This study examined the correlations among the Berg Balance Scale, which is a clinical tool used to evaluate balance ability, spatiotemporal parameters of gait, and falling; determined the parameters most closely related to falling; and identified a discriminatory parameter and its predictability. Thirty-four subjects aged 72 to 92 years participated in this study. Following a questionnaire survey about falling, the Berg Balance Scale and spatiotemporal parameters of gait were measured. The results revealed that the incidence of falls increased with aging and an accompanying reduction in the flexion range of motion of the hip joint. The gait characteristics of elderly people who fell easily included a slower walking speed, shorter stride, and longer stance time than other elderly. When the cutoff score was set at 45, the Berg Balance Scale was able to identify correctly those individuals who truly have experience of falling than when the cutoff score was set at 39. But when the cutoff score was set at 39, the scale's specificity identifying correctly those individuals who truly have not experience of falling was higher than at the cutoff score of 45. Therefore, the Berg Balance Scale is an appropriate screening method in a clinical setting for the early detection of elderly people at risk of falling. In conclusion, elderly people with a Berg Balance Scale score. below 45 are the most likely to fall owing to their decreased balance ability.

In this study, vertical acceleration of center of mass was observed along normal gait phases in 9 healthy male volunteers (aged ). The developed wireless accelerometric device was attached on the intervertebral space between L3 and L4 using a semi-elastic waist belt. A three-dimensional motion analysis system, synchronized with the accelerometry, was used for detecting gait phases. There was no significant correlation between the body weight and the acceleration. The first peak curve covered loading response phase. The second downward peak point was matched accurately with the opposite toe-off. In mid-stance and terminal stance, the acceleration curve highly resembled the vertical ground reaction force curve. There was no significant difference in timing between the final upward peak point and the initial contact. Therefore, the developed accelerometry system would be helpful in determining determine temporal gait pattems in patients with gait disorders.

The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

The purpose of this study was to compare the balance and gait between fallers and non-fallers in elderly. A brief questionnaire was used to obtain the fall history. Twenty-seven women subjects were evaluated in this study. Eleven subjects and a mean age of 84.5 years (SD=4.6) were designated as the faller group. Sixteen subjects and a mean age of 80.3 years (SD=5.3) were designated as the non-faller group. The fall-related factors (mental status, balance, range of motion and muscle strength of lower extremity, sensation of foot, and cadence, walking velocity, stride length) were compared between faller group and non-faller group and measured. The results showed that faller group had significantly less range of motion of the hip flexion and knee extension, and strength of the knee extensor and ankle dorsiflexor and plantar flexor than non-faller group. The scores of the Functional reach test and One leg standing were significantly less in faller group than in non-faller group. Faller group showed less walking velocity and stride length compared to non-faller group. However, there was no significant difference in cadence during comfortable waking and fast walking between two groups. There were no significant differences in pressure, position sensory between two groups. These results suggest that exercise for improving the flexibility, muscle strength of the lower extremity and balance may be useful strategies to prevent fall in elderly. Further studies are needed to identify which specific factors are related to fall in the elderly population.

전시냅스 억제(presynaptic inhibition)와 동시냅스 억제(homosynaptic depression)는 보행 시에 분절반사(segmental reflex)를 조절하는 두 가지 독립적인 기전이다. 근방추 피드백(feedback)은 전시냅스 억제(inhibition)를 통해 보행 시 원심성 근육 수축기에서 적절이 조절될 수 있다. 이러한 전시냅스 억제 작용은 H-reflex의 강도로 나타내질 수 있는데, 원심성 근육 수축기 동안 H-refl

This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ( months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.

본 연구는 강직성 편측 뇌성마비 환자의 보행 기시(gait initiation)의 특성을 파악하고, 동적 단하지 보조기(dynamic ankle foot orthosis : DAFO)가 이런 환자들의 보행 기시에 미치는 영향을 알아보기 위하여 실시하였다. 연구대상자는 19세 선천성 강직성 우측 뇌성마비를 가진 여자 대학생이었다. 연구대상자는 4개의 다른 보행 기시 조건에서 각 조건당 7회의 보행 기시를 하였는데, 각각의 보행 기시 조건은: 1) 보조기

This study was to investigate the effects of a functional electrical stimulation (FES) on temporal parameters (stride length, step width and cadence) of gait patterns in a patient with right hemiparesis. A single-subject reversal (ABAB) design was used. The subject was a 25-year-old male who had foot drop and circumduction gait pattern. An ink foot-print method was used to assess the temporal parameters of gait between the baseline phase and the intervention phase. FES was applied at 8 m walkway, three times a week for 5 weeks. The results showed that stride length was increased by 4.04 cm and that step width was decreased by 3.93 cm in the intervention phase. There was no difference in cadence between the baseline phase and intervention phase.

The purpose of this study was to compare the effects of anterior walker and posterior walker on gait parameters and body alignment of children with cerebral palsy. The intraclass correlation coefficient was .99 for intertester reliability. Intratester reliability was between .96 and .99. The use of posterior walker increased gait velocity and facilitated more upright posture. The measurement of joint angle program was found to be reliable to measure range of motion. This study has a limitation of generalizing the results to all children with cerebral palsy. Research is required to investigate the effect of posterior walker on energy efficiency.

이 연구의 목적은 젊은 아시아인과 코카시아 여성의 보행패턴 중 보폭시간(step time) 과 보폭 (step length)을 비교하고 두 집단의 골반넓이와 보폭과 상관관계가 있는지 알아보는 것이다. 연구대상자는 15명의 아시아인과 15명의 코카시아 여성이었으며 나이는 23세에서 35세 범위에 있었다. 보행분석을 위해서는 GAITRite System을 사용하였으며 분석방법으로는 인종(아시아인대 코카시아인)과 신체부위(좌측, 우측)를 요인으로 하여 반복측

The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.89 and =0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.82 and =0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

The purpose of this study was to determine the effects of pelvic and lower extremity exercise on the gait in 25 patients(11 men, 14 women) with hemiplegia. Their mean age was 65.2 years and the mean post-onset duration was 8.7 months. Each participant received a total of 15 sessions of PNF(five times per week), and each session lasted 40 minutes and consisted of 2 procedures(20 minutes each). The first procedure was pelvic anterior elevation and posterior depression pattern. And the second procedure was lower extremity flexion-adduction with knee flexion pattern. Results showed significant progressive improvement in gait speed and cadence after each 5 session period(5th, 10th, 15th session) compared with pre-treatment data(P<0.05). Furthermore improvements were noted in stride length.

The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

It is well known that visual cues can improve the motor performance of Parkinsonian patients. Previous laboratory studies have examined the effects of visual cueing to the floor. This case study examined the effects of using a visual cue above eye level on the gait of a Parkinsonian man. It was found that cueing the patient to a target above eye level while waking not only improved the kinematic parameters of the gait cycle but also facilitated a more functional gait pattern with re-intergration of arm swing, rhythm, heel strike and a more erect posture. Visual targeting above eye level may serve as an important clinical tool for physiotherapists treating Parkinsonian patients.

An important characteristic of people with partially impaired walking ability, such as incomplete paraplegics, is that they are able to generate voluntary motion of lower-limbs. Therefore, wearable robots for the incomplete paraplegic patients require a different assistance method compared to those of complete paraplegics. First, the wearable robot should be controlled to not resist wearer’s motion. Second, it should be able to generate assistive torque accurately when needed. In this paper, a wearable robot, called EROWA, for the incomplete paraplegic patients is introduced. EROWA utilizes compact rotary series elastic actuators (cRSEAs) and a control method called the zero impedance control to reduce the mechanical resistance. An assistive torque trajectory is proposed to assist gait in this paper. The proposed method is verified by simulation and experimental studies.

One of the important issues for structural and electrical specifications in developing a robot is to determine lengths of links and motor specifications, which need to be appropriate to the purpose of robot. These issues become more critical for a gait rehabilitation robot, since a patient wears the robot. Prior to developing an entire gait rehabilitation robot, designing of a 1DOF assistive knee joint of the robot is considered in this paper. Human gait motions were used to determine an allowable range of knee joint that was rotated with a linear type actuator (ball-screw type) and links. The lengths of each link were determined by using an optimization process, minimizing the stroke of actuator and the total energy (kinetic and potential energy). Kinetic analysis was performed in order to determine maximum rotational speed and maximum torque of the motor for tracking gait trajectory properly. The prototype of 1 DOF assistive knee joint was built and examined with a impedance controller.

This paper presents the use of 3 axis accelerometer for getting the gait information including the number of gaits, stride and walking distance. Travel distance is usually calculated from the double integration of the accelerometer output with respect to time; however, the accumulated errors due to the drift are inevitable. The orientation change of the accelerometer also causes error because the gravity is added to the measured acceleration. Unless three axis orientations are completely identified, the accelerometer alone does not provide correct acceleration for estimating the travel distance. We proposed a way of minimizing the error due to the change of the orientation. Pedestrian localization is implemented with the heading angle and the travel distance. Heading angle is estimated from the rate gyro and the magnetic compass measurements. The performance of the localization is presented with experimental data.