https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/390 Fri, 03 Jul 2026 23:04:54 GMT 2026-07-03T23:04:54Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/213294 Title: Lesion-Specific Clinical Implications of Oral Hesitation After Stroke: A Comparative Study of Frontal Versus Parietal Lobe Lesions Authors: Yun, Yeo Joon; Jang, Seong Ho; Park, Jae Hyeon; Choi, Seung Yoon; Lee, Ji Woo; Han, Seung Hoon Abstract: Background and Objectives: Whether post-stroke oral hesitation carries different clinical implications by lesion location is unclear. We compared oral hesitation and its relationship with chewing, cognition, and aspiration risk between frontal and parietal lobe stroke. Materials and Methods: We retrospectively analyzed 242 patients (35 frontal, 207 parietal) from 946 consecutive stroke admissions (2016–2020) with isolated lesions and videofluoroscopic swallowing study within one month. Oral hesitation, chewing, Clinical Dysphagia Scale (CDS), and Mini-Mental State Examination (MMSE) were recorded. Penetration-Aspiration Scale (PAS) scores were categorized as Normal (1), Penetration (2–5), or Aspiration (6–8). Multivariable logistic regression adjusting for age, sex, stroke type, and lesion side was performed. Firth’s penalized estimation was used for models with quasi-separation. Results: Groups were demographically comparable in age (68.1 ± 15.0 vs. 71.7 ± 12.2 years; p = 0.206) and female sex (48.6% vs. 42.0%; p = 0.590). Oral hesitation was significantly more prevalent in the frontal group (liquid: 80.0% vs. 23.2%, p < 0.001; semisolid: 68.6% vs. 26.6%, p < 0.001). Frontal patients scored worse on six of seven CDS subcomponents (p < 0.01), yet chewing was uncorrelated with oral hesitation or residue (p > 0.3), unchanged after MMSE adjustment. In parietal patients, chewing correlated with all outcomes (ρ = 0.19–0.30, p < 0.01). In parietal stroke, oral hesitation was linked with liquid aspiration (64.3% vs. 35.7%; OR = 3.25, p = 0.001) and semisolid airway invasion (OR = 2.70, p = 0.005); these associations remained significant after multivariable adjustment and FDR correction. No such association was detected in the frontal group, although this finding is limited by the smaller sample size. Conclusions: Oral hesitation may carry different clinical implications by lesion site. In parietal stroke, it was associated with chewing impairment and higher aspiration risk, suggesting a possible sensorimotor contribution. Frontal group findings were underpowered and should be considered exploratory. Lesion-specific interpretation warrants larger-cohort confirmation. Fri, 01 May 2026 00:00:00 GMT https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/213294 2026-05-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/211130 Title: Verification of Markerless Gait Analysis: Multi-Camera and Single-Camera Approaches in Comparison to Marker-Based Gait Analysis Authors: Park, Yong Seok; Yu, Yeon Woo; Cha, Hari; Lee, Joon Seok; Yoon, Chan; Kim, Byung-Hoon; Park, Jae Hyeon; Lee, Ki-Kwang Abstract: Background and Objectives: This study aimed to verify the validity of markerless gait analysis using both single-camera markerless system (S-ML) and multi-camera markerless system (M-ML) approaches by comparing them with a gold-standard marker-based system (MB). Materials and Methods: Sixteen healthy adults walked at their gait speed, and their gaits were simultaneously analyzed using three systems: S-ML, M-ML, and MB. Intraclass correlation coefficients were used to assess the reliability of the spatiotemporal parameters, and the root mean squared error (RMSE) was calculated to quantify the kinematic differences relative to the MB systems. Results: Both S-ML and M-ML demonstrated good-to-excellent reliability in spatiotemporal parameters, including step length, stance time, and gait speed, whereas stride length and swing time measured by S-ML revealed moderate reliability. In terms of joint kinematics, S-ML demonstrated a performance comparable to that of M-ML, particularly at the hip and knee in the sagittal plane. For certain parameters, such as knee abduction/adduction in the frontal plane, the S-ML demonstrated lower RMSE values than M-ML. In contrast, the ankle joint angles estimated using S-ML exhibited reduced agreement. Conclusions: In conclusion, markerless gait analysis can serve as an alternative to conventional gait analysis. However, certain parameters need to be improved. Sun, 01 Feb 2026 00:00:00 GMT https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/211130 2026-02-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/213060 Title: Deep Convolutional Neural Network Analysis of Biomechanical Gait Improvements Following Ankle-Foot Orthosis Use in Stroke Patients Authors: Jang, Seongho; Lee, Shi-Uk; Yun, Yeo Joon Abstract: Background & Objective: Advanced computational approaches, such as deep convolutional neural networks (DCNN), provide new opportunities for objectively classifying and interpreting complex biomechanical gait improvements following Ankle-Foot Orthosis (AFO) use in stroke rehabilitation. This study aimed to evaluate the efficacy of DCNN models in distinguishing affected versus control gait patterns and identifying subtle biomechanical improvements after AFO use, utilizing Gradient-weighted Class Activation Mapping (Grad-CAM) for interpretability.Materials and Methods: Gait data from 48 stroke patients (56 datasets) were collected pre- and post-AFO using inertial measurement units. Additionally, an extensive control dataset comprising 5,826 gait samples from 828 healthy individuals, previously validated was included to train and validate the DCNN model. Raw IMU sensor data underwent rigorous preprocessing including normalization, alignment, and segmentation into fixed-length sequences. Multi-plane hip-knee cyclogram data were transformed into numerical arrays representing sagittal, coronal, and transverse joint angles. Clinical covariates including age, sex, height, and weight underwent Z-score normalization for standardization.The DCNN model was developed and validated for two primary tasks: (1) distinguishing affected stroke gait from normal gait patterns, and (2) detecting subtle biomechanical gait improvements post-AFO. Grad-CAM visualizations identified critical gait phases significantly enhanced by AFO use.Results: The DCNN model achieved exceptional accuracy (99.9%), precision (100%), recall (100%), and F1-score (100%). Grad-CAM visualizations highlighted key biomechanical improvements, particularly increased hip and knee flexion during initial swing, improved knee extension and hip stability at terminal swing to initial contact transition, and enhanced joint stability during mid-stance phases. Notably, only two of 28 patients exhibited gait patterns approaching normal following AFO use, indicating a need for individualized rehabilitation strategies beyond orthotic support.Conclusion: The DCNN analysis successfully identified and visualized clinically relevant biomechanical gait improvements, underscoring its utility for precision medicine and individualized stroke rehabilitation strategies. Sun, 01 Feb 2026 00:00:00 GMT https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/213060 2026-02-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212328 Title: A Pilot Study on the Short-Term Effects of an Electric Knee-Ankle-Foot Orthosis on Gait Performance and Physiological Cost Index in Patients With Hemiplegia: Influence of Initial Balance Ability Assessed by the Berg Balance Scale Authors: Choi, Hyuk-Jae; Heo, Yoon; Lee, Jong-Won; Cho, Hyeonseok; Bae, Ju-Hwan; Hwang, In Ho; Kim, Mi Jung; Ko, Chang-Yong Abstract: Gait impairment is one of the most disabling consequences of stroke and substantially limits functional independence. While traditional orthoses provide joint stabilization, they often restrict natural motion and lack adaptive support. This study is aimed at evaluating the short-term effects of an electric knee–ankle–foot orthosis (E-KAFO) on gait performance and energy efficiency in patients with hemiplegia and at assessing how baseline balance ability, measured using the Berg Balance Scale (BBS), influences outcomes. This pre–post intervention, nonrandomized study enrolled poststroke survivors (n = 22), who were stratified into high- (BBS > 45) and low- (BBS ≤ 45) balance groups (HBG and LBG, respectively). Participants underwent gait assessments under two conditions: body-powered condition (BP_C), to evaluate rehabilitation effects independently of the device, and E-KAFO_C, to assess short-term assistive efficacy immediately after device use. All assessments were conducted before and after a 3-week intervention comprising seven E-KAFO training sessions. The primary outcome was gait speed, measured using the 5-m walk test (5-mWT). The 3-min and 6-min walk tests (3-MWT and 6-MWT) and the physiological cost index (PCI) were also evaluated to assess gait endurance and energy efficiency. The 5-mWT and 3-MWT/6-MWT were performed in randomized order to minimize order-related bias. No standard rehabilitation-only control group was included. Assistive effects (E-KAFO_C) and rehabilitative effects (BP_C) were analyzed and reported separately. Two-way repeated measures analysis of variance was used to assess the effects of group, time, and their interaction. Significant improvements in gait speed and endurance were observed across both conditions, with the LBG showing greater relative gains postintervention. In the E-KAFO_C condition, the LBG demonstrated a 33.31% increase in 5-mWT speed and a 25.51% increase in 3-MWT distance. Notably, PCI decreased in both groups, although the reduction was significant only in the LBG. These findings underscore the distinction between the short-term assistive benefits of the E-KAFO and the rehabilitative improvements captured by BP_C outcomes, emphasizing that BP_C results serve as the primary indicator of rehabilitation effectiveness. Importantly, baseline balance ability assessed by the BBS influenced assistive and rehabilitative responses, supporting its relevance for patient stratification. Given the exploratory design and limited sample size, these findings are hypothesis-generating and require confirmation in larger randomized controlled trials. Thu, 01 Jan 2026 00:00:00 GMT https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212328 2026-01-01T00:00:00Z