The current study examined if a 14-week treadmill gait training changed gait patterns and isokinetic strength of lower extremities of ten hemiplegic subjects who had a stroke previously. In this study, I assigned the subjects randomly into two treadmi ...

The current study examined if a 14-week treadmill gait training changed gait patterns and isokinetic strength of lower extremities of ten hemiplegic subjects who had a stroke previously. In this study, I assigned the subjects randomly into two treadmill training conditions (i.e., either incline and decline training condition; five subjects for each condition) and the training program had three stages (i.e., treadmill training, detraining, and retraining; 6, 4, and 4 weeks, respectively.) Results of the study are as follows: 1) In both affected and unaffected sides, step length of lower limbs and the ratio between step length and lower limb were increased during the training session but decreased during the detraining session. However, there was no difference between the two training conditions in step stride and the ratio between step stride and lower limb length in both sides. 2) Stride length and the ratio between stride length and lower limb length in both sides were steadily increased during the training session but decreased a little during the detraining session. The training condition didn't make any differences, however, in stride length and the ratio between stride length and lower limb length in both sides. 3) During the training session, swing phase of lower limb was decreased in both sides. However, stance phase of lower limb was increased in the affected side but decreased in the unaffected side. Neither swing phase nor stance phase was changed according to the training condition. 4) Total stride time in both limbs was decreased steadily during the training session but the training condition didn't make any differences in total stride time. 5) The angle of ankle joint in both lower limbs except RTO became smaller as the training was progressed. However, there was no difference between the two training conditions. A noticeable change in the subjects with the training session is that they had a tendency to stretch their toes up during landing. 6) The angle of knee joint in both lower limbs became smaller as the training was progressed. With the increase of step length and stride length in the affected side, the angle was decreased steadily. There was a significant difference between the two training conditions in terms of the angle of knee joint. Specifically, the decrease in the angle of knee joint was smaller in the decline gait training than the decline gait training condition. 7) The angle of hip joint in the affected side lower limbs decreased as treadmill gait training was performed because of the increase of step length and stride length while the hip joint angle increased at RTO making driving force. The hip joint angle of unaffected side lower limbs decreased as treadmill gait training was performed as LHC1, RTO, LHC2 but increased at RHC2 and LTO2. The ways of gait training didn't make any differences for hip joint angle. 8) The flexion of knee in both lower limbs, peak torque during extension, peak torque/BW, average power, average power/BW, total work, and total work/BW were increased as the training was progressed, especially in the decline gait training group. The present study shows that the gait ability of hemiplegic patients after a stroke was improved through a 14-week treadmill gait training and the training program had positive influences in improving isokinetic strength. During the detraining session, the effects of the training session was decreased. Therefore, the patients need a steady gait training program. There were only a handful differences between the two gait training conditions, but the decline treadmill gait training had better effects than the other. In conclusion the decline treadmill gait training was better than the incline treadmill gait training in improving gait ability of hemiplegic patients after a stroke. If we use both training methods simultaneously, however, it will be the best way to prevent additional diseases and recurrence of strokes.

1) 환측하지와 건측하지의 보폭과 보폭/하지장은 트레드밀 보행운동 기간이 경과함에 따라 점증적으로 증가하였으나, 훈련중지 기간에는 다소 감소하였다. 그리고 보행운동 방법에 따른 보폭과 보폭/하지장의 차이는 나타나지 않았다. 2) 활보장과 활보장/하지장은 트레드 ...

1) 환측하지와 건측하지의 보폭과 보폭/하지장은 트레드밀 보행운동 기간이 경과함에 따라 점증적으로 증가하였으나, 훈련중지 기간에는 다소 감소하였다. 그리고 보행운동 방법에 따른 보폭과 보폭/하지장의 차이는 나타나지 않았다. 2) 활보장과 활보장/하지장은 트레드밀 보행운동 기간이 경과함에 따라 점증적으로 증가하였으나, 훈련중지 기간에는 다소 감소하였다. 그리고 보행운동 방법에 따른 활보장과 활보장/하지장의 차이는 나타나지 않았다. 3) 환측하지의 지지시간은 트레드밀 보행운동 기간이 경과함에 따라 증가하는 추세를 나타내었고, 건측하지의 지지시간은 감소하는 추세를 나타내었다. 그리고 보행운동 방법에 따른 지지시간의 차이는 나타나지 않았다. 체공시간은 트레드밀 보행운동 기간이 경과함에 따라 감소하는 추세를 나타내었고 보행운동 방법에 따른 체공시간의 차이는 나타나지 않았다. 4) 환측하지와 건측하지의 보행 총 소요시간은 트레드밀 보행운동 기간이 경과함에 따라 점증적으로 감소하였으며 보행운동 방법에 따른 보행 총 소요시간의 차이는 나타나지 않았다. 5) 환측하지와 건측하지의 발목 관절각도는 보행운동 기간이 경과함에 따라 RTO를 제외하고 작아지는 경향을 보였으며 보행운동 방법에 따른 발목 관절각도의 차이는 나타나지 않았다. 그리고 환측하지 착지 시에 이전보다 발끝을 세워 착지하고 있었다. 6) 환측하지와 건측하지의 무릎 관절각도는 보행운동 기간이 경과함에 따라 점차 작아지는 경향을 보였으며 환측 보폭과 활보장의 증가로 무릎 관절각도가 점증적으로 감소하였다. 그리고 보행운동 방법에 따른 환측하지의 무릎 관절각도의 차이는 오르막 보행운동그룹보다 내리막 보행운동그룹에서 유의하게 감소된 것으로 나타났다. 7) 환측하지의 고관절각도는 보행운동 기간이 경과함에 따라 착지동작에서는 보폭과 활보장 증가에 기인하여 감소하였지만, RTO에서는 고관절각도가 증가하고 있어 추진에 필요한 힘을 발생시키고 있었다. 건측하지의 고관절각도는 보행운동 기간이 경과함에 따라 LHC1, RTO, LHC2에서는 감소하는 추세로 나타났고, RHC2, LTO2에서는 증가하는 것으로 나타났다. 그리고 보행운동 방법에 따른 고관절각도의 차이는 나타나지 않았다. 8) 환측하지와 건측하지의 무릎관절 굴곡과 신전회전 시 최대회전력, 체중당 최대회전력비, 평균파워, 체중당 평균파워비, 전체 일량, 체중당 전체 일량비는 보행운동 기간이 경과함에 따라 점증적으로 향상되었으며, 특히 오르막 보행운동그룹보다 내리막 보행운동그룹에서의 보행운동 효과가 더 크게 나타났다.