Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
권호 표지
DOI QR코드

DOI QR Code

A Effect of the Squat Convergence Exercise Among Knee Joint Angle on Quadricpes Strength in the Patients With Patellofemoral Pain Syndrome

무릎넙다리통증증후군 환자에서 무릎관절 각도별 스쿼트 융합운동이 넙다리네갈래근의 근력에 미치는 효과

  • Cho, Sang-Hee (Stroke Clinic, Hyojung Rehabilitation Hospital) ;
  • Lee, Su-Young (Dept. of Physical Therapy, Division of Health Science, Baekseok University)
  • 조상희 (효정재활요양병원 뇌졸중 클리닉) ;
  • 이수영 (백석대학교 보건학부 물리치료학과)
  • Received : 2016.01.26
  • Accepted : 2016.03.31
  • Published : 2016.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to suggest the effective squat exercise position to strengthening vastus medialis oblique, and vastus lateralis in quadriceps. Subjects were twenty patients with patellofemoral pain syndrome (PFPS) volunteered to participate in this study. All subjects were applied to static squat convergence exercise with knee flexed $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ for 30 seconds total 5 times. Measurement variables were maximal voluntary isometric contraction (MVIC) of the quadriceps, Q angle and length of thigh. Those were measured before and after the squat exercise on knee joint angle, change rate of which were used for statistical analysis. As a result, squat exercise with knee flexed $90^{\circ}$ increase significantly among knee joint angle in the MVIC change rates of quadriceps (p<.05), however the rates of Q-angle and length change of thigh showed no significant difference. Therefore, this findings suggest that squat exercise with knee flexed $90^{\circ}$ strengthen quadriceps effectively in patients with PFPS.

본 연구의 목적은 넙다리네갈래근 중 안쪽빗넓은근과 가쪽넓은근의 강화를 위해 효과적인 스쿼트 운동자세를 제시하는 데 있다. 연구대상자는 무릎넙다리통증증후군이 있는 20명의 환자로 본 연구에 자발적으로 참여하였다. 대상자들은 무릎관절 굽힘 각도 $45^{\circ}$, $60^{\circ}$, $90^{\circ}$ 자세에서 정적인 스쿼트 융합운동을 30초 동안 총 5회 실시하였다. 측정변수는 넙다리네갈래근의 최대 수의적 등척성 수축력(MVIC), 넙다리네갈래근 각(Q 각)과 넙다리 둘레이며, 무릎관절 자세에 따라 스쿼트 운동 전후로 측정되었으며 그 변화률을 통계분석에 사용하였다. 연구결과 넙다리네갈래근의 무릎관절 각도별 MVIC 변화율은 $90^{\circ}$ 무릎관절 굽힘에서 유의하게 증가하였으나(p<.05), Q 각과 넙다리 둘레의 변화율엔 유의한 차이가 없었다(p>.05). 따라서 무릎통증증후군 환자의 넙다리네갈래근의 강화를 위해서 무릎관절 $90^{\circ}$ 굽힘된 스쿼트 자세가 효과적임을 제시한다.

Keywords

References

  1. D. A. Neumann, Kinesiology of the Musculoskeletal System: Foundation for Rehabilitation. 2nd ed, London: Mosby, 2010.
  2. R. V. Linschoten, M. V. Middelkoop, M. Y. Berger, E. M. Heintjes, J. A. N. Verhaar, S. P. Willemsen, B. W. Koes, S. M. Bierma-Zeinstra, "Supervised Exercise Therapy Versus Usual Care for Patellofemoral Pain Syndrome: A open label randomized controll trial", BMJ, Vol. 339, pp. b4074, 2009. https://doi.org/10.1136/bmj.b4074
  3. J. E. Earl, R. J. Schmitz, B. L. Arnold, "Activation of the VMO and VL During Dynamic Mini-Squat Exercise With and Without Isometric Hip Adduction", J Electromyogr Kinesiol, Vol. 11, No. 6, pp. 381-386, 2001. https://doi.org/10.1016/S1050-6411(01)00024-4
  4. S. Doucette., E. Goble, E. "The Effect of Exercise on Patellar Tracking in Lateral Patellar Compression Syndrome", Am J Sports Med, Vol. 20, No. 4, pp. 434-440, 1992 https://doi.org/10.1177/036354659202000412
  5. M. Whittingham, S. Palmer, F. Macmillan, "Effects of Taping on Pain and Function in Patellofemoral Pain Syndrome: A randomized controlled trail", J Ortho Sports Phys Ther, Vol. 34, No. 9, pp. 504-510, 2004. https://doi.org/10.2519/jospt.2004.34.9.504
  6. B. C. Heiderscheit, J. Hamill, R. E. van Emmerik, "Q-Angle Influences on the Variability of Lower Extremity Coordination During Running", Med Sci Sports Exerc, Vol. 31, No. 9, pp. 1313-1319, 1999. https://doi.org/10.1097/00005768-199909000-00013
  7. R. Nagamine, T. Otani, S. E. White, D. S. McCarthy, L. A. Whiteside, "Patellar Tracking Measurement in the Normal Knee", J Orthop Res, Vol. 13, No. 1, pp. 115-122, 1995. https://doi.org/10.1002/jor.1100130117
  8. J. P. Boucher, M. A. King, R. Lefebvre, A. Pepin, "Quadriceps Femoris Muscle Activity in Patellofemoral Pain Syndrome", Am J Sports Med, Vol. 20, No. 5, pp. 527-532, 1992. https://doi.org/10.1177/036354659202000507
  9. L. Reynolds, T. A. Levin, J. M. Medeiros, N. S. Adler, A. Hallum, "EMG Activity of the Vastus Medialis Oblique and the Vasts Lateralis in Their Role in Patellar Alignment", Am J Phys Med, Vol. 62, No. 2, pp. 61-70, 1983.
  10. D. R. Souza, M. T. Gross, "Comparison of Vastus Medialis Obliquus: Vastus Lateralis Muscle Integrated Electromyographic Ratios Between Healthy Subjects and Patients With Patellofemoral Pain", Phys Ther, Vol. 71, No. 4, pp. 317-320, 1991. https://doi.org/10.1093/ptj/71.4.317
  11. M. E. Brunet, G. W. Stewart, "Patellofemoral Rehabilitation", Clin Sports Med, Vol. 8, No. 2, pp. 319-329, 1989.
  12. L. A. Steinkamp, M. F. Dillingham, M. D. Markel,, J. A. Hill, K. R. Kaufman, "Biomechanical Considerations in Patellofemoral Joint Rehabilitation", Am J Sports Med, Vol. 21, No. 3, pp. 438-444, 1993. https://doi.org/10.1177/036354659302100319
  13. K. E. Wilk, R. F. Escamilla, G. S. Fleisig, S. W. Barrentine, J. R. Andrews, M. L. Boyd, "A Comparison of Tibiofemoral Joint Forces and Electromyographic Activity During Open and Closed Kinetic Chain Exercises", Am J Sports Med, Vol. 24, No. 4, pp. 518-527, 1996. https://doi.org/10.1177/036354659602400418
  14. M. P. de Looze, H. M. Toussaint, J. H. van Dieen, H. C. Kemper, "Joint Moments and Muscle Activity in the Lower Extremities and Lower Back in Lifting and Lowering Tasks", J Biomech, Vol. 26, No. 9, pp. 1067-1076, 1993. https://doi.org/10.1016/S0021-9290(05)80006-5
  15. G. J. Salem, C. M. Powers, "Paatellofemoral Joint Kinetics During Suqatting in Collegiate Women Athletes", Clin Biomech, Vol. 16, No. 5, pp. 424-430, 2001. https://doi.org/10.1016/S0268-0033(01)00017-1
  16. R. A. Palmitier, K. N. An, S. G. Scott, E. Y. Chao, "Kinetic Chain Exercise in Knee Rehabilitation", Sports Med, Vol. 11, No. 6, pp. 402-413, 1991. https://doi.org/10.2165/00007256-199111060-00005
  17. J. Iwasa, M. Och, N. Adachi, M. Tobita, K. Katsube, Y. Uchio, "Proprioceptive Improvement in Knees With Anterior Cruciate Ligament Reconstruction", Clin Orthop Relat Res, No. 381, pp. 168-176, 2000.
  18. R. F. Escamilla, N. Zheng, T. D. Macleod, W. B. Edwards, R. Imamura, A. Hreljac, G. S. Fleisig, K. E. Wilk, C. T. Moorman, J. R. Andrews, "Patellofemoral Joint Force and Stress During the Wall Squat and One-leg Squat", Med Sci Sports Exerc, Vol. 41, No. 4, pp. 878-888, 2009.
  19. J. W. Kim, S. H. Yoo, W. S. Chang, K. S. Sung, H. J. Nam, H. H. Choi. "Dynamic Electromyography Analysis and Comparison of the Knee Isometric Exercise According to Angles", The Korean Journal of Walking Science, Vol. 4, No. 4, pp 99-112, 2005.
  20. S. F. Tang, C. K. Chen, R. Hsu, S. W. Chou, W. H. Hong, H. L. Lew,. "Vastus Medialis Obliquus and Vastus Lateralis Activity in Open and Closed Kinetic Chain Exercises in Patients With Patellofemoral Pain Syndrome: An Electromyographic Study", Arch Phys Med Rehail, Vol. 82, No. 10, pp. 1441-1445, 2001. https://doi.org/10.1053/apmr.2001.26252
  21. S. Y. Jang, S. Y. Lee. "A Comparison of Vital Capacity Values and Respiratory Muscles Activities on Pelvic Tilt Position", Phys Ther Rehail Sci, Vol. 4, No. 2, pp. 108-114, 2015.
  22. Sang-Yong Park, Jae-Hun Shim, "Effect of 8 Weeks of Schroth Exercise (Three-dimensional Convergence Exercise) on Pulmonary Function, Cobb's Angle, and Erector Spinae Muscle Activity in Idiopathic Scoliosis", Journal of the Korea Convergence Society, Vol. 5, No. 4, pp. 61-68, 2014. https://doi.org/10.15207/JKCS.2014.5.4.061
  23. W. G. Yoo, C. H. Yi, H. J. Lee. "Effects of a Combined Posture of the Lower Extremity on Activity of the Vastus Medialis Oblique Muscle and Vastus Lateralis Muscle During Static Squat Exercise", Physical Therapy Korea, Vol. 11, No. 3, pp. 1-9, 2004.
  24. S. Y. Lee, J. Y. Kim, "The Comparison of Low Intensity Eccentric Exercise and Dynamic Stretching on Delayed Onset Muscle Soreness", Journal of the Korea Academia-Industrial cooperation Society, Vol. 13, No. 10, pp. 4676-4685, 2012. https://doi.org/10.5762/KAIS.2012.13.10.4676
  25. H. J. Hislop, D. Avers, M. Brown, "Daniels and Worthingham's Muscle Testing", 9th ed, St. Louis: SAUNDERS, 2014.
  26. N. W. Park, W. H. Lee. "A Study of the Effects of a Quadricpes Strengthening on the Q-Angle and Patellofemoral Joint Functional Level Among Patellofemoral Pain Syndrome Patients", Journal of KSSPT, Vol. 1, No. 1, pp. 87-100, 2005.
  27. H. M. Jin, H. Jung. "A Study on the Effects of Initial Rehabilitation Exercise Program on Knee Joint's Myofunction After the Reconstruction of Anterior Cruciate Ligament", Journal of Korean Physical Education Association for Girls and Women, Vol. 20, No. 2, pp. 55-66, 2006.
  28. L. A. Bolgla, M. C. Boling, "An Update for the Conversative of Patellofemoral Pain Syndrome: A systemic review of the literature from 2000 to 2010", Phys Ther, Vol. 6, No. 2, pp. 112-125, 2011.
  29. R. S. Francis, D. E. Scott, "Hypotrophy of the Vastus Medialis in Knee Extension", Phys Ther, Vol. 54, No. 10, pp. 1066-1070, 1974. https://doi.org/10.1093/ptj/54.10.1066
  30. H. G. Speakman, J. Weisburg, "The Vastus Medialis Controversy", Physiothraphy, Vol. 63, No. 8, pp. 249-254, 1977.
  31. M. Cesarelli, P. Bifulco, M. Baracale, "Study of Control Strategy of the Quadriceps Muscles in Anterior Knee Pain", IEEE Trans Rehabil Eng, Vol. 8, No. 3, pp. 330-341, 2000. https://doi.org/10.1109/86.867875
  32. R. P. Grelsamer, J. R. Klein, "The Biomechanics of the Patellofemoral Joint", J Orthop Sports Phys Ther, Vol. 28, No. 5, pp. 286-298, 1998. https://doi.org/10.2519/jospt.1998.28.5.286
  33. E. Witvrouw, S. Werner, C. Mikkelsen, D. van Tiggelen, L. Vanden Berghe, G. Cerulli, "Clinical Classification of Patellofemoral Pain Syndrome: Guidelines for Non-Operative Treatment", Knee Surg Sports Traumatol Arthrosc, Vol. 13, No. 2, pp. 122-130, 2005. https://doi.org/10.1007/s00167-004-0577-6
  34. S. Y. Park, J. W. Kim, H. S. Nho. "Vastus Medialis Oblique and Vastus Lateralis Electromyographic Activities During Closed Kinetic Chain Exercises in Male Athletes With and Without Patllofemoral Pain Syndrome", The Korea Journal of Sports Science, Vol. 17, No. 1, pp. 487-495, 2008.
  35. S. W. Han. "A SEMG Analysis of Knee Joint Angle During Close Kinetic Chain Exercise and Open Kinetic Chain Exercises in Quadriceps Muscle", The Journal of Korean Society of Physical Therapy, Vol. 8, No. 3, pp. 261-268, 2006.
  36. J. F. Signorile, D. Kacsik, A. Perry, B. Robertson, R. Williams, L. Lowensteyn, S. Digel, J. Caruso, W. G. LeBlanc, "The Effect of Knee and Foot Position on the Electromyographical Activity of the Superficial Quadriceps", J Orthop Sports Phys Ther, Vol. 22, No. 1, pp. 2-9, 1995. https://doi.org/10.2519/jospt.1995.22.1.2
  37. Sung-Ok Hong, Young-Teak Kim, Youn-Hee Choi, Jong-Ho Park, Sung-Hong Kang, "Development of severity-adjusted length of stay in knee replacement surgery", Journal of digital Convergence , Vol. 13, No. 2, pp. 215-225, 2015.
  38. Gi-Chul Kim, "The Effect of Visual Feedback Squat on Lower Extremity Alignment and Muscular Function of Young Adults with Patellofemoral Pain Syndrome", Ph.D. dissertation, Daegu University, 2013.
  39. V. Raveendranath, S. Nachiket, N. Sujatha, R. Priya, D. Rema, "The Quadriceps Angle (Q angle) in Indian men and women", Eur J Anat, Vol. 13, No. 3, pp. 105-109, 2009.
  40. Oh-Jeoung Kwon, "Correlation Between Cross-Sectional Areas of Intrinsic Patellofemoral Pain Syndrome in Young Adult and Lower Extremity Biomechanics" M.S. Dissertation, Sahmyook University, 2008.
  41. C. M. N. Cabral, A. M. De Oliveira Melim, I. De Camargo Nerves Sacco, A. P. Marques, "Physical Therapy in Patellofemoral Syndorme Patients: Comparison of open and closed kinetic chain exercises", ACTA ORTOP BRAS, Vol. 16, No. 3, pp. 180-185, 2008. https://doi.org/10.1590/S1413-78522008000300012
  42. S. R. Christian, B. Anderson, R. Workman, W. F. Conway, T. L. Pope, "Imaging of Anterior Knee Pain", Clin Sports Med, Vol. 25, pp. 681-702, 2006. https://doi.org/10.1016/j.csm.2006.06.010