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Knee extension test for assessing hamstring flexibility (넓적다리뒤근육의 유연성 측정을 위한 무릎폄 검사)

  • Wootaek Lim
    • Journal of Korean Physical Therapy Science
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    • v.30 no.1
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    • pp.31-40
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    • 2023
  • Hamstring flexibility is an important factor that affects muscle performance of the lower extremities and is closely associated with sports injuries. Therefore, evaluation of flexibility is important in clinical practice. Results of evaluation are determined by types of tests and cut-off values used; therefore, accurate and detailed understanding of these is necessary before examination. Although the straight leg raise and sit and reach tests are used to evaluate hamstring extensibility, structures including the nerves, fascia, and other muscles can significantly confound the results of these tests. The knee extension test is performed at 90° of hip flexion to minimize the posterior pelvic tilt that occurs during the straight leg test. The knee extension test is most recommended for selective evaluation of hamstring flexibility. The knee extension test is classified into active and passive tests. The cut-off value is usually set at 20° for the active and at 10° for the passive knee extension test. Although a strong association is observed between the two tests, the active knee extension test is preferred in clinical practice because it can be performed by a single examiner, which serves as an advantage. Age, sex, and warm-up exercise tend to affect flexibility; therefore, results should be interpreted with caution. Detailed understanding of each flexibility test is important for reliable evaluation.

Modifying a Back Endurance Test for Examining Erector Spine Muscles by Adding Lateral Trunk Bending and Trunk Rotation

  • Park, Se-Yeon;Park, Du-Jin
    • PNF and Movement
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    • v.15 no.3
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    • pp.381-387
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    • 2017
  • Purpose: Although some studies indicate that the Sorensen test may not be used to examine back muscles such as the erector spinae, alternatives to the back-extension test are rarely suggested. Therefore, the purpose of the present study was to investigate an effective way to stimulate the erector spinae muscles by adding a component of trunk rotation and lateral bending to general back extensions. Methods: A total of 18 healthy, physically active participants performed simple trunk extension, extension with trunk rotation, and extension with lateral bending. Surface electromyography responses of the latissimus dorsi, thoracic, and lumbar levels of the erector spinae; the gluteus maximus; and the biceps femoris muscles were investigated during these 3 conditions of modified back extension tests. Results: The simple trunk extension exercise caused significant increases in activity of the gluteus maximus and biceps femoris muscles as compared to the extension with rotation and lateral bending exercises. The extension with trunk rotation exercise showed significantly greater activation in the thoracic and lumbar levels of the erector spinae and in the latissimus dorsi as compared to the other exercises. The index measuring subjective difficulty was significantly lower in the simple trunk extension exercise as compared to the extension with trunk rotation and extension with lateral bending exercises. Conclusion: The present study suggests that extension with trunk rotation has the advantage of stimulating the para-spinal muscles, while simple trunk extension may not be adequate to selectively simulate the para-spinal muscles but may be appropriate for examining global trunk extensors.

The Effects of Hamstring Length on the Static Stance Balance Ability (슬괵근 길이가 정적 기립균형 능력에 미치는 영향)

  • Nam, Kun-Woo;Park, Dae-Sung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.45-54
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    • 2007
  • The purpose of this study was effect of hamstring length on one leg stance test(OLST) in 108 persons. (men 28, women 80). The active knee extension test(AKE) was applied 3 times on both leg and high score was selected. Then, one leg stance test(OLST) was applied 3 times on both leg and high score was selected. Also, persons divided two group that is normal hamstring length group and shortening group). The result were as follows : 1. The correlation analysis between Lt. hamstring length and one leg stance time was no significant relation($p_{Lt.}=0.271$, $p_{Rt.}=0.051$). 2. The correlation analysis between Rt. hamstring length and one leg stance time was no significant relation($p_{Lt.}=0.837$, $p_{Rt.}=0.334$). 3. The independent T -test between Lt. hamstring normal (knee extension > 150degrees) & shortening group (knee extension ${\leq}$ 150 degrees) in Lt. leg stance time was no significant difference(p=0.73), but in Rt. leg stance time was statistically significant difference(p=0.04). 4. The independent T-test between Rt. hamstring normal (knee extension > 150degrees) & shortening group (knee extension ${\leq}$ 150 degrees) in one leg stance time was no significant difference($p_{Lt.}=0.09$, $p_{Rt.}=0.16$).

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The Reliability Evaluation of TBN Valve Testing Extension in NPP (원자력발전소 터빈밸브 시험주기 연장시 신뢰도평가)

  • Lim, Hyuk-Soon;Lee, Eun-Chan;Lee, Keun-Sung;Hwang, Seok-Won;Seong, Ki-Yeoul
    • Proceedings of the KSME Conference
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    • 2007.05b
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    • pp.3221-3223
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    • 2007
  • Recently, nuclear power plant companies have been extending the turbine valve test interval to reduce the potential of the reactor trip accompanied with a turbine valve test and to improve the NPP's economy through the reduction of unexpected plant trip or decreased operation. In these regards, the extension of the test interval for turbine valves was reviewed in detail. The effect on the destructive overspeed probability due to the test interval change of turbine valves is evaluated by Fault Tree Analysis(FTA) method. Even though the test interval of turbine valves is changed from 1 month to 3 months, the analysis result shows that the reliability of turbine over speed protection system meets acceptance criteria of 1.0E-4/yr. This result will be used as the technical basis on the extension of the test interval for turbine valves. In this paper, the propriety of the turbine valve test interval extension is explained through the review on the turbine valve test interval status of turbine overspeed protection system, the analysis on the annual turbine missile frequency and the probability evaluation of the destructive overspeed due to the test interval extension.

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Characterization of In-plane Shear Behaviors of Woven Fabrics by Bias-extension and Trellis-frame Tests (편향 인장 및 트렐리스 시험에 의한 직물 복합재료의 면내 전단 물성 평가)

  • Lee, Won-Oh;Um, Moon-Kwang;Byun, Joon-Hyung;Cao, Jian
    • Composites Research
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    • v.23 no.5
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    • pp.8-14
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    • 2010
  • Three types of glass woven fabrics (plain, balanced twill, and unbalanced twill) having various sample sizes and aspect ratios were tested using the bias-extension tests. Real-time deformation images, force, and displacement data were collected. For the bias-extension test, the shear angle of the fabrics from the equation based on the crosshead displacement and fabric size was compared with direct manual measurements of the warp and weft angles as well as the optical measurement software. To determine the shear force, an analytical equation was introduced considering the kinematics of the bias-extension test. The obtained shear behaviors were further compared with the results by the trellis-frame test. The optical measurement methods showed that the mathematical method was reasonable before the shear angle of the fabrics reaches $30^{\circ}$ in the bias-extension tests. Also, the bias-extension test gave consistent behaviors with the trellis-frame test only for isotropic and homogeneous fabrics such as balanced plain and twill weaves.

The Reliability and Validity of the Passive Lumbar Extension Test and the Prone Instability Test (수동적 요추 신전 검사와 엎드린 상태에서 요추 불안정성 검사의 신뢰도와 타당도)

  • Sa, Jae-Min;Kim, Sun-Yeop
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.85-93
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    • 2011
  • The purpose of this study was to establish the reliability and validity of the passive lumbar extension (PLE) test and prone instability test (PIT). Thirty-three subjects (14 males, 19 females) with lower back pain enrolled in the study and the subjects were divided into 2 groups (positive and negative instability groups) on the basis of radiographies of flexion and extension. Reliability was determined by the kappa coefficient and validity was examined using calculated sensitivity, specificity, and the likelihood ratio. The results showed that the reliability of the PLE test was higher than the PIT (intra-rater reliability: k=.86 and k=.81, interrater reliability: k=.65 and k=.62) and the validity of the PLE test was also higher than the PIT (sensitivity: 91% and 62%, specificity: 95% and 85% positive likelihood ratio: 20.00 and 4.10, negative likelihood ratio: .10 and .45). In conclusion, we think that the PLE test was a more reliable and valid method for lumbar instability than the PIT.

Influence of successive active knee extension tests on hamstring flexibility (연속적 능동무릎폄 검사가 뒤넙다리근의 유연성에 미치는 영향)

  • Lim, Woo Taek
    • Journal of Korean Physical Therapy Science
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    • v.28 no.1
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    • pp.76-84
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    • 2021
  • Background: In clinical practice, active knee extension (AKE) test has been widely used to measure hamstring flexibility. During the AKE test, the knee extension is repeated six times. The first five repetitions are considered as warm-up, and the sixth is used as baseline. In order to accurately measure the subject's inherent flexibility, warm-up trials have been proposed as mentioned above; but currently, the evidence is insufficient. Design: Cross-sectional study. Methods: Forty-three healthy adults participated in this study. The AKE was performed slowly after flexing the hip and knee joints by 90° in a supine position. The knee was extended as far as could be done without causing discomfort or pain. When reaching the end range, knee flexion was performed without stopping. As per standard protocol, the subjects performed the knee extension six times. Results: There was no significant difference between the AKE value in the first trial with those in the other five trials. During the repetitions, the average value in the group with higher flexibility tended to decrease and the Intraclass correlation coefficient gradually decreased. Conclusion: Successive repetitions of the AKE test can misrepresent an individual's inherent hamstring flexibility. In order to avoid a decrease in hamstring flexibility, it is strongly recommended that individuals with high initial hamstring flexibility avoid unnecessary repetitions of the AKE test.

The Change of Strength of Trunk Flexion and Extension by Intervention of Taping on Abdominal and Back muscles (배부근과 복부근에 대한 테이핑 적용이 체간 굴곡, 신전 근력에 미치는 영향)

  • Gong, Won-Tae;Kim, Dong-Dae;Kim, Sang-Su
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.2
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    • pp.35-43
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    • 2009
  • Purpose : The purpose of this study was to measure the change of strength of trunk flexion and extension on abdominal and back muscles. Methods : Each taping group 1(n=14), taping group 2(n=14), taping group 3(n=14) and control group(n=15) were measured a muscle strength by Biodex at first test, second test, third test and forth test in 3 days. Results : The strength of trunk flexion and extension was significantly different among the experimental groups (p<.05). It also shows that significant increasing of muscle strength at 48 hours after application of taping (p<.05). Conclusion : In conclusion, we were found that taping technique base on taping type show immediately assistance of muscle strength and enduring effect for 48 hours.

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Reliability of the Modified - Modified $Sch{\ddot{o}}ber$ Methods for Measuring Lumbar Flexion and Extension ROM (요부굴곡과 신전관절범위측정을 위한 MMS방법 신뢰도)

  • Kim, Tae-Suk;Cho, Jung-Sun;Park, Young-Han
    • Journal of Korean Physical Therapy Science
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    • v.2 no.4
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    • pp.763-770
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    • 1995
  • The primary purpose of this study was to determine the reliability of lumbar flexion and extension range-of -motion measurements obtained with the modified -modified $Sch{\ddot{o}}ber$ methods on normal and subjects with low back pain. Sixty two, aged 20 to 30 years(x = 22.0, SD = 2.07), with normal and twenty two, aged 14 to 66 years(x = 35.6, SD = 15.88) with chronic low back pain were measured by two physical therapist with 3 to 10 years (x = 6.5) of clinical experience. The therapist used the modified-modified $Sch{\ddot{o}}ber$(MMS) techniques to measure, in random order and on two occasions, the subjects' lumbar flexion and extension. For therapist 1, Intraclass correlation coefficients(ICC) for test-retest reliability for normal varied .9923, .8802(flexion, extension). and low back pain pateint varied .9950, .9313(flexion, extension). For therapist 2. ICC. for test-retest reliability for normal varied .9903, .8921(flexion, extension). and low back pain pateint varied .9843, .9551(flexion, extension). Interrater reliability for normal varied .9477, .6960(flexion, extension) and low back pain pateint varied. 9776, .7576(flexion, extension). Thus the MMS. method appears to be a reliable method for normal and patient with low back pain.

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A study of variation level for each region changed in trunk at sagittal plane after Trunk Flexion-Extension Exercise (체간 굴곡-신전운동 후 체간 각 부위 별 시상면 높이변화에 대한 조사)

  • Kim, Keun-Jo;Lee, Cu-Rie;Jung, Byeong-Ok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.1-15
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    • 2008
  • Purpose : This survey was to investigate on the effect of each region changed in trunk through sagittal plane after Trunk Flexion-Extension Exercise. Methods : 18 students of Gimcheon College participated in this study for the period of July 9-30, 2007. Analyzed factor were 1) degree of pain 2) presence of Gillet test and 3) difference of right-left for 7 landmark region in trunk applying I.B.S.-2000 after Trunk Flexion - Extension Exercise. We used the SPSS $PC^+$ program for classifying into analysis of frequency, $x^2$-test, t-test and Simple Linear Regression analysis test. Results: Followings are concluded For degree of pain, 13(72.2%) of students answered "No pain" after Trunk Flexion-Extension Exercise and in the result 4 more students decreased the pain. In the Gillet test, 14(77.8%) of students answered "positive" after Trunk Flexion-Extension Exercise and in the result 4 more students increased mobility of Sacroiliac joint. In the differences of right-left for 7 landmark region in trunk by B.M.I. scale, Slim type was decreased both Acromion(0.45mm), both Iliac crest(0.44mm), and both ASIS(0.31mm) to anterior plane, Normal type was decreased both inferior angle of Scapular(0.02mm), both L4-5(0.07mm), and both PSIS(0.09mm) to posterior plane Fatness type was decrease both Acromion(0.05mm), both ASIS(0.05mm) to anterior plane. In the differences of right-left for 7 landmark region in trunk for degree of pain No pain group was decreased both Acromion(0.17mm), both Nipple(0.25mm) to anterior plane and both PSIS(0.13mm) to posterior plane Pain group was decreased both Acromion(0.04mm), both Iliac creast(0.03mm) to anterior plane and both inferior angle of Scapular(0.18mm) both PSIS(0.13mm) to posterior plane. In the difference of right-left for 7 landmark region in trunk for each of the exercises, Both iliac crest(0.1mm), both ASIS(0.12mm) to anterior plane were decreased after Flexion Trunk Exercise. Both acromion(0.27mm) to anterior plane, both inferior angle of scapular(0.14mm) and both PSIS(0.12mm) to posterior plane were decreased after Extension Trunk Exercise. Each of the exercises, The both inferior angle of Scapular showed high scores($0.65{\pm}0.23$) at Trunk Extension Exercise group and there was statistical significance between Trunk Flexion Exercise group and Extension exercise group(t :-2.502, p < 0.05). 7. At Pre-exercise group, Both inferior angle of Scapular showed low scores($0.23{\pm}8.27$) at Trunk Extension Exercise group and there was statistical significance between Pre- Exercise group and Trunk Extension Exercise group(t :-2.5430, p<0.05). Conclusion : The simple linear regression analysis was presented at Acromion(-0.243), L4-5(-0.753), PSIS(0.576) and there was statistical significance in BMI scale(p<0.01).

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