OBJECTIVE: The aim of this study is to evaluate the acceleration of the center of mass (COM) of the body in stroke patients. METHOD: Seventeen stroke patients and 9 normal subjects were participated. Three dimensional gait analysis was used to classify gait phases for the reference. The accelerometer held over the COM were used to record vertical and medio- lateral accelerations of the COM of the body. Modified Ashworth scale and Brunnstrom stage were used to evaluate the clinical status of stroke patients. RESULTS: In normal subjects, the acceleration showed symmetric pattern. The maximum peak of vertical acceleration occurred in loading response. In stroke patients, the acceleration wave was characterized by asymmetry and polyphasicity. Maximum peak in affected side was higher than that in unaffected side (p<0.05). There were significant correlations between several elements of hemiplegic gait and the correspondent acceleration values; interval of successive peak I in vertical acceleration vs. step time, walking velocity and swing symmetry ratio vs. mean peak I, swing symmetry ratio vs. affected side peak I, step length symmetry ratio vs. peak I symmetry ratio. CONCLUSION: The accelerometer can be an easy and useful way to evaluate gait characteristics in stroke patients.
Acceleration ; Gait Disorders, Neurologic ; Gait* ; Humans ; Stroke* ; Walking

OBJECTS: The purpose of this study is to estimate the values of foot pressure of the stance phase during a gait cycle in hemiplegic gait. METHOD: Thirty patients who had a stroke and forty healthy adults were evaluated by the EMED-SF system to analyze the stance phase of hemiplegic gait. The stance phase was evaluated by 6 points according to the foot pressure and center of pressure proposed by Lee et al.2) RESULTS: 1) In hemiplegics, the stance time of involved limb decreased compared with that of the uninvolved limb and increased that of control groups (p<0.05). 2) In hemiplegics, the midstance time increased but the loading response and terminal stance decreased compared with the uninvolved limb and controls (p<0.05). 3) In hemiplegics, the midstance time decreased and the loading response and terminal phase increased according to the increased Brunnstrom stage (p<0.05). CONCLUSION: The results showed that an analysis of stance phase by the measurement of plantar pressure was a valuable parameter in the gait analysis of hemiplegic patients.
Adult ; Extremities ; Foot ; Gait ; Gait Disorders, Neurologic ; Humans ; Stroke

In this paper, the research has been conducted by the Microsoft kinect for windows v2 for obtaining the walking trajectory data from hemiplegic patients, based on which we achieved automatic identification of the hemiplegic gait and sorted the significance of identified features. First of all, the experimental group and two control groups were set up in the study. The three groups of subjects respectively completed the prescribed standard movements according to the requirements. The walking track data of the subjects were obtained straightaway by Kinect, from which the gait identification features were extracted: the moving range of pace, stride and center of mass (up and down/left and right). Then, the bayesian classification algorithm was utilized to classify the sample set of these features so as to automatically recognize the hemiplegia gait. Finally, the random forest algorithm was used to identify the significance of each feature, providing references for the diagnose of disease by ranking the importance of each feature. This thesis states that the accuracy of classification approach based on bayesian algorithm reaches 96%; the sequence of significance based on the random forest algorithm is step speed, stride, left-right moving distance of the center of mass, and up-down moving distance of the center of mass. The combination of step speed and stride, and the combination of step speed and center of mass moving distance are important reference for analyzing and diagnosing of the hemiplegia gait. The results may provide creative mind and new references for the intelligent diagnosis of hemiplegia gait.
Algorithms ; Bayes Theorem ; Gait ; Gait Analysis ; methods ; Gait Disorders, Neurologic ; diagnosis ; Hemiplegia ; complications ; Humans ; Walking

OBJECTIVE: To identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients. METHODS: A total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training. RESULTS: Paired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%-100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9' CONCLUSION: Our results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group.
Classification ; Gait Disorders, Neurologic ; Gait* ; Humans ; Physical Therapy Modalities ; Rehabilitation ; ROC Curve ; Sensitivity and Specificity ; Stroke* ; Walking

OBJECTIVE: To evaluate the effects of functional electrical stimulation (FES) to ankle dorsiflexor (DF) and ankle plantarflexor (PF) on kinematic and kinetic parameters of hemiplegic gait. METHODS: Fourteen post-stroke hemiplegic patients were considered in this study. Electrical stimulation was delivered to ankle DF during the swing phase and ankle PF during the stance phase via single foot switch. Kinematic and kinetic data were collected using a computerized motion analysis system with force plate. Data of no stimulation (NS), DF stimulation only (DS), DF and PF stimulation (DPS) group were compared among each other. RESULTS: Peak ankle dorsiflexion angle during swing phase is significantly greater in DS group (-1.55degrees+/-9.10degrees) and DPS group (-2.23degrees+/-9.64degrees), compared with NS group (-6.71degrees+/-11.73degrees) (p<0.05), although there was no statistically significant difference between DS and DPS groups. Ankle plantarflexion angle at toe-off did not show significant differences among NS, DS, and DPS groups. Peak knee flexion in DPS group (34.12degrees+/-13.77degrees) during swing phase was significantly greater than that of NS group (30.78degrees+/-13.64degrees), or DS group (32.83degrees+/-13.07degrees) (p<0.05). CONCLUSION: In addition to the usual FES application stimulating ankle DF during the swing phase, stimulation of ankle PF during stance phase can help to increase peak knee flexion during the swing phase. This study shows the advantages of stimulating the ankle DF and PF using single foot switch for post-stroke gait.
Ankle* ; Biomechanical Phenomena ; Electric Stimulation* ; Foot* ; Gait ; Gait Disorders, Neurologic ; Hemiplegia* ; Humans ; Knee ; Stroke*

OBJECTIVE: We used music as a rhythmic cue in gait training of patients with hemiplegia and analysed its effect on gait parameters. METHOD: Twenty hemiplegic patients were included in the study. Gait cycle, foot contact area, and center of pressure pathway were measured by F-scan with and without music. Four subjects were followed after 3 weeks of gait training using rhythmic cue with music. RESULTS: 1) In involved limb, stance phase was slightly increased from 65.8+/-9.9% to 67.8+/-7.9%, and single limb support was changed from 17.1+/-6.3% to 17.2+/-6.2%, without statistical significance. 2) Stance and swing symmetry was slightly increased from 0.77+/-0.13 and 0.52+/-0.21 to 0.83+/-0.09 and 0.54+/-0.16 respectively, without statistical significance. 3) Foot contact area and anteroposterior distance of center of pressure were not changed significantly. 4) All 4 subjects who were followed after 3 weeks showed increased single limb support of involved limb (from 14.5% to 18.8%) and swing symmetry (from 0.47 to 0.67). CONCLUSION: Though it was not proved to be effective for every hemiplegics, use of rhythmic cue with music in gait training may be helpful in some patients. Further study is needed to confirm these results.
Cues ; Extremities ; Foot ; Gait ; Gait Disorders, Neurologic* ; Hemiplegia ; Humans ; Music Therapy ; Music* ; Rehabilitation

OBJECTIVE: To investigate the biomechanic influence of body weight unloading on the hemiplegic gait and to provide database for producing optimal strategies of gait training through body weight unloading (BWU) in hemiplegic patients. METHOD: We evaluated dynamic electromyographic data, temporal parameters of gait, and energy consumption in 20 hemiplegic patients walking on a treadmill with 0%, 10%, 20%, 30% and 40% of their BWU at their comfortable walking speed. RESULTS: 1) Stance phase and double limb support phase significantly decreased, and swing phase and single limb support phase increased according to BWU. 2) Asymmetricity of temporal parameters of gait improved according to BWU. 3) O2 rate, O2 cost, O2 pulse and heart rate significantly decreased with increasing BWU. 4) Muscular activities of rectus femoris, vastus medialis and biceps femoris decreased at initial contact and first half of stance phase and activities of medial gastrocnemius significantly decreased during entire stance phase with increasing BWU. CONCLUSION: BWU during treadmill locomotion would be advantageous as a therapeutic approach to retrain gait in hemiplegic patients.
Body Weight* ; Electromyography ; Extremities ; Gait ; Gait Disorders, Neurologic* ; Heart Rate ; Humans ; Locomotion ; Quadriceps Muscle ; Walking

OBJECTIVE: To investigate the changes of gait patterns in hemiplegic patients with ankle foot orthosis (AFO) and with functional electrical stimulation (FES). METHOD: Fifteen hemiplegic patients who can walk independently with cane participated in this study. Kinematic gait analysis was performed for all subjects using three-dimensional gait analysis system in barefoot, wearing AFO, and applying FES. The mean values of each gait trials were taken and statistically analysed by repeated measures of ANOVA. RESULTS: Genu recurvatum at stance phase and excessive ankle plantar flexion at stance and swing phase were decreased after wearing AFO. Excessive ankle plantar flexion at swing phase were decreased after applying FES. CONCLUSION: The results showed that the FES is useful for the correction of hemiplegic gait as mush as of wearing AFO.
Ankle* ; Canes ; Electric Stimulation* ; Foot Orthoses* ; Foot* ; Gait ; Gait Disorders, Neurologic* ; Humans ; Plastics*

OBJECTIVE: To examine the validity of the fuctional reach test (FRT) for evaluation of standing balance in hemiplegic patients. METHOD: Twenty three hemiplegic patients who were capable of standing without assistive devices were assessed on the FRT only with intact upper limb, the one-legged stance, the timed up and go test (TUG), the 10 meter walking time (10 mWT), the 'Hauser' ambulation index (AI), and the standing balance of Bohannon. RESULTS: The forward reach of FRT demonstrated significant correlation with the TUG and the 10 mWT (p<0.01), but no significant relationship with the one-legged stance, standing balance of Bohannon and AI. CONCLUSION: The forward reach of FRT may be simple and useful tool for assessing the clinical balance function and reflecting gait ability and fall-down risk in hemiplegic patients.
Gait ; Gait Disorders, Neurologic ; Humans ; Self-Help Devices ; Upper Extremity ; Walking

OBJECTIVE: The aims of this study were to verify that the newly developed ankle control elastic band (ACE band) can improve the gait pattern of hemiplegic patients by assessment of objective and subjective data. METHOD: ACE band consisted of medial ring, lateral ring, and elastic band was devised and 11 ambulatory stroke patients were evaluated with gait measurements, functional ambulation categories (FAC), functional reach test (FRT), and questionnaires for the effect of ACE band. Gait measurements were of 10 m walking time, cadence, stride length, stride period, stance phase, single support time, and single support time asymmetry ratio. RESULTS: Gait measurements with the ACE band showed significant improvement (p<0.05 or p<0.01). FAC and FRT with the ACE band were significantly increased (p<0.01), and the questionnaires suggested that wearing the ACE band helped improve toe dragging, swinging leg forward, taking weight through foot, confidence of gait, safety of gait, gait distance and gait velocity. CONCLUSION: ACE band was invented for improvement of hemiplegic gait, and its evaluation of gait measurements, FAC, FRT, and questionnaire showed that the ACE band was effective for hemiplegic gait after stroke.
Ankle* ; Foot ; Gait ; Gait Disorders, Neurologic ; Humans ; Leg ; Surveys and Questionnaires ; Stroke ; Toes ; Walking*