The purpose of this study was to determine the effect of gait initiation training on gait and center of
pressure (CoP) during gait initiation in stroke patients. Twenty-three subjects were randomly assigned to either an experimental group (EG) or a control group (CG). The EG received gait initiation training with increased CoP posterior distances the maximum the rear on gait training. The CG received general gait training. Both groups received training three times a week over a period of four consecutive weeks. The figures for CoP distances the maximum the rear, CoP distances time the mover the maximum the rear, the Tinetti Performance-Oriented Mobility Assessment (POMA), and gait velocity were recorded both before and after the training sessions for both groups. The EG’s results for CoP distances the maximum the rear, CoP distances time the mover the maximum the rear, and POMA improved after training (p<.05). In terms of the rate of change of CoP distances the maximum the rear, the EG demonstrated a significantly higher increase (p<.05) than did the CG. The results of this study suggest that increased CoP distances the maximum the rear affect the gait initiation and gait performance of stroke patients. Further studies with a larger sample size are necessary to verify the accuracy of the results of this study.
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 the current experiment was to describe interlimb coordination when swing limb conditions are being manipulated by constraining step length or by adding a 5 or 10 pound weight to the swing limb distally. Subjects were asked to begin walking with the right limb to land on the primary target (normal step length) that is 10 cm in diameter. However, if, during movement, the light was illuminated, then the subject had to step on one of the secondary targets (long and short step length). These three step length conditions were repeated while wearing a 5 pound ankle weight and then when wearing a 10 pound ankle weight. Ground reaction force (GRF) data indicated that there were changes in the forces and slopes of the swing and stance Fx GRFs. Long stepping subjects had to increase the propulsive force required to increase step length. Consequently, swing and stance toe-off greatly increased in the long step length condition. Short step length subjects had to adequately adjust step length, which decreased the speed of gait initiation. Loading the swing limb decreased the force and slope of the swing limb. Swing and stance toe-off was longest for the long step length condition, but there was a small difference of temporal events between no weight and weight condition. It appears that subjects modulated GRFs and temporal events differently to achieve the peak acceleration force of the swing and stance limb in response to different tasks. The findings from the current study provide preliminary data, which can be used to further investigate how we modulate forces during voluntary movement from a quiet stance. This information may be important if we are to use this or a similar task to evaluate gait patterns of the elderly and patient populations.
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
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