The purposes of this study were to determine the effects of rehabilitation programs on functional performance of the lower extremities and whether additional therapeutic exercise with routine rehabilitative therapy improves functional performance more than just routine rehabilitative therapy by it self for inpatients who have suffered a stroke with below moderate severity within 3 to 6 months after the onset of the stroke. Fifty-eight subjects were divided into two groups. Group I was given routine rehabilitative therapy and group II was given additional therapeutic exercise along with the routine rehabilitative therapy. Each group received 6 weeks of rehabilitation. The timed get-up and go test (TUG), the Fugl-Meyer score (FMS), functional independence measure (FIM), functional reach (FR), gait velocity (GV), and the strength of knee extensor and flexor were selected to measure effect of rehabilitation programs. The main results were measured and analysed at baseline, 3 weeks, and 6 weeks after the start of the rehabilitation programs. The results revealed that all of functional performance of the lower extremities in 3 weeks after the start of the rehabilitation programs were significantly improved compared with before the rehabilitation programs in both groups. In 6 weeks, TUG, FIM, FR, GV, and the strength of knee extensor in group I, TUG, FMS, FIM, FR, GV, and the strength of knee extensor and flexor in group II were significantly improved compared with the results after 3 weeks. At 3 weeks after rehabilitation programs, group II made significantly greater gains in TUG, FR, GV, and the strength of the knee flexor compared to the group I. At 6 weeks, group II made significantly greater gains in TUG, FR, GV, and the strength of the knee extensor and flexor compared to the group I. In conclusion, rehabilitation programs for stroke patients within 3 to 6 months after stroke onset significantly contributed to improve functional performance of the lower extremities. It is desirable for improvement of functional performance of the lower extremities to perform additional exercise with routine rehabilitative therapy.