• 제목/요약/키워드: walking rehabilitation

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Comparison of Motor Function and Skill between Stroke Patients with Cerebellar and Non-cerebellar Lesion in Sub-acute Stage

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • 제24권6호
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    • pp.423-427
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    • 2012
  • Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.

실내 승마운동이 고령자의 기초체력 및 ADL 기능에 미치는 효과 (Effect of Basal Physical Fitness and ADL Function in the Aged According to Horse Riding Exercise)

  • 김의령;강승록;유창호;문동안;박상용;권대규
    • 대한의용생체공학회:의공학회지
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    • 제34권4호
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    • pp.163-169
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    • 2013
  • The purpose of this study was to verify exercise effect of horse riding exercise according to estimate basal physical fitness and activities of daily living(ADL) function in the aged. Participants were nineteen peoples who have no impediment of activity. They performed horse riding exercise using SRider(Neipplus, Co., Korea) at sixty minutes a day. Exercise has progressed three days a week for eight weeks. We measured trunk flexion, sit up, whole body reaction, leg strength and maximal oxygen uptake as basal physical fitness. Also three meter gait, single stance with eyes opened and single stance with eyes closed as ADL function were estimated once a month. The result of legs strength and whole body reaction showed the higher significantly than before the exercise. Moreover, the result of three meter walking ability only increased significantly among the ADL function. This means that horse riding exercise might be activated continuous muscular contraction with maintained tonus of muscle. We thought that continuous movement of horse riding could be lead to isometric muscle contraction in lower limbs. Our study found that horse riding exercise could improve lower strengths and muscle reaction for exercise effect. Also we suggested that horse riding exercise could be adapted to exercise methods that could provide rehabilitation and treatment enough for the aged or disabled person.

편마비 환자의 트레드밀과 체중지지의 트레드밀 훈련이 균형능력 및 보행능력에 미치는 영향 (The Effect of Treadmill and Body Weight Support Treadmill Training on Balance and Gait Ability in Hemiplegia Patients)

  • 김성철;허영구
    • 대한물리치료과학회지
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    • 제25권1호
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    • pp.31-43
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    • 2018
  • Purpose: The purpose of this study is to investigate and to verification of changes that the effect of treadmill and body weight support treadmill training on balance and gait ability for sub-acute stroke patients during 4 week. Method: 16 subjects who was diagnosed stroke were divided into 2 groups(8-treadmill training group, 8-body weight support treadmill group) by randomized control trial. Both training programs were consisted with 40 minuted, 5 times a week for 4 weeks and after training programs. Analysis: We analysed effects and changes on balance and gait ability. Analyses were performed using PASW ver. 18.0 and results were reported as mean ${\pm}$ standard deviation (S.D.). To investigate within group comparisons and to verification on effects of exercise, we did paired t test and repeated measured ANOVA test. Significance was set at p<.05. Result: Both training programs showed positive changes in Limit of Stability but significant results which is area of hemiside, area of intact side, area of posterior, total area were reported in body weight support treadmill training group. Changes of Berg Balance Scale was significantly increase and it had significant correlation between groups. Changes of 6 Minutes Walking Test was significant increase in both groups but there was no significant changes on Foot print and Romberg test. Conclusion: After considering all factors, both training programs showed effect on improvement of balance and gait ability in sub-acute stroke patients, but body weight support treadmill training group had better improvement in dynamic balance than treadmill training group. For the increase of balance and gait ability in sub-acute stroke patients, we need to continues study on difference of treadmill and body weight support treadmill and then we will give stroke patients a better satisfaction if we develop and provide a rehabilitation program for improvement of balance and gait ability.

편마비 환자의 보행시작 시 총 압력중심 변화 : 사전연구 (Net Center of Pressure Analysis during Gait Initiation Patient with Hemiplegia : a pilot study)

  • 황선홍;박선우;최희석;김영호
    • 대한의용생체공학회:의공학회지
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    • 제31권1호
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    • pp.50-55
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    • 2010
  • Gait initiation is a transitional process from the balanced upright standing to the beginning of steady-state walking. Dysbalanced gait initiation often causes stroke patients to fall. The net center of pressure, measured by two triaxial force plates from twenty healthy subjects and two stroke patients, was investigated to assess asymmetry of gait initiation in hemiparetic subjects. The time interval and distance of the net center of pressure(CoP) moved from the initiation point to the toe off(S1) and from the toe off to the initial contact(S2) were calculated during gait initiation of normal and stroke patients. When the patient with right hemiplegia(A) initiated his gait with right foot, the time interval and the distance of the net CoP in S1 and S2 were smaller than that of normal subjects' values. However, he initiated the gait with left foot(unaffected side) the time interval and the distance of net CoP in S1 were larger than normative values. Differently, the patient with left hemiplegia(B) has shown that larger time interval and distance in S1 and smaller time interval and distance in S2 in both sides. His asymmetry(with which side the gait initiated) was not significant. It is too early to conclude that these results could be general characteristics of the stroke patients because the variations were large and moreover, the level of motor recovery of the patients was different. However, it is expected that these trials could help to set up the strategy of the therapy for the rehabilitation or prevention of fall in stroke patients.

비탄력 테이핑이 슬개대퇴관절 통증증후군 환자의 슬개건 통증과 슬관절부 근력, 보행에 미치는 영향 비교 (Comparison of the Effects of Non-elastic Taping on Patellar tendon Pain, Knee Muscle Strength and Gait in Patients with Patellofemoral Joint Pain Syndrome)

  • 정상모;정영준;안승원
    • 대한정형도수물리치료학회지
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    • 제25권2호
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    • pp.39-46
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    • 2019
  • Background: Ground repulsion or impact on the ground during daily activities, sports, or occupational activities may cause injury to the knee when walking. Non-elastic taping is effective in treating these problems in previous studies. Non-elastic taping strengthens the structure of the soft tissues of the injured knee joint to maintain constant tension, improves muscle rearrangement and function, and improves proprioception. Based on previous studies, we intended to see the therapeutic changes of non-elastic taping in patients with patellofemoral joint pain syndrome. Methods: The non-elastic taping application method was applied to the patient three times for five hours for one week. Non-elastic taping was applied to the patellar tendon with little space above the skin segment of the patellar femur, with both sides fixed by taping. Muscle strength and gait change were evaluated with non-elastc taping. Results: The knee flexion, extension strength and gait evaluation of the knee joint with inelastic taping showed significant differences after treatment. There was a significant difference in the comparison between the two groups after the treatment method was applied (p<.05). Conclusion: As a result, this study confirms that the non-elastic taping method applied for the treatment of patellar femoral joint pain syndrome is effective in the treatment.

보행 시 정상인과 당뇨병성 족부궤양 환자의 족관절 운동역학적 변수와 근활성도 비교 (Comparison of Kinetic Variables and Muscle Activity of Ankle Joint During Walking in Subjects With and Without Diabetic Plantar Ulcers)

  • 권오윤;최규환
    • 한국전문물리치료학회지
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    • 제8권4호
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    • pp.45-61
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    • 2001
  • 본 연구는 보행주기 동안 정상인과 당뇨병성 족부궤양 환자의 족관절 운동역학적 변수와 족관절 근육들의 근활성도에 차이가 있는지 알아보기 위하여 실시하였다. 본 연구의 대상자는 당뇨병성 족부궤양이 있는 환자 9명(남자: 6명, 여자: 3명)과 성, 연령, 체중으로 짝짓기(matching)시킨 대조군 9명이었다. 3차원 동작분석기, 힘판, 표면 근전도를 이용하여, 보행주기 동안 족관절의 관절가동범위, 모멘트(moment), 일률(power), 그리고 내측가자미근, 전경골근, 비복근의 근수축 개시시간(onset time)과 종료시간(cessation time)을 측정하였다. 정상군과 비교하여 당뇨병성 족부궤양군의 보행속도는 느렸고, 입각기 기간이 길었으며, 족관절의 가동범위가 적었고, 족관절 최대 족저굴곡 모멘트와 일률이 정상군에서보다 유의하게 낮았다. 보행주기에서 당뇨병성 족부궤양군에서 내측 가자미근과 비복근의 근수축 개시시간은 유의하게 빨랐으며, 전경골근과 비복근의 근수축 종료시간은 유의하게 지연되었다. 당뇨병성 족부궤양 환자군의 족관절 근육에서 동시수축(co-contraction)이 증가되고, 보행속도가 느리며, 입각기 기간이 증가하였다. 이러한 보행특성의 차이는 족부 감각손실에 따른 보행의 안정성을 유지하기 위한 보행전략 때문으로 판단된다. 앞으로 이러한 비정상적인 보행특성이 당뇨병성 족부궤양에서 발생하는 비정상적인 족저부 압력분포과 족부궤양 발생과 어떤 관계가 있는지 알아보는 연구가 필요할 것이다.

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체중이동 과제 학습시 효과적인 운동학적 되먹임 유형과 상대적 빈도 (Kinetic Feedback Frequency Effects on Learning Weight Shifting Skills in Nondisabled Subjects)

  • 차승규;박소연;정진호;김영호
    • 한국전문물리치료학회지
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    • 제7권1호
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    • pp.55-63
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    • 2000
  • Physical therapists have been using balance and weight shifting training to induce improvements in standing and walking. This study compared the effects of kinetic feedback frequency and concurrent kinetic feedback on the performance and learning of a weight shifting skill in young, nondisabled adults. Sixteen young adults without known impairment of the neuromusculoskeletal system volunteered for the study. Subjects in each of three kinetic feedback groups performed a weight shifting task in an attempt to minimize error between their effort and a center of pressure (COP) template for a 12 second period. Feedback was provided: 1) concurrently (concurrent feedback), 2) after each trial (100% feedback), 3) after every other trial (50% feedback). Immediate and delayed (24 hour) retention tests were performed without feedback. During acquisition phase, the concurrent feedback group exhibited less error than either of the post response feedback group. For the immediate retention test, the 50% feedback group exhibited less error than did the 100% feedback and concurrent feedback. During the delayed retention, 50% feedback group displayed less error than did the other groups. But no significant differences were found between groups. These results suggest that practice with concurrent feedback is beneficial for the immediate performance, but not for the learning of this weight shifting skill. Lower frequency of feedback resulted in more permanent changes in the subject's ability to complete the task.

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The Effects of Foot Intrinsic Muscle and Tibialis Posterior Strengthening Exercise on Plantar Pressure and Dynamic Balance in Adults Flexible Pes Planus

  • Lee, Da-bee;Choi, Jong-duk
    • 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.

뇌졸중 환자의 낙상 예측을 위한 평가도구 비교 (A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke)

  • 원종임
    • 한국전문물리치료학회지
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    • 제21권2호
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

퇴행성 슬관절염 환자의 굴곡 및 신전 제한이 기능 장애에 미치는 영향 (The Effect of Functional Impairment on Limitation of Flexion and Extension in Patients with Knee Osteoarthritis)

  • 박승규;박래준;김태열
    • The Journal of Korean Physical Therapy
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    • 제13권3호
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    • pp.643-651
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    • 2001
  • Osteoarthritis(OA) is a widespread, slowly developing disease with a high prevalence rate increasing with age. The most common big joints involved in OA is the knee, where the disease particulary strikes, causing difficulties in rising from a chair. climbing stairs, kneeling. standing, and walking. The primary complaints of these patients include pain, stiffness. instability, and loss of function. The purpose of this study was to assess the impact of self-reported symptoms and limited flexion, and limited extension on functional impairment in patients with knee osteoarthritis. In the data collection, a total of 206 who had visited the physiotherapy unit at six different departments of orthopedics were interviewed in K City from June to September, 2000. The results of the study summarized are as fellows: 1. There was a significant difference among different degree group of limited flexion(p<0.05). A group difference was demonstrated between <5 ${\sim}$ 15 and 16 > (F=16.21, p<0.05). In the relationship between the degree of limited flexion and the level of functional impairment, the h igher the range of limited flexion, the lower the level of functional impairment. 2. In the relationship between the degree of limited extension and the level of functional impairment, a group difference was revealed between the non-limitation group and the <10 and 11 < However, no significant difference was noted between 11 ${\sim}$ 20 and 21 >(F= 13.37, p<0.05). In conclusion, finding above suggest that functional impairment is closely correlated with limited tlexion and extenion

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