Analysis on Change in Lower Limb Coordination in Unilateral Transfemoral Amputees with Integrated Rehabilitation Program

장윤희(Yoon Hee Chang),고창용(Chang Yong Ko),정보라(Bo Ra Jeong),강정선(Jung Sun Kang),김규석(Gyoo Suk Kim),류제청(Jei Cheong Ryu) Korean Society for Precision Engineering 2018 한국정밀공학회지 Vol.35 No.1

Gait analysis is the best objective measurement tool for monitoring rehabilitation. However, it has limitations to evaluate gait recovery. Previous studies have evaluated the effect of gait training using continuous relative phase. The objective of this study was to determine the effect of gait recovery by rehabilitation gait training on lower limb coordination. We analyzed spatio-temporal parameters and CRP values of hip and knee joints based on gait analysis data obtained by 3D motion analysis system at 15 days intervals in 24 uni-lateral transfemoral amputees participated in IRP. Our results revealed that walking velocity of uni-lateral transfemoral amputees who participated in the program during a mean of 107.1 days was 49.2% faster than that at initial stage. The walking velocity showed a 46% increase at the end of 30 days after training. In gait coordination, values of CRP-RMS and CRP-SD were increased and maintained in-phase pattern. CRP showed symmetry in both limbs at the end of 90 days after training. Therefore, CRP is a significant factor in the gait recovery process. Effects of various rehabilitation training methods can be determined through CRP analysis.

무릎 신전 제한형 보조기 착용이 보행 시 하지 내 협응에 미치는 영향

장윤희(Yoonhee Chang),정보라(Bora Jeong),강성재(Sungjae Kang),류제청(Jeicheong Ryu),김규석(Gyu Seok Kim),문무성(Museong Mun),고창용(Chang-Yong Ko) 한국재활복지공학회 2016 재활복지공학회논문지 Vol.10 No.3

본 연구의 목적은 무릎 신전 제한형 보조기 착용 후 보행시 하지 내 협응에 미치는 영향을 평가하는 하는 것이다. 본 연구에는 7명의 건강한 성인 남성(32.3±2.7 세, 175.2±3.8cm, 76.2±8.7kg)이 참여하였다. 이들은 무릎보조기를 착용하거나 착용하지 않고 10m의 평지를 보행하였다. 이때 시공간적 파라미터, 하지의 각도, 하지 내 연속상대위상(CRP)를 측정 및 계산하였다. 그 결과 시공간적 요인은 차이가 없었다 (all p > 0.05). 무릎보조기 착용 시 엉덩관절의 가동범위 및 각도 변화는 없었으나, 무릎관절의 가동범위는 감소하였으며 (65.5±3.7° vs. 60.5±3.5°, p < 0.05), 최대 굴곡 역시 감소하였다 (입각기: 31.9±4.6 vs. 25.6±5.5, 유각기: 76.7±3.1 vs. 68.9±3.4, all p < 0.05). 발목관절의 가동범위는 변화가 없었으나, 최대 배측굴곡 (22.4±2.6 vs. 19.2±2.1, p< 0.05)은 감소하였으며, 최대 족저굴곡이 증가하였다 (9.5±3.0 vs. 15.7±2.2, p<0.05). 대부분의 CRP는 차이가 없었으며, 유각기 엉덩관절과 무릎관절 사이의 CRP만 감소하였다 (93.0±7.8 vs, 84.7±4.9, p < 0.05). CRP의 표준편차는 대부분 증가하였다 (유각기 엉덩관절과 무릎관절사이: 25.1±6.7 vs. 32.4±1.9, 입각기 무릎관절과 발목관절사이: 46.0±12.9 vs. 80.1±31.1, 유각기 무릎관절과 발목관절 사이: 34.5±4.1 vs. 37.6± 3.1, all p < 0.05). 이와 같은 결과로부터 무릎 신전 제한형 보조기 착용은 관절의 각도, 하지 내 협응에는 영향을 미치지만, 보행특성에는 큰 영향을 미치는 않는다는 것을 확인하였다. The aim of this study was to evaluate Influence on intra-limb coordination in individuals wearing knee brace during walking. Seven healthy male adults (32.3±2.7 years old, 175.2±3.8cm, 76.2±8.7kg) participated. They wore knee brace or didn`t wear any knee brace and were asked to walk along a 10 m long walkway. Spatiotemporal parameters, angles of the lower limbs, and intra-limb continuous relative phase (CRP) were measured and calculated. No differences of spatiotemporal parameters were shown (all p > 0.05). There were no changes in the angle and its range of motion (ROM) in the hip for the subjects as wearing knee brace, while ROM (65.5±3.7° vs. 60.5±3.5°, p < 0.05) of the angle and maximum flexion angles (stance: 31.9±4.6 vs. 25.6±5.5, swing: 76.7±3.1 vs. 68.9±3.4, all p < 0.05) in the knee significantly decreased. No changes in ROM of angle in the ankle were shown, whereas maximum dorsiflexion decreased (22.4±2.6 vs. 19.2±2.1, p< 0.05) and maximum plantarflexion increased (9.5±3.0 vs. 15.7±2.2, p<0.05). There were no changes in most of CRP between joints. CRP between the hip and knee joints decreased (93.0±7.8 vs, 84.7±4.9, p < 0.05). Most of CRP standard deviation increased (between the hip and ankle joint during swing: 25.1±6.7 vs. 32.4±1.9, between the knee and ankle joint during stance: 46.0±12.9 vs. 80.1±31.1, between the knee and ankle joint during swing: 34.5±4.1 vs. 37.6±3.1, all p < 0.05). These results indicated that wearing knee brace affected joint angle and intra-limb coordination, but less affected gait features.

트레드밀 내리막 보행의 적응기동안 하지협응패턴의 변화

윤석훈(Yoon, Suk-Hoon),김주년(Kim, Joo-Nyeon) 한국체육과학회 2016 한국체육과학회지 Vol.25 No.1

The purpose of this study was to determine the familiarization period required to find the most reproducible coordination pattern of lower extremities through the assessment of continuous relative phase(CRP), derived from phase planes of two adjacent joints, during treadmill downhill walking. Twelve healthy subjects participated in overground downhill walking and treadmill downhill walking which lasted 10 min. A three-dimensional motion data were collected from the first 6 trials of each minute, beginning when the treadmill reached full speed. CRP measures between pelvis-thigh, between thigh-shank and between shank-foot were obtained by subtracting the distal from the proximal phase angle in a range from 0° to 180°. CRP patterns were examined with cross-correlation coefficient and root mean square differences (RMS differences) when comparing ensemble mean curves of the treadmill downhill walking to overground downhill walking. For thigh-shank CRP pattern, significant reductions in RMS differences were found over 10 min. There were no increases in cross-correlation coefficient values for all familiarization periods. These findings suggested that subjects should be familiarized to the treadmill downhill walking for at least 10 min prior to data collection that can be generalized to overground downhill walking.

위성 영상을 활용한 딥러닝 기반 운량 예측 알고리즘 개발

조은빈,최예지,전태균 한국기상학회 2022 한국기상학회 학술대회 논문집 Vol.2022 No.4

Changes in Spatiotemporal Parameters and Lower Limb Coordination During Prosthetic Gait Training in Unilateral Transfemoral Amputees

Yunhee Chang,Chang-Yong Ko,Bo Ra Jeong,Jung Sun Kang,Hyuk-Jae Choi,Gyoosuk Kim,Hyunjun Shin,Sehoon Park 한국정밀공학회 2022 International Journal of Precision Engineering and Vol.23 No.3

When applying prosthetic gait training to patients with lower limb amputation, monitoring the gait change process is crucial for establishing and modifying rehabilitation training plans. In addition, since human gait involves complex movement of several joints, it is necessary to analyze the organic movement of adjacent joints rather than a single joint in the lower extremities for understanding the process of gait change. Therefore, this study aimed to analyze changes in spatiotemporal parameters and lower limb coordination during prosthetic gait training in unilateral transfemoral amputees (TFAs). This retrospective case–control study included 10 unilateral TFAs and 10 healthy individuals as controls. TFAs received prosthetic gait training for 12 weeks and gait changes were analyzed every 2 weeks using a 3D motion analysis system. The measured variables were spatiotemporal parameters and the continuous relative phase between hip and knee joints. The highest improvement in walking speed was seen at week 4 of training, and the continuous relative phase was most symmetric at week 8. The lower limb coordination pattern was more in-phase in the TFAs than in the controls, and the coordination variability was also lower for the TFAs than for the controls. In addition, the rate of change in lower limb coordination of TFAs was lower than that of spatiotemporal parameters and was significantly different from that of the controls even after training. Considering that the decrease in lower limb coordination is related to gait efficiency, balance, and risk of fall, there is a need to develop therapeutic strategies that can further improve the coordination of TFAs.

보행경로 너비와 운동발달수준에 따른 아동의 보행 가변성 연구

양진주,송영훈 한국초등체육학회 2019 한국초등체육학회지 Vol.24 No.4

본 연구의 목적은 아동의 운동발달 수준과 보행경로 너비에 따른 보행 가변성을 분석함으로써 그 차이점을 규명하는 것이다. 만 7-8세의 아동에게 운동발달검사(MABC-2)를 실시하여 목적적 표집방법으로 선정된 16명을 운동발달 수준에 따라 상·하 집단으로 배정하였다. 실험 참가자들은 경로너비가 지정되지 않은 일반 경로보행과 각자의 전상장골극 50%의 길이에 해당되는 좁은 경로보행을 각 10회 수행하였다. 연구 결과, 일반 경로보행과 좁은 경로보행에서 보폭 너비와 길이의 가변성은 운동발달 수준 하 집단에서 크게 나타났으며, 특히 좁은 경로보행에서 두 집단의 가변성 차이가 더 크게 나타났다. 연속상대위상을 통한 운동발달 수준의 하지협응 가변성은 발목-무릎, 무릎-고관절에서 두 집단의 차이가 나타났으며, 연속상대위상을 통한 보행 경로너비의 하지협응 가변성은 발목-무릎, 고관절-발목에서 두 집단의 차이가 나타났다. 마지막으로 좁은 경로보행에서 운동발달 수준별 스텝에러 비율을 분석한 결과, 운동발달 수준 상 집단의 스텝에러 비율이 하 집단의 비율보다 낮게 나타났다. 본 연구를 통해 아동의 보행 가변성과 하지협응 패턴에 대한 기본적인 정보를 제공할 수 있을 것이며, 추후 아동 보행에 대한 기초 자료로 사용하고자 한다. This study investigated the difference of walking variability according to child's level of motor development and width of walking path. There were 103 participants with normal or neurological abnormality of 7-8 years old who underwent a motor developmental test and assigned two group. Each participant performed 10 times narrow and general path walking, respectively, that did not consider the width of walking path. There was a significant difference in the width and length variability between two groups of the motor development level. The difference between the two groups was larger in the narrow pathway walk. Secondly, as a result of analyzing the difference of lower coordination variable through continuous relative phase (CRP), the group with high level of motor development showed a small variability compared to the lower group. Finally, step error ratio by the level of motor development in the narrow path gait were analyzed. The step error ratio of the group with high level of motor development was smaller than that of the lower group. It is expected that gait variability and CRP would be used as basic data for the child's gait.

보행시 하지 관절의 협응을 평가하기 위한 Hilbert transform 방법과 Portrait 방법 비교

고창용(C.Y. Ko),최혁재(H.J. Choi),김규석(G. Kim),류제청(J. Ryu),문무성(M. Mun) 한국정밀공학회 2016 한국정밀공학회 학술발표대회 논문집 Vol.2016 No.10월

Comparison of Methods to Evaluate Joint coordination of Lower Limb in the Elderly during Walking.

Hyuk-Jae Choi,Gyoosuk Kim,Chang-Yong Ko 한국재활복지공학회 2020 한국재활복지공학회 학술대회논문집 Vol.2020 No.11

대퇴절단자와 하퇴절단자의 보행시 하지 협응 비교

고창용(C. Y. Ko),장윤희(Y. Chang),정보라(B. Jung),손진호(J. H. Son),김규석(G. Kim),류제청(J. Ryu) 한국정밀공학회 2017 한국정밀공학회 학술발표대회 논문집 Vol.2017 No.12월

수중운동이 여성노인 장애물보행 시 하지 협응에 미치는 영향 - 훈련 및 훈련잔여효과 중심으로 -

윤석훈 ( Suk Hoon Yoon ),장재관 ( Jae Kwan Chang ),김주년 ( Joon Yeon Kim ) 한국운동역학회 2014 한국운동역학회지 Vol.24 No.2

The purpose of this study was to investigate the training and detraining effects of a 8-week water exercise on lower extremities coordination during obstacle gait in the female elderly. Eight elderly participants (age: 76.58±4.97 yrs, height: 148.88±7.19 cm, body mass: 56.62±6.82 kg, and leg length: 82.36±2.98 cm), who stayed at the Seoul K welfare center, were recruited for this study. All participants had no history of orthopedic abnormality within the past 1 year and completed the aquatic exercise program which lasted for 8 weeks. To identify the training and detraining effect of 8 weeks of water exercise, a 3-D motion analysis with 7 infrared cameras and one force plate sampling frequency set at 100 Hz and 1,000 Hz, respectively, was performed. A two-way ANOVA was performed to find training and detraining effects among diferent obstacle heights. In this study significant level was set at .05. Significant training effects of LTS (lead foot thigh and shank) coordination in all obstacle height were found (p<.05). It is also found that the training effect of LTS remained 37%, 58%, and 25% in obstacle height of 30%, 40%, and 50%, respectively. Lead foot showed the greater detraining effect of coordination compared with trail foot, and SF (shank and foot) coordination revealed better detraining effects of coordination compare with TS (thigh and shank) in both feet. Based on the findings, a 8 week water exercise give an positive effects to the elderly in terms of segment cooperation which potentially helps reducing their accident falls. The magnitude of detraining may also help the elderly to find the retraining moment.