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http://dx.doi.org/10.18857/jkpt.2016.28.2.65

Effects of EMG-Biofeedback Using Closed Kinetic Chain Exercise on Q-angle and Quadriceps Muscle Activation in Patellofemoral Pain Syndrome  

Kim, Je-Ho (Department of Physical Therapy, Graduate School, Sehan University)
Publication Information
The Journal of Korean Physical Therapy / v.28, no.2, 2016 , pp. 65-70 More about this Journal
Abstract
Purpose: The aim of this study was to determine the effects of electromyographic (EMG)-Biofeedback using closed kinetic chain exercise (EB-CKCE) on quadriceps angle (Q-angle) and quadriceps muscle activation and muscle activation ratio in subjects with patellofemoral pain syndrome and to provide fundamental information on rehabilitation exercise in patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included. The subjects were randomly divided into three groups: control group (Group I, n=10), semi-squat exercise group (Group II, n=10), and EMG-Biofeedback using closed kinetic chain exercise group (Group III, n=10). Intervention was provided to each group for eight weeks (three times per week; 30 minutes per day). Subjects were measured on Q-angle and quadriceps muscle activation. Results: Significant difference in Q-angle and quadriceps muscle activation was observed in groups II and III compared with control group I (p<0.01). Results of post-hoc analysis showed a significant difference in Q-angle and quadriceps muscle activation in on group III compared with groups I and II. Conclusion: Findings of this study suggest that closed kinetic chain exercise using EMG-Biofeedback that provides real-time biofeedback information on muscle contraction may have a beneficial effect on improvement of Q-angle and quadriceps muscle activation in patellofemoral pain syndrome.
Keywords
Patellofemoral pain syndrome; Q-angle; Quadriceps muscle activation; EMG-Biofeedback;
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1 Nijs J, Van Geel C, Van der auwera C et al. Diagnostic value of five clinical tests in patellofemoral pain syndrome. Man Ther. 2006;11(1):69-77.   DOI
2 Welsh C, Hanney WJ, Podschun L et al. Rehabilitation of female dancer with patellofemoral pain syndrome: Applying concepts of regional interdependence in practice. N Am J Sports Phys Ther. 2010;5(2):85-97.
3 Nha KW, Papannagari R, Gill TJ et al. In vivo patellar tracking: clinical motions and patellofemoral indices. J Orthop Res. 2008;26(8):1067-74.   DOI
4 Ramappa AJ, Apreleva M, Harrold FR et al. The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics. Am J Sports Med. 2006;34(5):749-56.   DOI
5 Kan JH, Heemskerk AM, Ding Z et al. DTI-based muscle fiber tracking of the quadriceps mechanism in lateral patellar dislocation. J Magn Reson Imaging. 2009;29(3):663-70.   DOI
6 Freedman BR, Brindle TJ, Sheehan FT. Re-evaluating the functional implications of the Q-angle and its relationships to in-vivo patellofemoral kinematics. Clin Biomech. 2014;29(10):1139-45.   DOI
7 Koh EK, Weon JH, Jung DY. Effects of activation of gluteus maximus and abdominal muscle using EMG Biofeedback on lumbosacral and tibiocalcaneal angles in standing position. J Kor Phys Ther. 2013; 25(6):411-6.   DOI
8 Yip SL, Ng GY. Biofeedback supplementation to physiotherapy exercise programme for rehabilitation of patellofemoral pain syndrome: A randomized controlled pilot study. Clin Rehabil. 2006;20(12):1050-7   DOI
9 Syme G, Rowe P, Martin D et al. Disability in patients with chronic patellofemoral pain syndrome: a randomised controlled trial of VMO selective training versus general quadriceps strengthening. Man There. 2009;14(3):252-63.   DOI
10 Freedman BR, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006;85(3):234-43.   DOI
11 Lee J, Lee H, Lee W. Effect of weight-bearing therapeutic exercise on the Q-angle and muscle activity onset times of elite athletes with patellofemoral pain syndrome: A randomized controlled trial. J Phys Ther Sci. 2014;26(7):961-4.   DOI
12 Ng GY, Zhang AQ, Li CK. Biofeedback exercise improved the EMG activity ratio of the medial and lateral vast muscles in subjects with patellofemoral pain syndrome. J Electromyogr Kinesiol. 2008;18(1):128-33.   DOI
13 Dutton RA, Khadavi MJ, Fredericson M. Update on rehabilitation of patellofemoral pain. Curr Sports Med Rep. 2014;13(3):172-8.   DOI
14 Miao P, Xu Y, Pan C et al. Vastus medialis oblique and vastus lateralis activity during a double-leg semi squat with or without hip adduction in patients with patellofemoral pain syndrome. BMC Musculoskelet Discord. 2015;12:289
15 Park S, Lee WJ, Park JW. Differences of onset timing between vastus medialis and lateralis during knee isometric contraction on individuals with genu varum or valgum. J Kor Phys Ther. 2014;26(1):9-14.
16 Park SK, Kang JY. Effects of EMG-Biofeedback training on functional ability and Q-angle in Patellofemoral pain syndrome. J Kor Phys Ther. 2014;26(2):68-73.
17 Fagan V, Delahunt E. Patellofemoral pain syndrome: A review on the associated neuromuscular deficits and current treatment options. Br J Sports Med. 2008;42(10):789-95.
18 Kwon YJ, Park SJ, Jefferson J et al. The effect of open and closed kinetic chain exercises on dynamic balance ability of normal healthy adults. J Phys Ther Sci. 2013;25(6):671-4.   DOI
19 Irish SE, Millward AJ, Wride J et al. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res. 2010; 24(5):1256-62.   DOI
20 Yilmaz OO, Senocak O, Sahin E et al. Efficacy of EMG-biofeedback in knee osteoarthritis. Rheumatol Int. 2010;30(7):887-92.   DOI
21 Dogan-Aslan M, Nakipoglu-Yuzer GF, Dogan A et al. The effect of eletromyographic biofeedback treatment in improving upper extremity functioning of patients with hemiplegic stroke. J Stroke Cerebrovasc Dis. 2012;21(3):187-92.   DOI
22 Coqueiro KR, Bevilaqua-Grossi D, Berzin F et al. Analysis on the activation of the VMO and VL muscles during semisquat exercise with and without hip adduction in individuals with patellofemoral pain syndrome. J Electromyogr Kinesiol. 2005;15(6):596-603.   DOI
23 Park SK, Kim JH. Effects of EMG-biofeedback training on total knee replacement patient’s lower extremity muscle activity and balance. J Kor Phys Ther. 2013;25(2):81-7.   DOI
24 Oravitan M, Avram C. The effectiveness of electromyographic biofeedback as part of a meniscal repair rehabilitation programme. J Sports Sci Med. 2013;12(3):526-32.
25 Kim DY, Kim SH, Lim YE et al. Effect of EMG Biofeedback training and taping on vastus medialis oblique for functional improvement of patient with patella malalignment. J Kor Phys Ther. 2008;20(3):35-44.
26 Yang DJ, Uhm YH, Kim JH. The biofeedback scapular stabilization exercise in stroke patients effect of muscle activity and function of the upper extremity. J Kor Phys Ther. 2015;27(5):325-31.
27 Park SK, Yang DJ, Park JM et al. Analysis of patellar tracking and Q-angle during semi-squat exercises. Kor J Sport Biomechanics. 2011;21(1):107-14.   DOI
28 Petersen W, Ellermann A, Gosele-Koppenburg A et al. Patellofemoral pain syndrome. Knee Surg Sport Traumatol Arthrosc. 2014;22(10):2264-74.   DOI
29 Pattyn E, Verdonk P, Steyaert A et al. Vastus medialis obliques atrophy: Does it exist in patellofemoral pain syndrome?. Am J Sports Med. 2011;39(7):1450-5.   DOI
30 Kim YK, Song JC, Choi JW et al. Functional electric stimulation-assisted biofeedback therapy system for chronic hemiplegic upper extremity function. J Kor Phys Ther. 2012;24(6):409-13.   DOI