Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.
Background: The purpose of this study was to investigate the influence of short-term treadmill walking with high-heeled shoes on electromyography activities of the medial gastrocnemius, lateral gastrocnemius and tibialis anterior in healthy young females. Methods: Fifteen healthy females were recruited for this study. To measure muscle activation, the subjects were asked in random order to walk on a treadmill using either high-heeled shoes or barefoot conditions. The shoe heel height for high-heeled walking was 7 cm. The walking speed on the treadmill was 4 km/h, and the inclination rate of the treadmill was 10%. The subjects performed treadmill walking in the barefoot and high-heeled walking conditions for 5 minutes. Electromyography data were collected from the tibialis anterior, medial gastrocnemius, lateral gastrocnemius, and soleus on both firm and foam surfaces and during eyes-open and-closed conditions while standing. Results: Tibialis anterior activity was significantly different before and after the walking task while standing on a foam surface with eyes closed (p<.05). Conclusion: This finding suggests that the activity of the tibialis anterior may be lowered after high-heeled walking. Therefore, high-heeled shoes contribute to harmful effects at the ankle joints, increasing the risks of falling and musculoskeletal injury.
Purpose: We investigated how nerve mobilization influence ankle plantar flexor muscles of the affected lower extremity on the spasticity in stroke patients. Method: Total 12 patients were recruited, who had spasticity on ankle of the affected lower extremity, and applied nerve mobilization on the sciatic and tibial nerves in supine position. H-reflex was measured using EMG equipment, detected the ratio of maximum H/M and H-reflex latency, and compared the changes before, during, right after, 5 minutes after and 10 minutes after the application of nerve mobilization. The data were analyzed using repeated measure ANOVA to compare the changes in length of time. Results: In comparison with the ratio before nerve mobilization, the ratio of maximum H/M was significantly decreased during nerve mobilization(p<0.05), and it tended toward recovery right after, 5 minutes after and 10 minutes after applying nerve mobilization, there was no statistically significant difference(p>0.05). In comparison with the ratio before nerve mobilization, the ratio of maximum H/M was most significantly decreased during the first 10 seconds after nerve mobilization and it tended toward recovery gradually(p<0.05). In comparison with the H-reflex latency before nerve mobilization, it was significantly increased during nerve mobilization(p<0.05) and it was decreased right after nerve mobilization, After 5 and 10 minutes, it had a tendency toward recovery but it revealed no statistically significant difference (p>0.05). Conclusion: It is considered that nerve mobilization could contribute to initial rehabilitation with stroke patients for relieving spasticity and nerve contracture.
The aim of this study was to investigate the effect of resistance training with and without whole-body vibration(WBV) on the biomechanical properties of the plantarflexor in the elderly women (>60 yrs., n=35). Thirty-five volunteers were randomly assigned to a resistance training with WBV group (RVT, n=14), a resistance training without WBV (RT, n=11), and a non-training control group (CON, n=10). The RVT and the RT groups participated in the training sessions three times a week for 8 weeks, followed by a 4-week detraining period. The CON group was instructed to refrain from any type of resistance training. To assess strength and activation of the plantarflexor muscles, maximum isometric ankle plantarflexion torque and muscle activation of the triceps surae muscles were measured using dynamometry, twitch interpolation technique and electromyography at four different ankle joint angles. Also, the lower extremity function was assessed by vertical jumping. The measurements were performed prior to, 2 and 8 weeks after the training and after a 4-week detraining period. Following the 8-week training sessions, an increase in the isometric plantarflexion strength was found to be greater for the RVT compared with the RT group (p<.05). Muscle inhibition was significantly decreased after training than before training only for the RVT (p<.05). Following the detraining period, a decrease in isometric plantarflexors strength and a increases in muscle inhibition were significantly less in the RVT compared with the RT group. In conclusion, the exercise with WBV is a feasible training modality for the elderly and seems to have a boosting effect when used with conventional resistance training.
Objective: The aim of this study was to determine the peak torques of the knee and ankle joint and local stability of the lower extremity's joints, and muscle activation patterns of the lower extremity's muscles between fallers and non-fallers in the elderly women during walking. Method: Four elderly women (age: $74.5{\pm}5.2yrs.$; height: $152.1{\pm}5.6cm$; mass: $55.3{\pm}5.4kg$; preference walking speed: $1.19{\pm}0.06m/s$) who experienced falls within six months since experiment had been conducted (falls group) and thirty-six subjects ($74.2{\pm}3.09yrs.$; height: $153.6{\pm}4.9cm$; mass: $56.7{\pm}6.4kg$; preference walking speed: $1.24{\pm}0.10m/s$) who had no experience in falls (non-falls group) within this periods participated in this study. They were measured torque peaks of the knee and ankle joint using a Human Norm and while they were walking on a treadmill at their natural pace, kinematic variables and EMG signals were collected with using a 3-D motion capture system and a wireless EMG system, respectively. Lyapunov Exponent (LyE) was determined to observe the dynamic local stability of the lower extremity's joints, and muscles activation and their co-contraction index were also analysed from EMG signals. Hypotheses between falls and non-falls group were tested using paired t-test and Mann-Whitey. Level of significance was set at p<.05. Results: Local dynamic stability in the adduction-abduction movement of the knee joint was significantly lower in falling group than non-falling group (p<.05). Conclusion: In conclusion, muscles which act on the abduction-adduction movement of the knee joint need to be strengthened to prevent from potential falls during walking. However, a small number of samples for fallers make it difficult to generalize the results of this study.
Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.
The purpose of this study was to investigate whether there were improvements on balance when both ankle-jointed calf muscles and hip muscles, which affect balance capabilities, were activated through taping techniques and EMS. In this study, the One Leg Standing Test, a static balance test, was conducted by experimenting on a flat floor, foam pad, and a stretching board with a gradient of 20 degrees, respectively, to study static balance capabilities in different situations. Nine healthy men in their 20s were measured five times every five minutes considering muscle fatigue, and the difference between each variable was analyzed through post-test using nonparametric statistical analysis. Our results showed an equal increase in static balance capability was similar when EMS was applied only to calf muscles and only to hip muscles. Notably most improvements were seen when wearing calf supporters and taping technology pants, and applying EMS together. It was also found that the difference between EMS electric stimulation and balance capability was greater when wearing and applying supporters and taping technology pants. Based on the results of the present study, a muscle support band and EMS of taping techniques can improve balance capabilities. These findings are expected to form a basis for solutions Improving the balance capabilities
Purpose: Leg-crossing sitting is very common for men and woman. No solid evidence exists for either a beneficial or a detrimental effect of this posture. This study investigated the change of activities of trunk muscles between the normal group and the low back pain group during various leg-crossing positions. Methods: The subjects were consisted of 10 subjects who don't have low back pain and 10 subjects who have low back pain. In this study, we used electromyography(EMG) to evaluate the activities of both the trunk muscles (rectus abdominis, external oblique, internal oblique, and multifidus) during various leg-crossing positions (up-right, leg-crossing, tailor-crossing, and ankle-crossing). We analyzed the data by using repeated one way ANOVA. Results: In normal group, there were increased in EMG activities of trunk muscles, but no significant differences during leg-crossing positions. In back pain group, there were increased in EMG activities of right external oblique, left. internal oblique, and both multifidus muscles in leg-crossing and tailor-crossing position, but no significant differences during leg-crossing positions. There was no significant difference of muscle activity of trunk muscles between the back pain group and the normal group. Conclusion: We suggest that low back pain people who have weak muscles of rectus abdominis, external and internal oblique are often experienced in leg-crossing posture than normal. To compensate this unstability of trunk, leg-crossing posture is substituted passive structure for activities of active muscle.
PURPOSE: The imbalance of pretibial muscles can be a factor contributing to the development of pes planus. However, no study has yet compared the muscle activity of the tibials anterior (TA) to that of the extensor digitorum longus (EDL). The purpose of this study was to determine whether there are differences in the electromyographic (EMG) TA and EDL amplitude indexes (AIs) between normal and pes planus feet. METHODS: A total of 14 subjects with normal feet and 15 subjects with bilateral pes planus participated in this study. TA and EDL muscle activities were measured using a wireless EMG system and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured using a universal goniometer during active ankle dorsiflexion in the prone position. AI was calculated as follows: $\text{amplitude_{TA}-amplitude_{EDL}/(amplitude_{TA}+amplitude_{EDL})}/2{\times}100$. RESULTS: The AIs of the TA and EDL were significantly lower in pes planus feet than in normal feet (p<.05). The angle of subtalar eversion was significantly greater in pes planus feet than in normal feet during active ankle dorsiflexon (p<.05). However, there was no significant difference in the angle of ankle dorsiflexion between normal feet and pes planus feet (p>.05). CONCLUSION: This study showed that TA muscle activation was lower in pes planus feet than in normal feet, resulting from greater eversion range of motion during active ankle dorsiflexion. We suggest that the imbalance of ankle dorsiflexors must be considered in pes planus management.
PURPOSE: This study compared the effect of performing gastrocnemius stretching with and without the self-myofascial release of the sole on the active and passive ankle dorsiflexion angles and muscle tone of the gastrocnemius muscle in subjects with short gastrocnemius muscle. METHOD: A total of 23 subjects with short gastrocnemius muscles were included in this study. The study participants were divided into two experimental groups. Group A performed gastrocnemius muscle self-stretching exercises only, while group B performed self-myofascial release of the sole using a massage ball after the gastrocnemius muscle self-stretching exercises. For both groups, the active and passive ankle dorsiflexion angles were measured using a goniometer, and the tone of the gastrocnemius muscle was assessed using the MyotonPRO®. RESULTS: Within-group comparison showed that the participants in both groups A and B had significantly increased active and passive ankle dorsiflexion angles and decreased gastrocnemius muscle tone (p < .05) after performing their respective exercises. However, no significant differences in the said criteria were observed between groups A and B (p>.05). CONCLUSION: The results of this study showed that both methods were effective in increasing active and passive dorsiflexion angles and decreasing muscle tone. Thus, it is recommended to tailor gastrocnemius stretching exercises according to the patient's condition. If the patient does not experience discomfort in the plantar fasciae, it is recommended to perform the gastrocnemius stretching exercise only without myofascial release and use a massage ball afterward.
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