Correlation among Motor Function and Gait Velocity, and Explanatory Variable of Gait Velocity in Chronic Stroke Survivors

Dong Geon Lee,이규창 물리치료재활과학회 2022 Physical therapy rehabilitation science Vol.11 No.2

Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (β=-0.830) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

만성 편마비 장애인의 보행속도와 동맥경직도와의 관련성

이용희 ( Yong Hee Lee ),박수현 ( Soo Hyun Park ),윤은선 ( Eun Sun Yoon ),제세영 ( Sae Young Jae ) 한국특수체육학회 2012 한국특수체육학회지 Vol.20 No.1

동맥경직도의 증가는 심혈관계 질환의 위험성 증가와 관련이 높으며, 보행속도 또한 혈관의 죽상경화와 같은 심혈관계 질환의 위험요인과 관계한다. 최근 선행연구에서는 이와 같은 동맥경직도와 보행속도와의 관련성을 보고하고 있으나 동맥경직도가 높아져 있고, 보행에 문제가 있는 편마비 장애인을 대상으로 한 연구는 없다. 따라서 본 연구는 편마비 장애인을 대상으로 보행속도와 동맥경직도와의 관련성을 알아보는데 목적이 있다. 본 연구에서는 편마비 장애인 94명(남 68명, 여 26명, 평균 61세)을 대상으로 하였고, 보행속도는 10m 보행과 6분걷기 검사로 측정하였으며 동맥경직도의 지표로서 경동맥-대퇴동맥 맥파전파속도를 측정하였다. 그 결과 10m보행속도와 동맥경직도간에는 유의한 역 상관관계를 보였으며(r =-.34, p=.001), 6분 걷기에서도 역 상관관계가 나타났다(r =-.45, p=.001). 그리고 나이, 성별, 체질량지수, 체중, 유병기간, 혈압, 심박수, 약물복용을 보정한 후에도 보행속도는 동맥경직도와 관계하는 것으로 나타났다(10m 보행속도 β =-.19, p=.025; 6분 걷기 보행속도 β =-.27, p=.004). 또한 보행속도가 빠른 그룹이 느린 그룹에 비해 동맥경직도가 더 낮은 것으로 나타났다(8.6m/s vs. 11.4m/s, p=.001). 따라서 빠른 보행속도는 낮은 동맥경직도와 관계하는 것으로 사료된다. Increased arterial stiffness is a strong predictor of future cardiovascular events. Several studies have shown that gait velocity is associated with arterial stiffness, but it is unclear in individuals with chronic hemiplegia. We investigated the relationship between gait velocity and arterial stiffness in individuals with chronic hemiplegia. Ninety four patients with stroke(68 male , 26 female, mean age 61) were recruited in the study. We measured the 10 meter gait test and the six minutes walk test(6MWT) as indices of gait velocity. Arterial stiffness was assessed by carotid-femoral pulse wave velocity using applanation tonometry. There was a significant inversely association between gait velocity and pulse wave velocity(10m gait test r=-.34, p=.001; 6MWT r=-.45, p=.001). In separate multivariable linear regression models that adjusted for age, gender, body mass index, duration of stroke, systolic blood pressure, heart rate, and medication, gait velocity was an independent associated with pulse wave velocity(10m gait test β=-.19, p=.025; 6MWT β=-.27, p=.004). Subjects with fast gait velocity had significantly lower pulse wave velocity than subjects with low gait velocity(8.6m/s vs. 11.4m/s, p=.001). These findings demonstrate that high gait velocity was associated with low arterial stiffness independent of risk factors in individuals with chronic hemiplegia

The Study of Lumbar Erector Spinea and Rectus Abdominis Activations according to the Different Gait Velocities in Young Healthy Adults

장종성,이혜영,이미영 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.3

Purpose: The purpose of this study was to investigate the lumbar erector spinea and rectus abdominis activations, according to the different gait velocities in young healthy adults. Methods: We recruited 6 young male and 10 young female (mean age=21.43 years; range 19~23) in this study. We used a wireless surface electromyogram (Telemyo 2400T G2, Noraxon, USA) and a treadmill unit for the experiment. EMG activity from the lumbar erector spinea, and rectus abdominis of the dominant side was record with surface electrodes. On different day, all subjects gaited on 2.7 km/h, 4.5 km/h, and 6.3 km/h of speed in random order. They gaited at the same velocity, three times, on the treadmill unit. To reduce fatigue, sufficient rests were given between the measurements. Results: As the gait speed increased, lumbar erector spinea and rectus abdominis activations were significantly increased (p<0.05). Conclusion: In the current study, we found lumbar erector spinea and rectus abdominis activations were changed, according to the gait velocity. We suggested that rehabilitation intervention should be focused on the exercise velocity for the patients with problem of the trunk control. Purpose: The purpose of this study was to investigate the lumbar erector spinea and rectus abdominis activations, according to the different gait velocities in young healthy adults. Methods: We recruited 6 young male and 10 young female (mean age=21.43 years; range 19~23) in this study. We used a wireless surface electromyogram (Telemyo 2400T G2, Noraxon, USA) and a treadmill unit for the experiment. EMG activity from the lumbar erector spinea, and rectus abdominis of the dominant side was record with surface electrodes. On different day, all subjects gaited on 2.7 km/h, 4.5 km/h, and 6.3 km/h of speed in random order. They gaited at the same velocity, three times, on the treadmill unit. To reduce fatigue, sufficient rests were given between the measurements. Results: As the gait speed increased, lumbar erector spinea and rectus abdominis activations were significantly increased (p<0.05). Conclusion: In the current study, we found lumbar erector spinea and rectus abdominis activations were changed, according to the gait velocity. We suggested that rehabilitation intervention should be focused on the exercise velocity for the patients with problem of the trunk control.

만성 뇌졸중 환자의 보행속도와 보행 비대칭에 영향을 미치는 무릎근력과 발목 관절가동범위

원종임 ( Jong Im Won ),안창만 ( Chang Man An ) 한국전문물리치료학회 2015 한국전문물리치료학회지 Vol.22 No.2

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.

보행 속도가 하지 근육 근활성과 각 근육 간의 상관관계에 미치는 영향

오태영,차명빈,옥은진,김선희,정은진,이재호 대한신경치료학회 2022 신경치료 Vol.26 No.2

Purpose The purpose of this study was to investigate the effect of gait velocity on the correlation of the muscle activation of the lower limbs and between each muscle. Methods Participants were adult female college students (n = 20) who could walk normally. Subjects first measured the MVIC (Maximal Voluntary Isometric contraction) after attaching the electrodes to the gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior. Thereafter, treadmill exercise was performed to measure muscle activation during gait. The velocity of the treadmill was set to 0, 2, 3.5, and 6 (km/h). Results As a result, according to the increase in gait velocity of the treadmill gait, the muscle activation of the lower limbs has also increased. In addition, as a result of confirming the correlation between the muscles involved in gait under each velocity condition while gait velocity and muscle activation increased proportionally, the tibialis anterior located in front of the tibia showed a lower increase in muscle activity than gastrocnemius medialis, gastrocnemius lateralis, and soleus but gastrocnemius medialis showed a higher increase in muscle activation than gastrocnemius lateralis. In addition, at the only standing position at 0 km/h, the tibialis anterior showed a higher increase in muscle activation than gastrocnemius lateralis. Conclusion The regulation of gait velocity seems to be able to relatively increase muscle activation of the lower limbs as well as muscle activation of a particular muscle.

뇌졸중 환자의 보행 비대칭성과 속도, 하지 운동 기능과의 상관관계

남형천 ( Hyoung Chun Nam ),김성렬 ( Seong Yeol Kim ),안승헌 ( Seung Heon An ) 대한물리의학회 2010 대한물리의학회지 Vol.5 No.3

Purpose:The present study was to examine the difference and severity of asymmetry in independently ambulating stroke survivors and to establish the association between gait asymmetry, velocity, and the motor function of lower extremity. Methods:The subjects used in this study were 43 subjects with hemiparesis being able to walk independently. Motor function of lower extremity was measured clinically with the Fugl Meyer-Lower /Extremity Assessment. Overground gait velocity and spatio-temporal parameters were collected by the GAITRite system. Results:Thirty(69.77%) patients showed statistically significant temporal asymmetry while 28(65.1%) exhibited statistically significant spatial asymmetry. One-way ANOVA results showed a main effect of temporal symmetry group(normative, mild, severe) for gait velocity(F=74.129), FM-L/E(F=17.270), swing-stance symmetry(F=66.869, F=13.485, respectively), spatio-temporal symmetry(F=13.166, F=31.800, respectively) 66, F=31.800, respectively). Gait velocity was negatively associated with temporal asymmetry(r=-.83), spatial asymmetry(r=-.60). Motor function of lower extremity was also associated with temporal asymmetry(r=-.58), and spatial asymmetry(r=-.50). Conclusion:The study attempted to establish the standard assessment of hemiparesis gait symmetry in light of the complex relationship with motor impairment and gait velocity. More future work will need to link the degree of gait asymmetry to clinically relevant outcomes to better establish the clinical significance of such observations.

아급성기 뇌졸중 환자의 이중 과제 수행이 보행의 시⋅공간적 변수에 미치는 영향

장영민 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

The Study of Lumbar Erector Spinea and Rectus Abdominis Activations according to the Different Gait Velocities in Young Healthy Adults

Chang, Jong-Sung,Lee, Hae-Yong,Lee, Mi-Young The Korean Society of Physical Therapy 2012 대한물리치료학회지 Vol.24 No.3

Purpose: The purpose of this study was to investigate the lumbar erector spinea and rectus abdominis activations, according to the different gait velocities in young healthy adults. Methods: We recruited 6 young male and 10 young female (mean age=21.43 years; range 19~23) in this study. We used a wireless surface electromyogram (Telemyo 2400T G2, Noraxon, USA) and a treadmill unit for the experiment. EMG activity from the lumbar erector spinea, and rectus abdominis of the dominant side was record with surface electrodes. On different day, all subjects gaited on 2.7 km/h, 4.5 km/h, and 6.3 km/h of speed in random order. They gaited at the same velocity, three times, on the treadmill unit. To reduce fatigue, sufficient rests were given between the measurements. Results: As the gait speed increased, lumbar erector spinea and rectus abdominis activations were significantly increased (p<0.05). Conclusion: In the current study, we found lumbar erector spinea and rectus abdominis activations were changed, according to the gait velocity. We suggested that rehabilitation intervention should be focused on the exercise velocity for the patients with problem of the trunk control.

The Study of Lumbar Erector Spinea and Rectus Abdominis Activations according to the Different Gait Velocities in Young Healthy Adults

( Jong-sung Chang ),( Hae-yong Lee ),( Mi-young Lee ) 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.3

Purpose: The purpose of this study was to investigate the lumbar erector spinea and rectus abdominis activations, according to the different gait velocities in young healthy adults. Methods: We recruited 6 young male and 10 young female (mean age=21.43 years; range 19~23) in this study. We used a wireless surface electromyogram (Telemyo 2400T G2, Noraxon, USA) and a treadmill unit for the experiment. EMG activity from the lumbar erector spinea, and rectus abdominis of the dominant side was record with surface electrodes. On different day, all subjects gaited on 2.7 km/h, 4.5 km/h, and 6.3 km/h of speed in random order. They gaited at the same velocity, three times, on the treadmill unit. To reduce fatigue, sufficient rests were given between the measurements. Results: As the gait speed increased, lumbar erector spinea and rectus abdominis activations were significantly increased (p<0.05). Conclusion: In the current study, we found lumbar erector spinea and rectus abdominis activations were changed, according to the gait velocity. We suggested that rehabilitation intervention should be focused on the exercise velocity for the patients with problem of the trunk control.

맞춤형 신발 깔창과 4주간 하지 운동 프로그램이 보행 역학에 미치는 영향

신민영(Shin Min Young),최민라(Chio Min Ra),이기광(Lee Ki Kwang) 세계태권도문화학회 2017 세계태권도문화학회지 Vol.8 No.3

The purpose of this study is to compare kinematic variable of gait velocity, stride length and range of motion(ROM) of lower body jonit angle by apply of the lower body exercise program and of customized insole. thirty-six males without lower body medical history participated in study. In this study, lower body exercise program composed for aim to improve normal range of motion(ROM) of lower body jonit angle, strengthening of muscle and stability of gait were conducted for 4 weeks. Using the Depth Camera, we measured the height of the arch and produced a customized insole. To analyze the kinematic variable of gait after exercise program, the data were collected using the Xsens MTX sensor. The analyzed data brought about the following results by using two-way repeated ANOVA. As a result, gait velocity and stride length was indicated significant difference in apply of insole, the knee joints and ankle joint in range of motion(ROM) jonit angle showed significant difference in exercise program, apply of insole, exercise program apply of insole(p<001). From the result, lower body exercise program and apply of customized insole considered positively effects on strengthening of muscle and stability of gait.