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Journal of the Korean Academy of Rehabilitation Medicine 2009;33(6):668-674.
Crossing Obstacles of Different Heights in Hemiplegic Stroke Patients.
Kim, Seon Nyeo , Lee, Seung Hwa , Cheon, Yu Jeong , Cha, Dong Yeon , Choi, Jae Yung
1Department of Rehabilitation Medicine, Seoul Veterans Hospital, Korea. rmdlsh@hanmail.net
2Department of Rehabilitation Medicine, Seoul Red Cross Hospital, Korea.
편마비 환자의 장애물 보행
김선녀, 이승화, 천유정1, 차동연, 최재영
서울보훈병원 재활의학과, 1서울적십자병원 재활의학과
Abstract
Objective
To evaluate the changes of gait patterns during crossing obstacles of different heights in hemiplegic stroke patients and to compare gait characteristics with those of healthy control subjects.
Method
Subjects were 13 hemiplegic stroke patients and 9 age-matched healthy adults. Subjects stepped over obstacles with each height of 3, 8 and 13 cm. The three- dimensional gait analysis was performed. Temporospatial, kinematic and kinetic parameters were measured in both lead and trail limb. The pre- and post-obstacle distance, pre- and post-obstacle swing time and toe clearance were also measured.
Results
With increase in height of obstacles, ratio of single limb support time, angle of hip, knee flexion in swing phase and hip extensor moment increased in both lead and trail limbs. In the lead limb, post-obstacle distance and toe clearance also increased (p<0.05). Compared with control groups, the angle of knee flexion, hip extensor and hip flexor moment and pre- and post-obstacle distance decreased significantly in the lead limb of hemiplegic patients (p< 0.05). In the trail limb of hemiplegic patients, the angle of hip flexion, hip flexor moment and post-obstacle distance decreased (p<0.05).
Conclusion
Understanding strategies for adequate control and coordination of the swing limb during crossing obstacles may be the basis for the safe training of obstacle crossing in hemiplegic stroke patients. (J Korean Acad Rehab Med 2009; 33: 668-674)
Key Words: Stroke, Gait analysis, Obstacles


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