The purpose of this study was to determine the therapeutic effect of slope changes of the treadmill with body weight-supported training on gait characteristics in patients with hemiplegia. The volunteered subjects were divided into 3 groups based upon slope changes: control group (0° incline), 7° group (7° incline), 12° group (12° incline), They were trained the body weight-supported treadmill training (BWSTT) for 8 weeks. All subjects were supported up to 40% of their body weight on the treadmill training and the support was gradually decreased to 0~10% as the subjects were adapted to the training. There were significant improvements of walking velocity, step length of the affected side, the asymmetry ratio of step length in 7° group (57.80 cm/s, 67.25 cm, .14), 12° group (71.00 cm/s, 71.00 cm, .11) than control group (40.62 cm/s, 55.00 cm, .74) (p<.05): there were no differences between group 7° and 12° group in the all outcomes (p>.05). Both 7° group and 12° group scored higher than the control group in those outcomes and finally the effects of slopes changes of the treadmill were effective on gait characteristics of patients. But it s till remains undetermined what degree on the treadmill might be better to train the hemipareric patients. Therefore, more studies are required to look into minutely the changes of slopes of the treadmill influencing on gait characteristics.

The purpose of this study was to compare spatio-temporal parameters during walking between patients with idiopathic Parkinson's disease and a control group matched for age, height, and weight. Thirty-three subjects were included in this study. Fifteen normal subjects (age, 63.3±5.8 yrs; height, 164.1±8.7 cm; weight, 60.7±17.5 kg) and eighteen patients (age, 64.0±7.7 yrs; height, 164.7±7.3 cm; weight, 63.6±7.7 kg) participated in the study. The Vicon 512 Motion analysis system was used for gait analysis in each group during walking, with and without an obstacle. The measured spatio-temporal parameters were cadence, walking speed, stride time, step time, single limb support time, double limb support time, stride length, and step length. Results in stride length and step length, when walking without an obstacle, showed a significantly greater decrease in the patient group compared to the control group. During walking with an obstacle, the patient group showed a significantly greater decrease in the step length as compared to the control group. For the control group, there were significant decreases in parameters of cadence and walking speed and increases in parameters of stride time, step time, and single limb support time when walking with an obstacle. The patient group had lower cadence and walking speed and higher stride time, step time, and single limb support time during walking with an obstacle than in walking without an obstacle. These results suggest that patients with Parkinson's disease who walk over an obstacle can decrease cadence, stride length, and step length. Further study is needed, performed with more obstacles and combined with other external cues, such as visual or acoustic guides.

The range of motion (ROM) of ankle dorsiflexion in older women was associated with gait abnormalities and the risk of falls. The purpose of this study was to investigate the effect of self-stretching exercise on the flexibility of the plantar flexors of the ankle and the characteristics of gait in healthy elderly women. Fifteen participants were assigned randomly into an exercise (n=8) or control (n=7) group. The exercise group attended a self-stretching program approximately 30 minutes for 3 days per week for 4 weeks. The active ankle dorsiflexion ROM and gait measurements were taken prior to beginning the stretching program and 1 day after the last stretching day. Results showed that the active ankle dorsiflexion ROM was significantly increased in the exercise group than in the control group after the stretching program (p<.05). However, gait parameters, including gait speed, cadence, and stride length were not significantly different between the two groups (p>.05). The results suggest that a 4-week self-stretching program is capable of provoking a significant increase in ankle dorsiflexion ROM in elderly, community-dwelling women. Additional research is needed to investigate the effect of gait-specific exercise combined with stretching exercise on gait ability.

This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.

The purpose of this study was to investigate the effects of auditory cues in the form of a metronome on gait initiation (GI) in Parkinson's disease (PD). 2 patients (mean age: 54 yrs) with idiopathic PD participated in the study. All patients (Hoehn and Yahr disability score of 2.0) were tested in the "on" state approximately 1.5 hours following the administration and fully responding to their PD medications. Subjects first initiated walking at self-initiated speeds to determine their cadences. Then, subjects were asked to initiate gait along the walkway while keeping pace with a metronome. The metronome rate (in beats/min) was set at a cadence 85% (slow condition), 100% (normal condition) and 115% (fast condition) of gait for each subject. Subjects were able to increase the speed of GI with faster cadence, but the speed of GI for the slow condition was similar to that of the normal condition. Swing toe-off was 578.3 ms for the fast condition, 709.4 ms for the normal condition and 736.2 ms for the slow condition. Respective times for swing heel-strike were 894.3 ms, 1110.2 ms and 1119.1 ms, and stance toe-off were 1105.4 ms, 1338.5 ms, and 1343.1 ms. Except for stance unloading ground reaction forces were greatest for the fast condition and smallest for the slow condition. It appears that PD patients were able to modulate GRFs and temporal events in response to auditory cues to achieve the peak acceleration force of the swing and stance limb. The findings from this study provided preliminary data, which could be used to investigate how PD patients modulate GRFs and temporal events during GI in response to tasks.

The purpose of this study was to investigate the effects of walking aid on hemiplegic gait of chronic stroke patients. Twelve stroke patients participated in this study. Physiological cost index (PCI), gait speed, and climbing stairs with and without walking aid were measured and analyzed. The results showed that walking with walking aid significantly improved gait speed and reduced physiological cost index and time needed to climb stair (height 7 cm) in comparison with a walking without walking aid. In conclusion, walking aid may improve the speed and efficiency of hemiplegic gait in chronic stroke patients.

The limited walking ability after a stroke restricts a patient's independent mobility at home and in the community. It also brings about significant social handicaps. Therefore, it is necessary to improve walking ability in community-dwelling persons with stroke. The purpose of this study was to evaluate the effectiveness of gait training and muscle strengthening exercise of lower extremities in persons with chronic stroke. Nineteen community-dwelling individuals with stroke participated in this program. The exercise program lasted for seven weeks, with a 1-hour program twice per week, and it consisted of balance training, gait training, and strengthening of lower extremities. The outcome of the program was assessed by the gait speed, Wisconsin Gait Scale (WGS), Berg Balance Scale (BBS), and Stroke Impact Scale (SIS). Significant effects were found for the WGS, BBS, and mobility and hand function domain of the SIS (p<.05). It was found that short-term gait training exercise could improve quality of gait, balance, and mobility. Therefore, a more effective exercise program is required for community-based persons with stroke.

The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

The purpose of this study was to investigate how COP displacement of a hemiplegic foot in stance phase during gait is related to clinical balance measures and the recovery stage in hemiplegic stroke patients. Twenty-eight functionally ambulant hemiplegic patients who had suffered from strokes and thirty age-matched healthy subjects participated in this study. COP parameters were calculated. Clinical balance was measured using the Functional Reach Test (FRT) and Timed Up and Go Test (TUGT). The recovery stage, proprioception, and clonus of the ankles or lower extremities were also measured for physical impairment status. The COPx max-displacement in the medial-lateral side of the stroke patients was significantly longer than that of the normal group (p=.038). The COPy max-displacement in the anterior-posterior side of the stroke patients was significantly shorter than that of normal group (p<.001). Significant differences in the COPx and COPy displacement asymmetry index were found between the two groups (p<.01). The FRT was correlated with the COPx displacement (r=.552) and COPy displacement (r=.765). The TUGT was correlated with the COPy displacement (r=-.588) only. The recovery stage of the lower extremities was correlated with COPy displacement (r=.438). The results of the study indicate that the characteristic of COP displacement in hemiplegic feet in stance phase during gait is related to balance ability and recovery in stroke patients. COP parameters acquired by the mapping of foot pressure in stance phase during gait will provide additional useful clinical information. This information can be used by clinicians to assess objectively the pathologic gait with other diseases and to evaluate the therapeutic effects on gait in stroke patients.

The purposes of this study were to analyze gait patterns of patients with chronic lumboscaral radiculopathy and to investigate gait parameters which can reflect a functional deficit in relation to the level of lumbosacral radiculopathy. The study population consisted of 25 patients of chronic lumbosacral radiculopathy and 25 healthy control subjects. Conventional physical examinations and three-dimensional gait analyses were performed on all participants. The data were analyzed using an independent sample t-test. The results were as follows: (1) In the patients' group, cadence, walking velocity, stride length and double support time were less than in the control group (p<.05). (2) In the patients' group, maximum flexion of hip, maximum flexion of loading response, maximum flexion of swing phase on the knee and maximum plantar flexion of pre-swing were less than the control group (p<.05). Using three-dimensional gait analysis, we could identify specific gait parameters to reflect a functional deficit related to the level of lumbosacral radiculopathy.

These were two main purposes of this study. The first was to research the relevance between gross motor function measurement (GMFM) and the spatiotemporal parameters of gait in children with cerebral palsy. The second was to research the relevance between gross motor performance measure (GMPM) and the spatiotemporal gait parameters. Twelve children ( years) with cerebral palsy participated in this study. GMFM and GMPM were performed and the spatiotemporal parameters of gait were measured by using WalkWay MG-1000. There were no significant correlations between the GMFM score and the stride length, step length, step width, cadence, and velocity (p>.05). The GMPM score also had no significant correlation with the spatiotemporal gait parameter (p>.05).

This simulation study investigated the characteristics of normal gait, crouch gait, crouch/equinus gait, crouch gait, crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.

본 논문은 "풋 스캐너"와 "족압분석 시스템"을 이용하여 획득한 측정 데이터에서 새로운 보행분석 평가 방법을 제안하였다. 기존의 많은 연구자들에 의해서 보행시 발바닥의 육안적 검사와 압력분포의 분석 방법이 많이 논의되었다. 또한 연구자들은 압력곡선, 압력중심 궤적과 압력중심에서의 속도에 관해서 관심을 가져왔다. 그러나 이런 실험결과들은 실험환경과 피험자의 조건에 의해 의존된다. 결론적으로 우리는 이런 문제를 해결하기 위해 특별한 에너지 변수 등을 고려해야만 한다. 운동 에너지와 충격량 변수는 보행 분석에 활용될 수 있으며, 본 논문의 결과는 8명의 피험자들의 실험을 통하여 새로운 변수의 유용성을 확인하였다. 새로운 변수의 유용성을 확인하였다.

본 연구는 발가락 벌림 보조기(toe spreader)가 긴장성 발가락 굽힘 반사(Tonic Toe Flexion Reflex: TTFR)가 있는 양하지 뇌성마비 아동의 보행에 미치는 영향을 알아보고자 하였다. 12명의 TTFR이 있는 양하지 뇌성마비 아동을 대상으로 같은 날에 맨발과 발가락 벌림 보조기를 착용한 상태에서 보행분석을 실시하였다. 시간 거리 보행변수로 활보장(step length), 보장(step length), 보폭(step width)

보행 종료(gait termination)는 인간의 보행개시(gait initiation)나 율동성 보행(rhythmical walking)에 비해 관심을 적게 받고 있다. 파킨슨 환자들이 보행종료와 방향전환 시 가지는 어려움은 이들 환자들이 보행 시 넘어지게 되는 노출 요인으로 보고되어져 왔다. 보행종료에 대한 기전의 이해는 효과적으로 걸음을 멈추지 못해 넘어지게 되는 위험요인을 가진 사람들에게 적용되어질 수 있다. 이 논문에서 우리는 보행종료에 대한

Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of to and to . The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.

Body weight support treadmill training is a new and promising therapy in gait rehabilitation of patients with hemiplegia. The purpose of this study was to identify the effects of body weight support treadmill training on gait and standing balance in patients with hemiplegia. Eighteen patients with hemiplegia participated in the study. A 10 m-timed walk test, measurements of step length and standing balance score were administered. Intervention consisted of body weight support treadmill training five times a week for 2 weeks. The data were analyzed by paired t-test. Body weight support treadmill training scoring of standing balance, step length and 10 m-timed walk test showed a definite improvement. Body weight support treadmill training offers the advantages of task-oriented training with numerous repetitions of a supervised gait pattern. The outcomes suggest that patients with hemiplegia can improve their gait ability and standing balance through body weight support treadmill training.

본 연구는 하퇴의지 착용자와 정상 성인간의 시간-거리, 운동형상학 변수를 조사하고 비교하기 위하여 실시하였다. 연구 대상자는 외상으로 인한 하퇴 절단자로서 내골격식 하퇴의지를 착용하고 독립적으로 보행이 가능한 20명과 연령, 신장으로 짝짓기한 대조군(matched control group) 20명이 참여하였다. 보행분석은 Vicon Clinical Manager Software (VCM)를 내장한 PC에 5개의 카메라가 연결되어 있는 Vicon 512

Asymmetrical stance posture, balance, and gait disturbance are common problems in hemiplegic patients. Posterior leaf springs (PLS) are frequently prescribed to correct these problems. Recently, anterior leaf springs (ALS) have also been prescribed, but only limited studies have been performed to investigate the effects of ALS. The purpose of this study was to compare the effects of three conditions, i.e., wearing an ALS, wearing a PLS, and not wearing an AFO (ankle foot orthosis),: on 1) the distribution of weight bearing on the affected side, 2) standing balance, and 3) the gait patterns of hemiplegic patients. Eleven hemiplegic patients (10 men and 1 woman) participated in this study. The data were analyzed by the Friedman test. The results were as follows: 1) More weight bearing on the affected leg was observed in the ALS and PLS conditions than in the condition without an AFO. No significant difference between the ALS and PLS conditions was found. 2) There were statistically significant differences in the composite equilibrium scores (CES) among the three conditions. The CES in the PLS condition was significantly higher than in the ALS condition or the condition without an AFO. 3) Gait patterns improved significantly in the ALS and PLS conditions. No statistically significant difference between the ALS and PLS conditions was found. These results suggest that both ALS and PLS effectively improve the distribution of weight bearing on the affected side, standing balance, and gait patterns of hemiplegic patients. Further study using three-dimensional kinematic analysis and dynamic electromyography is needed to support these findings.