This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

목적: 이 연구에서는 장애물 높이에 따른 만성 뇌졸중 환자의 장애물 보행 특성과 보상전략을 파악하였다. 방법: 이를 위해 두 가지 장애물 높이 조건(5cm와 15cm)에 따라 장애물 보행의 운동학적 특성을 정상인과 비교하였다. 구체적으로 장애물 보행 전 이륙 거리, 장애물 통과 시 장애물 통과 높이와 장애물 통과 후 착지 거리를 측정하 였다. 결과: 분석결과, 만성 뇌졸중 환자들은 정상인보다 보행 전 이륙 거리와 장애물 통과 후 착지 거리가 상대 적으로 짧은 것으로 나타났다. 또한, 뇌졸중 환자들은 정상인보다 장애물을 통과할 때 통과 높이가 높은 것으로 밝혀졌다. 이러한 보행 움직임 패턴은 두 가지 장애물 조건에서 모두 유사하게 나타났다. 결론: 이러한 결과는 뇌 졸중 환자들이 편측 마비로 인한 움직임 제약에 기인하는 것으로 판단된다. 또한, 신체적 장애로 인해 뇌졸중 환 자들은 장애물 보행 시 낙상을 예방하고, 안정적으로 장애물 보행을 위한 운동보상전략에서 정상인과 차이를 보 인 것으로 생각된다. 결론적으로 이 연구는 만성 뇌졸중 환자들의 운동보상 전략을 장애물 보행을 통해서 규명했 다는 점에서 현장에 유용한 시사점을 제공할 것으로 기대된다.