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마비 환자의 정상적 보행을 위한 능동형 단하지 보조기 개발
황성재,김정윤,황선홍,박선우,이진복,김영호,Hwang, Sung-Jae,Kim, Jung-Yoon,Hwang, Seon-Hong,Park, Sun-Woo,Yi, Jin-Bock,Kim, Young-Ho 대한인간공학회 2007 大韓人間工學會誌 Vol.26 No.2
In this study, we developed an active ankle-foot orthosis(AAFO) which can control dorsi/ plantar flexion of the ankle joint to prevent foot drop and toe drag during walking. 3D gait analyses were performed on five healthy subjects under three different gait conditions: the normal gait without AFO, the SAFO gait with the conventional plastic AFO, and the AAFO gait with the developed AFO. As a result, the developed AAFO preeminently induced the normal gait compared to the SAFO. Additionally, AAFO prevented foot drop by proper plantarflexion during loading response and provided enough plantarflexion moment as a driving force to walk forward by sufficient push-off during pre-swing. AAFO also could prevent toe drag by proper dorsiflexion during swing phase. These results indicate that the developed AAFO may have more clinical benefits to treat foot drop and toe drag, compared to conventional AFOs, and also may be useful in patients with other orthotic devices.
두 가지 의지발 적용에 따른 편측 종아리절단장애인의 운동역학적 보행 특성 비교
심우섭 ( Sim Woo-sob ),김장환 ( Kim Jang-hwan ),이진복 ( Yi Jin-bock ),성우성 ( Seong Woo-sung ),안동영 ( Ahn Dong-young ) 대구대학교 특수교육재활과학연구소 2016 특수교육재활과학연구 Vol.55 No.4
본 연구는 편측 종아리절단장애인을 대상으로 2가지 종류의 의지발(prosthetic feet)을 각각 적용 시킨 후, 보행의 운동역학적(kinetic) 특성을 비교하고자 하였다. 남성 편측 종아리절단장애인 13명에게 단축발(single-axis foot)과 에너지저장발(energy-storing foot)이 적용된 종아리의지(transtibial prosthesis)를 1주일씩 착용하고 생활하도록 한 후 동작분석장비를 사용하여 보행분석을 실시하였다. 단축발에 비하여 에너지저장발을 착용하였을 때, 의지측 엉덩관절의 신전 모멘트가 유의하게 감소하였고(p<.05), 엉덩관절의 굴곡 모멘트와 발목관절의 저굴 모멘트가 유의하게 증가하였다(p<.05). 건측 엉덩관절의 굴곡 모멘트와 무릎관절의 신전 모멘트 두 번째 최대값이 유의하게 감소하였고(p<.05), 무릎관절의 굴곡 모멘트와 발목관절 저굴 모멘트가 유의하게 증가하였다(p<.05). 위 결과에 따라 단축발에 비하여 에너지저장발을 착용하였을 때, 의지측 발목관절에서 인체의 발과 보다 유사한 움직임 형태를 나타냈고, 건측 및 의지측 무릎관절과 엉덩관절에서도 정상보행의 관절 움직임에 가까웠다. 이러한 운동역학적 보행특성이 개선된 것을 고려할 때 에너지저장발이 보행 편위를 감소시키고 자연스러운 보행에 효율적임을 제시할 수 있다. The purpose of this study was to compare kinetic variables during gait of persons with unilateral transtibial amputation, during wearing a single-axis foot and a energy-storing foot. Thirteen subjects with unilateral transtibial amputation participated in this study voluntarily. To evaluate gait characteristics at wearing a single-axis foot and an energy-storing foot, motion analysis system and force plate were used. The differences of wearing an energy-storing foot compared with wearing a single-axis foot are as follows: increasing a hip flexion moment, decreasing a hip extension moment, and increasing an ankle plantarflexion moment were shown on sagittal plane of amputated leg, and decreasing a hip flexion moment, decreasing a second maximum value of knee extension moment, increasing a knee flexion moment, and increasing an ankle plantarflexion moment were shown on sagittal plane of sound leg. Through the results of this study, more similar in kinetics to normal gait during wearing an energy-storing foot compared with wearing a single-axis foot in persons with unilateral transtibial amputation suggested that natural gait was induced due to declined gait deviation and more efficient in their daily life.
이진복,강성재,김영호 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.3
In this study, vertical acceleration of center of mass was observed along normal gait phases in 9 healthy male volunteers (aged 25.7±2.18). The developed wireless accelerometric device was attached on the intervertebral space between L3 and L4 using a semi-elastic waist belt. A three-dimensional motion analysis system, synchronized with the accelerometry, was used for detecting gait phases. There was no significant correlation between the body weight and the acceleration. The first peak curve covered loading response phase. The second downward peak point was matched accurately with the opposite toe-off. In mid-stance and terminal stance, the acceleration curve highly resembled the vertical ground reaction force curve. There was no significant difference in timing between the final upward peak point and the initial contact. Therefore, the developed accelerometry system would be helpful in determining determine temporal gait patterns in patients with gait disorders.
정상 보행과 발가락 보행의 하지 근육 근 활성도 비교 : An Electromyographic Analysis3.
김택훈,최흥식,김창인,이진복 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.2
This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p<.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.