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

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

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*

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: 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: 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

PURPOSE: Chronic dorsal wrist pain limits hand function and is related to several diseases. Especially, pain and tenderness over the fourth extensor compartment with repetitive wrist dorsiflexion was described as distal posterior interosseous nerve syndrome. This article details the history, symptoms, physical findings, and treatment of this syndrome. MATERIALS AND METHODS: This study includes six patients seen between 1996 and 1998. Five men and one woman (ages 17 to 57 years) presented with localized, nonradiating, dull dorsal wrist pain, ulnar and distal to Lister's tubercle. Presumptive diagnostic test was an injection of selective lido cane 2 cm proximal to the wrist joint. RESULTS: Six patients were diagnosed of having distal posterior interosseous nerve syndrome. The five patients who recurred symptoms after injection underwent surgical exploration. Histologic evaluations revealed abnormal perineural fibrosis and edema. Patients were reexamined at least 12 months after surgery and have returned to full asymptomatic activity. CONCLUSIONS: Initially, non-operative treatment seems to be effective. If conservative treatment fails, operative excision of distal posterior interosseous nerve may be required
Canes ; Diagnostic Tests, Routine ; Edema ; Female ; Fibrosis ; Hand ; Humans ; Male ; Wrist ; Wrist Joint

Stroke patients have increased with the overall aging of our population, 60 years and older. Recently the number of stroke patients has been on the increase even among younger people in their thirties. The family support is frequently mentioned as a major variable which plays an important role in helping the patients adapt themselves to their hemiplegic situations. The purpose of the study was to examine between family support and activities of daily living(ADLs)abilities for the hemiplegic patients. and to provide the basic data to help the patients carry out their ADLs on their own. The sample for the study included 106 hemiplegic patients and their family members. The data were collected using a focused, structured interviews. The major findings of the study were as follows: 1. The hemiplegic patients perceived that their family supports were very high(Mean, 49.00). 2. The degree of family support was significantly higher in female, high economic status. and non-use of brace patients than in male, poor economic status, use of brace patients. 3. The ADL abilities of the hemiplegic patients were significantly higher in ambulatory. younger. and longer-period-of-illness patients and patients who used a cane as a assistive device. 4. The family support for the hemiplegic patients showed a statistically significant Cor relationship with their performance of ADL(r =.30809. p=0.0013). 5. The performance of ADL for the ambulatory patients were mainly affected by the degree of family support. the period of the hemiplegic illness, the use of brace, informal care giving, and the age. These variables explained 50% of variance. 6. The length of illness was a statistically significant affecting variable for ADL performance in OPD and assistive device in IPD. In conclusion. the higher the hemiplegic patients perceived the degree of family support. the better they performed ADL. We should develop nursing methods which enhance the family support for the hemiplegic patients in order to increase their performance of ADL.
Activities of Daily Living* ; Aging ; Braces ; Canes ; Female ; Humans ; Male ; Nursing ; Patient Care ; Self-Help Devices ; Stroke