• Title/Summary/Keyword: stance

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A Clinical Study of a Stroke Patient with a Worsened Gait Pattern after Discontinuing Rehabilitation (재활치료 중단 후 보행 양상이 다시 악화된 뇌졸중 환자 1례에 관한 고찰)

  • Kim, Cheol-hyun;Moon, Yeon-ju
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.118-124
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    • 2017
  • Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.

Robotic-assisted gait training applied with guidance force for balance and gait performance in persons with subacute hemiparetic stroke

  • Son, Dong-Wook;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • v.6 no.3
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    • pp.106-112
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    • 2017
  • Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions: The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.

An Evaluation of Fiscal Policy Response to Economic Cycles (재정정책의 경기 대응에 대한 평가)

  • Lee, Sam-Ho
    • KDI Journal of Economic Policy
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    • v.28 no.2
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    • pp.51-96
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    • 2006
  • Two conditions should be satisfied if fiscal policy is to stabilize economic cycles; proper policy timing and significant policy effect. This paper evaluates whether the policy timing has been proper in Korea by investigating the correlation between fiscal policy stance and economic conditions. We first calculate quarterly FIs (Fiscal Impulse) using the estimated potential GDP and fiscal balance data. Based on these indices, we 1) analyze how FIs respond to the economic conditions summarized in GDP gap through regression analysis, 2) compare average FIs in expansionary and recessionary periods according to the NSO's economic cycles, 3) evaluate fiscal policy maker's perception of economic conditions and its intention by reviewing the budget proposals. Although regression analysis shows that overall fiscal policy, especially expenditure side, has properly responded to economic conditions, average FIs do not show the significant difference between expansionary and recessionary periods. It is inconclusive whether the fiscal policy timing has been proper. Budget proposals show that actual fiscal policy stance has been sometimes inconsistent with the policy intention, which implies that it is hard to utilize fiscal policy actively to stabilize the economy.

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The Study on Political Stances based on Editorials of Korean Newspapers (한국 신문 사설의 정치적 성향 분석 연구)

  • Ban, Hyun
    • The Journal of the Convergence on Culture Technology
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    • v.4 no.3
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    • pp.87-92
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    • 2018
  • This paper aims to investigate political stances of news producers or news organizations by analyzing editorials from two Korean newspapers, Chosun Ilbo and the Hankyoreh, which are totally different in ideology, both qualitatively and quantitatively. In particular, the headlines from 16 editorials and 14 editorials from the two newspapers respectively published from May 28 to June 27 were analyzed in terms of political stances to a U.S-North Korea Summit. Moreover, two editorials published right after the U.S-North Summit were quantitatively analyzed within Martin and White (2005)'s framework. As a result, it was found that Chosun ilbo showed a negative stance to the summit by employing the 'feeling' factor within an attitude component most frequently, whereas the Hankyoreh was overwhelmingly positive toward the issue and the dialogue expansion factor within an engagement component is most frequently used to deliver its positive stance toward the issue.

Anatomical Study of Interdigital Neuroma Occurring Site and the Deep Transverse Metatarsal Ligament (DTML) (지간 신경종 발생 위치와 심부 횡 중족 골간 인대의 해부학적 연구)

  • Kim, J-Young;Choi, Jae-Hyuck;Lee, Kyung-Tai;Young, Ki-Won;Park, Jung-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.182-186
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    • 2007
  • Purpose: We examined the relationship of interdigital neuroma occurring site and the surrounding structures, including the deep transverse metatarsal ligament (DTML) by cadaver study and clinical results. Materials and Methods: Seventeen fresh frozen cadavers study were done to evaluate the relationship of interdigital neuroma occuring site and the DTML at two phase of the gait cycle with 60 degree of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from interdigital nerve bifurcation of the common digital nerve to anterior margin of the DTML and longitudinal length of DTML itself. Clinically, we checked the location of interdigital neuroma and DTML length during surgery in 32 feet. Results: In the second and third web space, the mean distance from bifurcation of the common digital nerve of foot to the anterior margin of DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm. 14.6 mm in heel-off position. Second, Third web space ligament itself length were average 12.8 mm, 10.6 mm. Clinically, all of the cases of interdigital neuroma started at the bifurcation area of the common digital nerve and interdigital neuroma was average 7.5 mm (range; 6-11 mm). Conclusion: Interdigital neuroma were located more distally than DTML in both the mid-stance and heel off stage. The main lesion was located between metatarsal head and metatarsophalangeal joint and more distal than the DTML anterior margin.

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The Effect of Tai Chi Training on the Center of Pressure Trajectory While Crossing an Obstacle in Healthy Elderly Subjects

  • Kim, Hyeong-Dong
    • Physical Therapy Korea
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    • v.15 no.4
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    • pp.27-33
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    • 2008
  • The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

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Effects of Abdominal Muscle and Pressure on the Spine Stability during Upright Stance Posture - For the Case where Intervertebral Disc Plays the Role of Mechanoreceptor (추간판이 물리적 자극의 수용기 역할을 하는 경우 기립 상태에서 복압 및 복근의 역할이 척추 안전성에 미치는 영향)

  • Choi, Hae-Won;Kim, Young-Eun
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.1
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    • pp.115-122
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    • 2011
  • Recently, we have proposed a hypothesis that spinal structures have a stress sensor driving feedback mechanism, In the human spine, spinal structure could react to modify muscular action in such a way so as to equalize stress at the disc, therefore reduce the risk of injury, In this analysis, abdominal muscle and abdominal pressure, which were not included in the previous study, were added to identify those effects in spine stability during upright stance posture for the case where the intervertebral disc plays the role of mechanoreceptor, The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Muscle architecture with 46 local muscles containing paraspinal muscle and 6 rectus abdominal muscles were assigned according to the acting directions. The magnitude of 4kPa was considered for abdominal pressure. Minimization of the nucleus pressure deviation and annulus fiber average tension stress deviation was chosen for cost function. Developed model provide nice coincidence with in-vivo measurement (nucleus pressure). Analysis was conducted according to existence of co-activation of abdominal muscle and abdominal pressure. Antagonistic activity of abdominal muscle produced stability of spinal column with relatively small amount of total muscle force. In contrast to the abdominal muscle, effect of abdominal pressure was not clear that was partly depending on the assumption of constant abdominal pressure.

Relationship between lower limb alignment and knee adduction moment during ambulation in the healthy elderly (노인의 하지 정렬 상태와 보행 시 슬관절 내전 모멘트 특성)

  • 조유미;홍정화;문무성
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.10a
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    • pp.24-24
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    • 2003
  • For the elderly, achieving a close-to-normal ambulation is important for activities of daily life. Recent researches of SE(Silver Engineering) restoring physical ability would help the elderly by developing the advanced gait assisting devices and orthoses. For the applications using the advanced technologies, the gait characteristics of the elderly must be understood. However, a few studies were performed to investigate the physiological or pathological gaits. The purpose of this study is to provide the gait analysis data and also to investigate relationships between alignment of the lower limb, foot progression angle and knee joint moments in the healthy elderly. By participating a total of 20 healthy elderly persons in this study, the following facts were found: 1) Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04m, Step length was 0.56m; 2) The maximum knee flexion angle through swing phase showed left 46.82$^{\circ}$, right 40.19$^{\circ}$ and the maximum knee extension angle showed left -1.32$^{\circ}$, right 2.01$^{\circ}$. Knee varus showed left 26.90$^{\circ}$, right 30.93$^{\circ}$; 3) The maximum knee flexion moment showed left 0.363 Nm/kg, right 0.464 Nm/kg, The maximum knee extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximum knee adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg. The maximum internal rotational moment showed left 0.13 Nm/kg, right 0.140 Nm/kg; 4) The subjects who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase; and 5) The subjects who had large foot progression angle had statistically lower in knee adduction moment in late stance phase.

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A Review on the Mechanism of Human Postural Control (인간의 자세조절 메커니즘에 대한 연구)

  • Lee, Dong-Woo
    • Korean Journal of Applied Biomechanics
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    • v.15 no.1
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    • pp.45-61
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    • 2005
  • Stance is defined as any state in which the total mass of the body is supported by the feet. In order to maintain stance, the sum of gravito-inertial forces acting on the body must be registered by equal and opposite forces at the region of contact between the organism and the support surface. Balance is controlled by applying forces to the surface of support so as to maintain the body's center of mass vertically above the feet. for a muIti-segment organism, there can be a variety of ways in which balance can be controlled, since movements of different body segments can have similar effects on the control of balance. In general, the organism tends to have a body configuration that is aligned with gravito-inertial force when there are no external forces acting on it. If any segments of the body are not aligned with gravito-inertial force vector, a torque on that segment would tend to move the body's center of mass. The maintenance of postural stability is accomplished in humans by a complex neural control system. This requires organizing integrating and acting upon visual, vestibular, and somatosensory input, providing orientation information to the postural control system. The information necessary to control and coordinate movement is provided by the visual sense of eye position with respect to the surrounding surface layout, the vestibular sense of head orientation in the gravito-inertial space, and the somatic sense of body segment position relative to one another and to the support surface. In this study, perception and action capability was examined from various points of view. The underlying assumption of the study was that the change of postural configuration could be effected by organism, environment and task goal.

The Kinematic Analysis of Gliding Type and Delivery Phase in Each Trails during Shot-Putting - Focusing on Lee, Hyung-Keun, Player in Men's High School Youth Group - (고등부 남자 포환던지기 선수의 시기 별 글라이드 유형과 딜리버리 국면의 운동학적 분석 - 고등부 이형근 선수를 중심으로 -)

  • Kim, Tae-Sam;Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.22 no.2
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    • pp.159-171
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    • 2012
  • The purpose of this study was to provide information about kinematic variables of the gliding and delivery motion of Hyung-Keun Lee, a high school shot putter who was ranked 1st at the 2011 National Sports Festivals. Three-Dimensional motion analysis using a system of 4 video cameras at a sampling frequency of 60 Hz was conducted during shot-putting events at the 2011 National Sports Festivals. During the gliding and delivery phase of the player the results showed following characteristics; 1) The gliding technique types of the player appeared to be the short-long technique as the gliding and stance length ratio were $42.3{\pm}3.87$ % and $57.7{\pm}3.87$ %, respectively. In addition, the trajectory of shots during the gliding and delivery phase showed different trajectory patterns with "S-shaped" type of elite players due to the deviation from a central axis of the APSS (athletic-plus shot system). 2) The horizontal velocity of COG made from gliding should maintain the velocity during transition and release phase, but the player showed a small momentum for a gradual decrease of velocity. 3) Therefore, the player requires to adjust an appropriate ratio between gliding and stance length with a strong muscle power at the trunk, throwing arm, and the lower extremity during gliding and delivery phase.