OBJECTIVE: Accelerometer is a convenient device that can easily measure human movement. The purpose of this study was to evaluate its usefulness in the assessment of hemiparetic gait after stroke. METHOD: Twenty hemiparetic stroke patients were enrolled in the study. A portable accelerometer was attached between L3,4 intervertebral area. Vertical and medio-lateral acceleration was measured while walking 10 m. Walking ability of each subject was classified by Functional Walking Category (FWC). RESULTS: Accelerometric parameters, such as walking speed, a mean amount of peak vertical acceleration in one gait cycle, mean peak value of unaffected side, peak vertical acceleration ratio, step time ratio were significantly higher in groups of FWC 4, 5, 6 than in groups of FWC 2, 3. In subjects using cane there was an extra peak other than peaks observed in non-users. Mean peak value, step length of unaffected side and cadence were significantly higher in non-users than in users. CONCLUSION: Trunk accelerometer can be used as an objective method to evaluate walking ability in hemiparetic patients after stroke.
Acceleration ; Accelerometry* ; Canes ; Gait ; Humans ; Stroke ; Walking*

OBJECTIVE: To investigate the clinical usefulness of the Korean version of Berg balance scale (K-BBS) by obtaining the cutoff value for the activities related to ambulation in subjects with stroke. METHOD: We measured the K-BBS and checked the activities related to ambulation in 52 subjects with stroke every other week. The activities related to ambulation were composed of 4 stages, including independent sitting, independent sit to stand, independent gait with Q (quad) cane and independent gait without any assistance. Data were analyzed by ROC (Receiver operating characteristic) curve technique to obtain each cutoff value of the K-BBS representing for the individual activities. RESULTS: The ROC analysis showed that each activity matched the following cutoff values: independent sitting, 5; independent sit to stand, 18; independent gait with Q cane, 25; and independent gait without any assistance, 34. CONCLUSION: The K-BBS would be a useful instrument to tell the degrees of the activities related to ambulation and the cutoff values could be helpful for judging the assistance level for ambulation in patients with stroke.
Canes ; Gait ; Humans ; ROC Curve ; Stroke* ; Walking*

BACKGROUND: The gaitaids are helpful for the patients of gait disturbance, but there was no study about the quantitative assessment of the effectiveness of gaitaids of several different types. But proper use of gaitaids is important for the disabled who is suffered from falls with or without trauma. The appropriate prescription of gaitaids is coming from the objective assessment for gaitaids. METHODS: We evaluated the 'balance index(BI)', which is originally suggested assessment scale by author, for the five different gaitaids :mono-cane, quad-cane, forearm crutch, axillary crutch, walker We assessed the difference of B.1 with or without using each gaitaids examined by 50 healthy adults and 20 stroke patients. RESULTS: The BI in the normal adult was 34.5+/-2.7, and 21.0+/-6.9 in the stroke patients. The balance index o( walker user was 37.6+/-1.4, which was the highest score. The BI of quad-cane was 30.1 +/-4.8, which was the next highest score and the BI of mono-cane, forearm crutch, axillary crutch were 25.5+/-5.6, 25.5+/-5.7, 25.5+/-5.4, which were lower than that of quad-cane. CONCLUSION: It can be suggested that the walker is the most effective for the support balance on gait and the quad-cane is more effective than mono-cane or crutches for balance support.
Adult ; Canes ; Crutches ; Forearm ; Gait ; Humans ; Prescriptions ; Stroke ; Walkers

OBJECTIVES: This study investigates the effects of using customized walking aids individualized for stroke patients by measuring the effects of different cane lengths to determine the ideal length of walking aids for stroke patients. METHODS: Cane lengths were determined from the greater trochanter with walking aids measured 5cm below, at the greater trochanter and 5cm above. All patients walked for ten meters with each cane length to measure speed. Then, we measured the opto gait, timed up go test, and electromyography three times each. Statistical analysis was performed using a linear mixed model, and in the case of significance, the p-value was corrected using the Bonferroni method. RESULTS: There was a statistically significant differences in time up and go test(TUGT), 10m walking, stride and speed between the groups. CONCLUSIONS: Long cane length increases body symmetry, stride, increasing muscle activity, and short cane length increases balance and walking.
Canes* ; Cerebrovascular Disorders ; Electromyography ; Femur ; Gait ; Humans ; Methods ; Stroke* ; Walking*

OBJECTIVE: To evaluate the correlation between Korean version of Berg balance scale (K-BBS) with activities related to ambulation in subjects with stroke in brain stem and cerebellum by obtaining the cutoff value for each step of K-BBS. METHOD: We divided the step of activities related to ambulation into 4 stages; independent sitting, independent sit to stand, independent ambulation with Q (quadripod) cane and independent ambulation without any assistance. Accordingly, we measured the K-BBS and checked the activity step in 31 subjects with stroke every other week. Data were analyzed by ROC (receiver operating characteristic) curve technique to obtain each cutoff value of the K-BBS representing individual step of activities. RESULTS: The ROC analysis showed that each step of activity matched the following cutoff values: independent sitting, 5; independent sit to stand, 16; independent gait with Q cane, 25; and independent gait without any assistance, 35. CONCLUSION: K-BBS is a useful instrument in representing each step of activities related to ambulation and the cutoff values. Also, it is helpful for judging the assistance level for ambulation in subjects with stroke in brain stem and cerebellum.
Brain ; Brain Stem ; Canes ; Cerebellum ; Gait ; ROC Curve ; Stroke ; Walking

PURPOSE: To compare the result of failed internal fixation of intertrochanteric fractures treated with arthroplasty and 95degrees angled blade plate. MATERIALS AND METHODS: From June 2000 to may 2003, there were 12 cases with failed internal fixation of intertrochanteric fractures among 185 cases treated with dynamic hip screw and followed up for more than 1 year. The 4 cases were treated with bipolar hemiarthroplasty, 1 case with total hip arthroplasty, and other 7 cases were treated with 95degrees angled blade plate with allograft, evaluated clinically the operation times, blood loss, walking ability and complication. RESULTS: In the 7 cases, which treated with 95degrees angled blade plate, the average operation time was 109 minutes, the average blood loss was 431 ml. The result of keeping abreast of 1 year, no aid ambulation was 4 cases, the cane ambulation was 2 cases, the walker ambulation was 1 case, and there was no pain in 3 cases, mild pain in 4 cases, and no moderate pain. In the 5 cases, which treated with arthroplasty, the average operation time was 157 minutes, the average blood loss was 618 ml. During 1 year, no aid ambulation was 3 cases, the cane ambulation was 1 case, the walker ambulation was 1 case, and no pain in 2 cases, mild pain in 1 case, moderate pain in 1 case. CONCLUSION: Both 95degrees angled blade plate and arthroplasty can be useful for failed internal fixation of intertrochanteric fractures, and the choice of implant must be determined with caution, considering the surgical conditions of patient, as well as benefits of each devices
Allografts ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Femur* ; Hemiarthroplasty ; Hip ; Hip Fractures* ; Humans ; Walkers ; Walking

PURPOSE: Clinical and radiologic results of femur intertrochanteric fractures treated with ITST nail in elderly patients with osteoporosis were analysized to evaluate the efficacy and complication of ITST nailing. MATERIALS AND METHODS: 32 patients who were treated with ITST nail due to femur intertrochanteric fracture and were followed up for more than 1 year were analysed. According to Evans classification, 11 cases were stable fractures and 21 cases were unstable fractures. Clinically, ambulatory function was compared and radiologically, BMD of healthy leg was checked with analysis of postoperative bone union and complication. RESULTS: In ambulatory function comparison before and after the operation, there were 9 cases of good, 17 cases of moderate and 6 cases of poor. Considering social activity after the operation, 7 cases showed normal ambulation, 9 cases showed ambulatory with one cane, 5 cases showed two cane ambulation and 11 cases showed dependent ambulation. In radiologic evaluation, T-score of ward triangle in healthy femoral neck showed BMD of -3.12. In 20 cases, bone union was observed within 3 months. The patients with low BMD result had poor outcome. There were 2 cases of intraoperative proximal femur fracture, 3 cases of nonunion and 4 cases of death within 1 year. CONCLUSION: In elderly patients with intertrochanteric fracture, ITST nailing is relatively efficient treatment. However, in pateint with severe osteoporosis (T-score<-3.0) and unstable fracture pattern, arthroplasty should be considered due to relatively high complicaton rate.
Aged ; Arthroplasty ; Canes ; Classification ; Dependent Ambulation ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Leg ; Osteoporosis ; Walking

PURPOSE: The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. PATIENTS AND METHODS: The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient's chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. RESULTS: In angular measurement, average occlusal canting change was 3.09degrees and standard deviation was 1.05degrees, average lip canting change was 1.56degrees and standard deviation was 1.05degrees. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(+/-8.4)percent in angular measurement and 48.8 (+/-9.1)percent in linear measurement. Under Pearson's correlation analysis, Pearson's correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement (p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. CONCLUSION: First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is 51.5+/-8.4percent, 48.8+/-9.1percent of occlusal canting correction in the study.
Canes ; Facial Asymmetry ; Head ; Humans ; Korea ; Lip* ; Molar ; Orthognathic Surgery* ; Seoul ; Surgery, Oral ; Sutures

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.
Amputation ; Ankle ; Canes ; Extremities* ; Foot Orthoses ; Hemiplegia* ; Humans ; Hyperplasia ; Lower Extremity ; Neuroma ; Putaminal Hemorrhage ; Stroke ; Walking

The writers performed Sbarbaro type total hip replacement arthroplasty on two cases with degenerative arthriris of both hips complicated by avascular necrosis of the femoral head. In each case, the procedure was carried out on the worse hip, while in one case a standard femoral head prosthesis was inserted to the less severely involved hip. The Sbarbaro type prosthesis consists of a modified Austin Moore head component and an acetabular cup with tynes that fix the metal to the acetabulum and does not require the use of cement. The initial results in both cases, evaluated by the method of D'Aubigne and Postel, are as follows; Grade 5 for pain(pain both slight or intermittent), Grade 5 for motion(very good or 161 to 210 degrees), and Grade 5 for ability to walk(very good; no cane or crutch but a slight limp).
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Head ; Hip ; Hip Prosthesis ; Methods ; Necrosis ; Prostheses and Implants