Background: Assessments of Sit-to-Stand (STS) and gait functions are essential procedures in evaluating level of independence for the patients after stroke. In a previous study, we developed the software to analyze center of pressure (COP) in standing position on Wii Balance Board (WBB). Objects: This purpose of this study is to measure test-retest reliability of ground reaction forces, COP and time using WBB on STS and gait in healthy adults. Methods: Fifteen healthy participants performed three trials of STS and gait on WBB. The time (s), vertical peak (%) and COP path-length (㎝) were measured on both tasks. Additionally, counter (%), different peak (%), symmetry ratio, COP x-range and COP y-range were analyzed on STS, 1st peak (%), 2nd peak (%) of weight were analyzed on gait. Intra-class correlation coefficient (ICC), standard error measurement (SEM) and smallest real difference (SRD) were analyzed for test-retest reliability. Results: ICC of all variables except COP path-length appeared to .676∼.946 on STS, and to .723∼.901 on gait. SEM and SRD of all variables excepting COP path-length appeared .227∼8.886, .033∼24.575 on STS. SEM and SRD excepting COP path-length appeared about .019∼3.933, .054∼11.879 on gait. Conclusion: WBB is not only cheaper than force plate, but also easier to use clinically. WBB is considered as an adequate equipment for measuring changes of weight bearing during balance, STS and gait test which are normally used for functional assessment in patients with neurological problems and elderly. The further study is needed concurrent validity on neurological patients, elderly patients using force plate and WBB.

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group (n1=15), which walked backward, and the control group (n2=15), which walked forward. To measure the improvement of the patients’ gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at α=.05. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

목적 : 본 연구의 목적은 보행시 상체의 움직임 변화를 알아보기 위하여 연구하였다. 방법 : 30명의 대상자들이 본 연구에 참여하였고, 모든 대상자들은 보행 시 상체의 움직임을 측정하 였다. 대상자들은 서로 다른 4가지의 타입의 보행을 실시하였다. 1) 앞으로 걷기(FW), 2) 뒤로 걷기 (BW), 3) 팔의 흔들림 없이 걷기(NS), 4) 뒷짐지고 걷기(HBB). 본 연구는 6대의 카메라를 사용한 3차 원 동작분석기를 사용하여 운동형상학적 자료를 수집하였다. 결과 : 척추의 관절움직임 관상면 시상면 횡단면, 흉부의 관절움직임 시상면 횡단면, 흉부의 움직임 관상면 시상면 횡단면에서 유의한 차이를 보였다. 그러나 흉부의 관절움직임 관상면에서는 유의하지 않았다. BW 는 FW와 비교하였을 때 척추의 관절움직임 관상면 시상면 횡단면, 흉부의 관절움직임 시상면 횡단면, 흉부의 움직임 관상면 시상면 횡단면에서 유의한 차이를 보였다. NS는 FW와 비교하 였을 때 척추의 관절움직임 관상면 횡단면, 흉부의 관절움직임 횡단면, 흉부의 움직임 관상면 시상면 에서 유의한 차이를 보였으며, HBB는 FW와 비교하였을 때 척추의 관절움직임 관상면 시상면 횡단 면, 흉부의 관절움직임 시상면, 흉부의 움직임 횡단면에서 유의한 차이를 보였다. 결론 : 우리는 각 보행형태에 따른 상체의 움직임 변화를 제공한다. 그리고 이 연구를 통해 뒤로 걷 기 시 척추의 시상면 관절범위와 흉부의 시상면 횡단면 관절범위, 흉부의 앞-뒤 움직임이 증가하는 것을 발견할 수 있었으며, 척추의 관상면과 횡단면의 관절범위, 흉부의 안쪽-가쪽, 위쪽-아래쪽으로 의 움직임은 감소하는 것을 발견할 수 있었다. 보행 형태에 따라 몸통 움직임은 다르게 나타나며 필 요에 따라 선택적 보행을 할 수 있을 것으로 사료된다.

Background: The Functional Gait Assessment (FGA) was developed to measure of gait-related activities. The FGA was translated in Korean but only a few psychometric characteristics had been studied. Objects: The purpose of this study was to evaluate the validity and reliability of the Korean version of FGA scale using Rasch analysis. Methods: The study included 120 patients with stroke (age range=30∼83 years; mean±standard deviation=58.3±11.1). The FGA and Berg Balance Scale were performed, and were analysed for dimensionality of the scale, item difficulty, scale reliability and separation, and item-person map using Rasch analysis. Results: The 4 rating scale categories of FGA were satisfied with optimal rating scale criteria. The most items of the FGA showed sound item psychometric properties except 2 items (‘gait with the horizontal head turns’, and ‘gait with narrow base of support’), and the 2 misfit items were excluded for all further analyses. The 8 items were arranged in order of difficulty. The most difficult item was ‘gait with eyes closed’, the middle difficult item was ‘gait level surface’, and the easiest item was ‘gait with vertical head turns.’ A person separation reliability was .93 and the person separation index was 3.57. Conclusion: This study suggests that the 8-item Korean FGA are valid measure of assess the gait-related balance performance, and to set the goal of rehabilitation plan in patient with stroke.

본 연구에서는 고강도 운동 후 전신진동이 근피로도 감소와 심박회복율에 미치는 효과를 알아보고자 하였다. 피험자 는 총 20명으로 진동을 제공받는 그룹과 진동을 제공받지 않는 그룹으로 구성되어 있다. 고강도 운동은 경사 8.5도와 보행속도 4km/h를 30분간 제공하였고, 그룹별 진동유무별 의자형 진동기 위에서 30분간 휴식을 취하였다. 전신진동자 극은 10Hz의 진동주파수와 5mm의 진폭을 제공하였다. 진동유무별 피로도 감소와 심박안정화 효과를 검증하기 위해 혈중 젖산농도와 실시간 심박수 변화를 측정하였다. 실험결과, 진동을 제공받는 그룹에서 95.2% 수준의 더 큰 근피로도 감소결과와 50.67%의 더 빠른 심박회복율 결과를 보였다. 이는 고강도 운동 후 전신진동이 근육속 혈관을 지속적으로 자극하여 운동 후 초과산소섭취를 빠르게 해소하고 혈액순환 기능을 증진시켜 피로도를 감소시킨다. 고강도 운동 후 전신진동을 이용한 휴식은 노약자나 여성들에게 운동 후 다른 육체적 활동 없이 마무리운동으로 긍정적 효과를 기대할 수 있다.

Background: Increased foot pronation causes biomedchanical changes at the lower limbs, which may result in musculoskeletal injuries at the proximal joints. Pronation rear-foot leads to plantar fasciitis, Achilles tendonitis, and posterior tibial tendonitis pathologically. According to the recent meta-analysis, They showed that therapeutic adhesive taping is more effective than foot orthoses and motion control footwear, low-Dye (LD) taping has become the most popular method used by physiotherapists. Objects: The purpose of this study was to determine the immediate effects of LD taping results in different ankle motion and ground reaction force (GRF) as before and after applied LD taping on pronated rear-foot during gait. Methods: Twenty-four participants were recruited for this study. The gait data were recorded using an 8-camera motion capture system and two force platforms. At first, the experiments were carried out that participants walked barefoot without LD taping. And then they walked both feet was applied LD taping. Results: The ankle inversion minimum was significantly greater after LD taping than before LD taping (p=.04); however, in the GRF, there were no significant differences in the inversion maximum or total motion of the stance phase (p=.33, p=.07), or in the vertical (p=.33), posterior (p=.22), and lateral (p=.14) peak forces. Conclusion: The application of taping to pronation rear-foot assists in increased ankle inversion.

The purpose of this study was to investigate temporal and spatial variations, and moments of the lower extremities of gait while playing the game with smartphone under different curb-heights. Ten male elementary school students(from 10 years to 13 years old) participated in this study. Twelve infrared cameras(Oqus-500) and two force plates(9260AA) were used for collecting data and these were processed via Visual 3D software. In conclusion, with or without smartphone and with different curb-heights, the spatial and temporal parameters of walking were not the same and coefficients of variations were not consistent. The maximum joint moments of the lower extremities with or without smartphone were not statistically significant but those of hip and ankle joint were statistically significant with regard to the different heights of the curbs.

The purpose of this study was to compare the effects of underwater treadmill gait training (UTGT) and overground treadmill gait training (OTGT) on the gait, balance ability and pulmonary function of stroke patients. Twenty subjects were recruited for this study. The subjects were randomly assigned to two groups: UTGT (n1=10) and OTGT (n2=10). The 10 m walk test (10 MWT), Berg Balance Scale, Timed Up and Go (TUG) test, center of pressure, pulmonary function of forced vital capacity (FVC), forced expiratory volume after 1 sec (FEV1) and FEV1/FVC were measured before and after 4 weeks of training. Both groups undertook the gait training for 30 min a day, 3 times a week, for 4 weeks, and rating of perceived exertion of the groups were measured and compared. All the studied variables were significantly improved in both groups (p<.05) at the end of the study, except in the FEV1 of OTGT (p>.05). There was significant between-group difference in all of the variables, except in the 10 MWT (p>.05). These findings suggest that UTGT is more effective than OTGT in improving the balance and pulmonary functions of stroke patients.

The purpose of this study was to find which spatiotemporal gait parameters gained from stroke patients could be predictive factors for the gait part of Tinetti Performance-Oriented Mobility Assessment (POMA-G). Two hundred forty-six stroke patients were recruited for this study. They participated in two assessments, the POMA-G and computerized spatiotemporal gait analysis. To analyze the relationship between the POMA-G and spatiotemporal parameters, we used Pearson’s correlation coefficients. In addition, multiple linear regression analyses (stepwise method) were used to predict the spatiotemporal gait parameters that correlated most with the POMA-G. The results show that the gait velocity (r=.67, p<.01), cadence (r=.66, p<.01), step length of the affected side (r=.49, p<.01), step length of the non-affected side (r=.53, p<.01), swing percentage of the non-affected side (r=.47, p<.01), and single support percentage of the affected side (r=.53, p<.01) as well as the double support percentage of the non-affected side (r=-.42, p<.01) and the step-length asymmetry (r=-.64, p<.01) correlated with POMA-G. The gait velocity, step-length asymmetry, cadence, and single support percentage of the affected side explained 67%, 2%, 2%, and 1% of the variance in the POMA-G, respectively. In conclusion, gait velocity would be the most predictive factor for the POMA-G.

The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from 15.32±5.98 to 18.16±6.95 ㎏) and knee flexor strength (p=.011, from 7.80±4.80 to 8.15±4.24 ㎏) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

The purpose of this study was to investigate the effects of vibration on Golgi tendon organ(GTO) and Hold-Relax of PNF in muscular activity and gait factors on Delayed Onset Muscle Soreness(DOMS). This study was conducted on 20 subjects. they were divided into two groups; Hold-Relax of PNF(n=10), Vibration on GTO(n=10). Both of the group was performed interventions 1 times a day for 3 days. The data was analyzed by the repeated-ANOVA for comparing before, after 24h and after 48h changes of factors in each group and the Independent t-test for comparing the between groups. The results are as follows. There was statistically significant difference of before, after 24h and after 48h vibration on GTO group and Hold-Relax of PNF group in muscular activity and gait factors on DOMS.(p<0.05). There was no statistically significant difference of between vibration on GTO group, but there was statistically significant difference Hold-Relax of PNF group in EMG, step width, step length, stride length(p>0.05). As a results of this study, Hold-Relax of PNF group are effective in improving muscular activity and gait factors

Improvement in functional gait is one of treatment goals in treatment of cerebral palsy children. This study intended to examine the effects of insoles for postural correction on gait in spastic cerebral palsy patients by investigating changes in gait temporal spatial parameters. As the subjects, 15 spastic bilateral cerebral palsy patients participated in this study. Temporal spatial parameters of gait were measured using GAITRite system under three gait conditions. Bare foot gait, gait in shoes, and gait in insoles for postural correction were conducted. In order to look at differences in temporal spatial parameters according to three gait conditions, repeated one way analysis of variance was conducted. As post hoc test, Bonferroni was conducted. A significant level was set at α=.05. According to the result of this study, gait velocity, cadence, step length, stride length of the left lower extremity significantly changed. When the subjects put on customized insoles for postural correction, the effect was greatest. There were no significant changes in stance time, single support time, double support time, swing % of gait, and stance % of cycle. Therefore, gait with insoles for postural correction positively influenced functional gait improvement and will be able to be usefully employed for spastic cerebral palsy children as one of gait assistance devices.

The aim of this study was to investigate kinematic mechanism of gait different road conditions(dry vs. oil) in order women. For this study, twenty older women and ten young women participated in this research. twelve infrared cameras were used to collect data. It appeared that the gait strategies of older women were slower velocity and higher CoM than young women. Depending on road conditions, gait velocities of dominant muscle older women on dry surface were faster than dominant sense older women, but those of them were inverse on oil surface. The slip displacement of dominant muscle older women was less than young women, but the slip displacement of dominant sense older women was greater than young women. In case of blind during stance phase on oil surface, the rotational motion of the ankle and knee joints were increased. In conclusion, older women were subjected to self-organization theory and phase shift in dynamic theory.

In this paper, we developed a virtual reality-based contents that can gait analysis and gait training on a treadmill using a depth camera of Kinect. This content was used in the user's step length, step velocity, step count, flexion angle extracted by the Kinect skeleton tracking. Nine male subjects (24.9 years, 173.2cm) performed gait training using avatars to reflect their movements on the treadmill and confirmed result of gait analysis using real-time graphs to display their gait variables. Implemented contents can lead to a cognition reaction that is to avoid collisions with obstacles, as well as to determine the gait movements in a virtual reality. Based on these results, we will be able to make real time gait analysis and gait training, in consider the characteristics and safety of a rehabilitation patient by developing content that we have fun with additional tests for gait analysis.

This study was conducted to investigate the effects of the removable ankle-foot orthosis (RAFO) which was developed to improve the gait of stroke patients. The subjects of this study were five stroke patients who agreed to participate in this study by signing a written consent form. To verify gait improvement after wearing the orthosis, a Timed Up and Go test and Functional Gait Assessment were performed, and spatiotemporal gait variables such as gait speed, cadence, stride length, double limb support, and the efficient gait test of body sway angle were performed. For every variable, the differences prior to and after wearing the RAFO were compared using the Wilcoxon signed-rank test. Every gait variable improved significantly after wearing the RAFO compared to prior to wearing it. The pilot study will enhance future efforts to evaluate orthotic function objectively during gait in stroke patients.

This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; n1=14) and a group to receive RAS using a metronome only (the control group; n2=14). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients’ gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at α=.05. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients’ gait.

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients’ functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186∼.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320∼.621) showed more effective than Lokomat (.169, 95% CI: .063∼.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects’ impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity (R2=.41), while ankle passive ROM was the most important determinant for temporal asymmetry (R2=.35). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry (R2=.17). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

This study examines changes in walking ability among patients with stroke after applying dual-task training under the condition of visual control and unstable supporting ground; the purpose is to provide reference data for selecting intervention methods that enhance the walking ability of patients with stroke. Among the patients with stroke who received rehabilitation treatment(at Rehabilitation Hospital B in Gyeonggi, South Korea from May 2014 to July 2014), 29 patients were selected as research subjects; all of them understood the purpose and contents of this research and agreed to participate in the experiment. The research subjects were divided into a visual control and unstable supporting ground dual-task(VUDT) group(10 patients), a visual control dual-task(VDT) group(10 patients), and an unstable supporting ground dual-task(UDT) group(9 patients); all of the subjects received 30-minute trainings, three times a week for a total of four weeks. A Timed-Up-and-Go(TUG) test was performed to investigate the change of walking function among the subjects, and a 10m walking test was conducted to measure their walking speed. According to the study results, all three groups showed significant differences after dual-task training; the dual-task training group under the condition of visual control and unstable supporting ground showed the most prominent change. This study confirmed that dual-task training using visual control and unstable supporting ground has a positive impact on the walking ability of patients with stroke. Through the study results, we found that implementing dual-task training under the condition of visual control and unstable supporting ground can more effectively improve the walking ability of patients with stroke, rather than performing visual control dual-task training or unstable supporting ground dual-task training only.

In this paper, the gait parameter detection system using an infrared rays elements was developed. This system consist of the transmission unit and receiver of an infrared LED light and the gait parameter were calculated by the non-transmission timing of infrared LED light from user’s leg movement Based on this method, we calculated the velocity of gait and gait stride of the person during the gait motion on the treadmill. To confirm the effectiveness of this system, we analyzed the real velocity of the treadmill using tachometer on treadmill compared with controlled velocity of treadmill.