: 1 2 1998 1). 1,2), (visual input) 3), (proprioceptive deficit) 4), (respiration) ), (knee flexion contracture) 6), (leg length discrepancy) 7), (foot position) 8) 9).. Cane, Cru tch, Walker Bar and Rail ), ).,., (Base of Support BOS)... :, 0 20, 20 60 ( ) 0, 97 9 97 12 20 (Table 1),,.,,, Table 1. Age & S e x Dis tribution of the S ubjects Age (yrs) 20-29 30-39 40-49 0-9 60-69 Normal Hemiplegia Male Female Total Total Total 2 2 0 20 2 3 4 6 79
( ) 1993 ) (,, ),, Balance Index 1,, (Both-foot) (One-foot), (Eye-open) (Eyeclosed), - (Hard-surface) - (Soft-surface) 4 (Table 2). - (Proprioception), Cushion 2. (sway), 3, 4,.,,,, 11).,, (Dominant), Cushion, cm 11). Medium-density foam 11). 6 8 40 (Standing balance index), 0,. Fig. 1. Gaitaids: 1) mono- cane, 2) quad- cane, 3) forearm crutch 4) axillary crutch ) walker. Table 2. Mean S cales of Unit Test of Balance in Normal Standing Hard surface Soft surface Both Foot One Foot Eye-Open Eye-Closed Eye-Open Eye-Closed.0.0.0 4. 4.9 4.6 3. 2.1 Total 34. Max : 40 80
, 40 (P<0.0), 60. 3) Table, 2,, monocane, quad-cane, forearm-crutch, axillary-crutch 22.4%, - -.9%, walker(fig. 1) 22.4%.. walker,,. 1) 21.0 6.9, (P<0.0), 60.% (Table 3). 2), (Randomized block design) 60.%, - -, 2 34.4%, 39.4% (In (Table 2). terrater Correlationship), 1 (between trials by one examiner) (Intrarater Correlationship), 1) Gait-aid gait-aid, walker (Average Correlation Coefficient) (test-retest reliability). unpaired t-test, (ANOVA). 40.0, quadcane 38.6 gait-aid. Forearm-crutch, axillary-crutch, monocane 37.1, 37.1, 36.9, 3 (Table 3). 2) gait-aid,, walker 1) 37.6, quadcane 30.3 3 34. 2.7, 3.1 2.4, 33.9 2.9 gait-aid, axillary-crutch, monocane, 2) 20 37.0 1.1, 30 36. 1.4, 40 33.7 2.0, 0 32.9 1.2, 60 31.1 2.2 forearm-crutch 26.0, 2.6, 2.8, 3 (Table 3). 3) Gait-aid 81
, Gait-aid Gait-aid, (Gaitaid - Gaitaid ) / Gaitaid Assist Ratio(%)( ),, walker 79.0%, Quad-cane 43.3%, mono-cane, forearm Table 3. Bala nce Inde x a s s ite d by Ga it-a ids in Norma l a nd S troke Gait-aid Normal Stroke None Mono-cane Quad-cane Forearm crutch Axillary crutch Walker 34. 2.7 36.9 1.3 38.6 0.8 37.1 1.1 37.1 1.0 40.0 0.0 21.0 6.9 2..6 30.1 4.8 2..7 2..4 37.6 1.4 crutch, axillary crutch 21.4 % (Table 4). 4) Gait-aid,, walker quad-cane, - - walker, walker (Table ). Intrarater Correlation Coefficient 0.94, 0.86, Interrater Correlation Coefficient 0.92 0.83. 0.73-0.97. Table 4. Ba la nce Inde x a s s ite d by Ga it-a ids Gait-aid None Mono-cane Quad-cane Forearm crutch Axillary crutch Walker Both Foot Stroke Balance index Assit ratio(%) Balance index Assit ratio(%) 34. 2.7 36.9 1.3 38.6 0.8 37.1 1.1 37.1 1.0 40.0 0.0-7.0 11.9 7. 7. 1.9 21.0 6.9 2..6 30.1 4.8 2..7 2..4 37.6 1.4-21.4 43.3 21.4 21.4 79.0 Table. Mean S cales of Unit Test of Balance in stroke patients Gait-aids None Mono-cane Quad-cane Forearm crutch Axillary crutch Walker Foot Surface Eye Boot One(Diff Hard Soft(Diff) Open Closed(Diff) 3.8 4.3 4.6 4.3 4.3 4.9 1.(2.3) 2.1(2.2) 3.0(1.6) 2.2(2.1) 2.1(2.2) 4.(0.4) 3.2 3.4 4.0 3. 3. 4.8 2.1(1.1) 3.0(0.4) 3.6(0.4) 3.0(0.) 3.0(0.) 4.6(0.2) 3.3 3.6 4.2 3.7 3.7 4.8 2.0(1.3) 2.8(0.8) 3.4(0.8) 2.8(0.9) 2.8(0.9) 4.6(0.2) 82
, 40, Berg 3 18),, Bohannon (biomechanical support), (motor coordination), (sensory integration) 12). (visual), (vestibular function), (proprioception) 3 13,14). 19).,,, 4 20), Bruell 21,22),. (Base of support: BOS), (Center of gravity:cog),,,,,,,. 12,1). B.O.S.,,,,,. C.O.G.,,, balance board,., 16)., Ruskin (Dynamic balance), cane, crutch, walker. cane C.O.G., mono-cane,,, quad-cane, cane 20-2%. crutch 17)., cane, crutch,,,, (Balance,. Forearm-crutch 4-0% index), axillary-crutch,, B.O.S. C.O.G.. 80%. Forearm-crutch, forearm-crutch. walker 83
, quad-cane mono-cane B.O.S. 20). mono-,, 8-,23). cane quad-cane,, quad-cane B.O.S. mono-cane.,,, 20).,,, quad-cane walker, 18).. (C.O.G.) 20). (B.O.S.) C.O.G.,,.,, 12,1). B.O.S. ). Cane., crutch B.O.S., 20).,., walker, quad-cane, 3 mono-cane, forearm-crutch, axillarycrutch. quad-cane mono-cane,, crutch.. 1993 Milezarek 9) mono-cane quad-cane, Kisler force plate, cane. 20 20 gait-aid, mono-cane 84
quad-cane, forearm crutch, axillary crutch, walker 1) 34. 2.7, 21.0 6.9. 40. 2) Gait-aid gait-aid,. 3) gait-aid walker, quad-cane. gait-aid,. 4) Gait-aid, walker 79.0%, Quad-cane 43.3%, mono-cane, forearm crutch, axillary crutch 21.4%. walker, quadcane, 3 mono-cane forearm crutch, axillary crutch.,, = Abstract = Assitive Effect of Gait-aids for the Standing Balance Ki Eon Jang, M.D., Tae Hwan Park, M.D. and Jong Lull Yoon, M.D. Department of Rehabilitation Medicine, Department of Family Medicine,* Hallym University College of Medicine 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 differnet 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.I. with or without using each gaitaids examined by 0 healthy adults and 20 stroke patients. Results : The BI in the normal adult was 34. 2.7, and 21.0 6.9 in the stroke patients. The balance index of 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 2..6, 2..7, 2..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. Key Words : Gaitaids, Cane, Balance, Stroke 8
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