Objective: The purpose of this study were to investigate the temporospatial, kinematic data and energy consumption in hemiplegic patients according to the types of ankle-foot orthosis (AFO), and to determine the most effective type of AFO for gait training.

Method: A prospective study was performed for 10 patients with hemiplegia who was able to walk independently at indoor level. The temporospatial, kinematic data and energy consumption were compared in each five different conditions: 1) barefoot, 2) donning AFO with posterior leaf spring (PLS), 3) donning PLS with the distal part of metatarsal head trimmed off (PLS-C), 4) donning hinged PLS (HPLS), 5) donning hinged PLS with the distal part of metatarsal head trimmed off (HPLS-C).

Results: With four types of PLS, maximal ankle plantar flexion was significantly decreased, however we didn't find any difference in kinematic data of the pelvis and hip as compared with barefoot and with PLS, HPLS, HPLS-C and maximal knee extension angle was significantly decreased compared with barefoot. With HPLS-C, cadence and walking speed significantly increased and double support time and oxygen cost significantly decreased as compared with barefoot.

Conclusion: This study showed increased walking speed, decreased energy cost and improved

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.

Objective: To evaluate the effect of a contralateral shoe-lift and ipsilateral leather outsole on the energy consumption in hemiplegic gait.

Method: Ten hemiplegic patients who could walk independently were enrolled. Using portable ergospirometer (K4b², Cosmed, Italy), quantitative evaluation of oxygen consumption under varying shoes conditions was done: 1) regular shoes 2) a half-inch shoe-lift on the sound side 3) a half-inch shoe-lift on the sound side and leather outsole on the plegic side. The evaluation distance was 20 meter on comfortable walking speed.

Results: The oxygen consumption was significantly decreased after the application of shoe-lift compared with regular shoes (p＜0.01), and the oxygen consumption was least with the application of shoe-lift and leather outsole (p＜0.05). This effect was prominent in subject with poor muscle power in hemiplegic lower extremity. The walking speed was also increased with shoe-lift and leather outsole (p＜0.05).

Conclusion: The results of this study demonstrate that proper shoes modification can reduce the energy consumption in hemiplegic gait and can lead to more efficient functional ambulation.

Objective: This study aimed to evaluate the kinematic data and energy consumption of domestic swing and stance phase (SNS) control knee assembly in transfemoral amputees.

Method: Five male transfemoral amputees took prosthetic training of more than one week and evaluated with random applying 3 types of knee assembly; mechanical type, pneumatic type, and domestic SNS type. Kinematic data was obtained by the VICON 370 system (Oxford Metrics Ltd., UK.). Energy consumption was measured using a KB1-C (Aerosport Inc, U.S.A).

Results: Domestic SNS type showed a significantly increased walking speed, cadence and step length compared with mechanical type and pneumatic type (p＜0.05). Domestic SNS type showed a significantly increased maximal hip flexion and extension compared with mechanical type and pneumatic type (p＜0.05). Domestic SNS type showed decreased peak knee flexion at swing phase and significantly increased peak knee extension at stance phase compard with mechanical type and pneumatic type (p＜0.05). In energy consumption, the domestic SNS type tended to show a lower O₂ cost and faster walking speed than the mechanical type and pneumatic type at free-walking.

Conclusion: We concluded the domestic SNS type had more tendency toward a normal gait pattern and lower energy consumption compared with mechanical type and pneumatic type.

Objective: The aim of this study was to speculate the role of arm swing during gait through the comparison of energy consumption and kinematic data between the arm restriction and free arm swing

Method: 20 healthy male adults were recruited as subjects. The kinematic data including upper trunk and oxygen consumption were compared at three different walking speeds (2 km/hr, 4 km/hr, 6 km/hr) between with and without arm restriction.

Results: The oxygen consumption rate with arm restriction was significantly increased at fast speed walking (6 km/hr) comparing that without arm restriction. We found the significant difference of anterior-tilt angle, range of motion (ROM) in the coronal and transverse plane of upper trunk, anterior pelvic tilting angle, ROM of pelvis in coronal and transverse plane, maximal flexion angle of hip, ROM of hip in the coronal plane, and the external rotation angle at single support time in the transverse plane of hip between with and without arm restriction at fast walking speed (p＜0.05).

Conclusion: These results revealed that arm restriction while walking resulted in the minimal, significant changes of energy consumption, and kinematic data. Therefore, arm swing on gait was considered to have roles on energy conservation at fast walking, and on getting better limb advancement and stability.