The walker provides stability for walking for people whose lower extremities are disabled. It is important to measure and determine the appropriate height of a walker to conserve energy and to improve function. The purposes of this study were to examine effects of walker height and gait velocity on triceps, latissimus dorsi muscle activation, and energy expenditure index (EEI) during ambulation with a walker. Fifteen healthy subjects participated in this study. Each subject was assigned a walker with one of three heights (high, standard, lower height) and of two gait velocities (comfortable gait velocity or fast gait velocity). Electromyographic data were collected from triceps and latissimus dorsi, and EEI was determined from each condition. Two-way repeated analysis of variance (ANOVA) was used to determine the statistical significance. Post hoc comparison was performed with the Bonferroni test. The results of this study were summarized as follows: 1. There was a significant difference in the %MVIC of triceps among different walker height factors. Post hoc comparison revealed that %MVIC of dominant triceps brachii was more significantly increased in patients who used the higher walker than those who used the lower walker (p<.05). 2. There were significant differences in the %MVIC of the latissimus dorsi among different walker height factors and gait velocity factors. Post hoc comparison revealed that the %MVIC of dominant latissimus dorsi was also more significantly increased in patients who used the higher walker than those who used the lower walker (p<.05) and in those who used the faster gait velocity than those who used the slower gait velocity (p<.05). 3. There were significant differences in the EEI among different walker height factors and gait velocity factors. Post hoc comparison revealed that the EEI was significantly increased among those who used higher and lower walkers compared with the standard walker. The EEI was also more significantly increased among those who used the fast gait velocity than those who used the slower gait velocity (p<.05). It has been concluded that increased muscle activation in triceps and latissimus dorsi was required when the walker height increased and that more energy was exp ended when the gait velocity increased. Therefore, from the findings of this study, it is recommended that walker height be adjusted according to the purposes of gait training and that healthy subjects conserve energy when ambulating with standard walkers in a comfortable gait velocity.

The purpose of this study was to investigate the effects of the increasing ankle range motion program on ambulation and balance for the elderly with balance disorder. Eighteen elderly subjects were administered with a timed test twice; approximately 4 weeks apart. The exercise group participated in a fall prevention exercise class at the Y.S. Senior Welfare Center of the Seoul Metropolitan Government. The session consisted of a stationary cycle, static stretching ankle joints, balance boards, and progressive resistive exercises using the Thera-band. The results were as follows: Firstly, the increasing ankle range of motion program was effective on the exercise group. Gait-speed was improved (p<.005). Secondly, balance was significantly improved (p<.000). Thirdly, increasing ankle range of motion program was effective in ankle dorsiflexion which was the major risk factor for falls among the elderly. Differences in gait and balance between the groups were examined using a paired t-test (p<.05). The exercise group demonstrated significantly higher values of gait-speed, ankle range of motion, and balance when compared with the non-exercise group. The results of this study suggest that the increasing ankle range of motion program is an effective intervention for the elderly with balance disorder.

The purpose of the study was to determine if there was a difference in the Functional Ambulation Performance score of senior adults with or without a history of falls during walking at a preferred velocity. Twelve subjects with a history of falling (mean age=73.8) and eight subjects with no history of falling (mean age=70.4) participated in the study. Temporal and spatial parameters of gait were analyzed using the computerized GAITRite system. The GAITRite system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance score. The Functional Ambulation Performance score is a Quantitative means of assessing gait based on specific temporal and spatial parameters. Statistical analysis of the two groups demonstrated a significant decrease in Functional Ambulation Performance score for those with a history of falls. They had lower values for step/extremity ratios, mean normalized velocity, and greater values for step times, percent in double support. These results indicate that the GAITRite system can be useful in detecting footfall patterns and selected time and distance measurements of persons with a history of falls and the Functional Ambulation Performance score can be used as indicators of gait performance for senior adults with a history of falls.

The purpose of this study is to introduce prosthetic discipline and ambulation training after hemipelvectomy due to osteosarcoma. Over the past years, when the malignant bone tumors occurs in the extremities amputation is not enough to prevent a part recurrence and distal transformation resulting in fatal prognosis. On the other hand, these procedures could bring about a difficulty in rehabilitation in curing patient who have had hemipelvectomy. However the recent development of chemotherapy and diagnostic facility have permitted the orthopedic surgeons to many try amputations for the treatment of the malignant bone tumors. Unfortunately, there has not been many researches on hemipelvectomy. Since there is no studies found on hemipelvectomy either. Therefore, we introduce successful procedures for rehabilitation through the ambulation training for patients who have had amputation. One of our patients, who is an eighteen years old male, has had hemipelvectomy on the eighteenth of June in 1997 after his anticancer treatment over 12 times. He has had physical therapy of prosthetic ambulation training at the department of rehabilitation medicine Yonsei University Medical Center from the fifteenth of October to December '2nd in 1997.

The purpose of this study was to introduce rotation-plasty procedure and prosthetic ambulation training. The recent development of chemotherapy and diagnostic facility have permitted the orthopaedic surgeons to try limb saving procedures rather than amputations for the treatment of the malignant bone tumors. If the tumors around the knee joint were treated by mid-thigh amputation or hip disarticulation, it would impose the client with a great handicap for rehabilitation. Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used a malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has the great functional advantage of converting the above-knee amputation to the below-knee amputation. The inverted foot was also good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight. This 15 years old girl case was had rotation-plasty due to osteosarcoma of the distal femur with 3rd postoperative chemotherapy, and admitted to Yonsei rehabilitation hospital for prosthetic ambulation training. Then, the case had excellent functional results of prosthetic ambulation training with rotaion-plasty after 3 months.