• Physical Therapy Korea
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• v.27 no.4
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• pp.241-249
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• 2020

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.

• Korean Journal of Applied Biomechanics
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• v.19 no.4
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• pp.617-625
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• 2009

The primary purpose of this study was to compare the hamstring-to-quadriceps strength(H/Q) ratios in collegiate soccer players and normal age-matched healthy students, and the secondary purpose was to investigate the changes in the H/Q ratio according to the degree of knee flexion. Twenty-five subjects volunteered to participate in this study. The study group comprised 12 healthy male collegiate soccer players, and the control group, 13 healthy age-matched male collegiate students. The modified N-K table was used for isometric strength measurement(unit: N). Mann-Whitney tests were performed to determine the differences in the H/Q ratios of soccer players and age-matched students at different knee flexion angles of the dominant leg. The strength of the hamstring muscle in the study group was significantly lower than that observed in the control group at knee flexion angles of $60^{\circ}$ (p<.001), $90^{\circ}$ (p<.01), and $120^{\circ}$ (p<05). The strength of the quadriceps muscle in the study group was significantly higher than that observed in the control group at flexion angles of $30^{\circ}$ (p<.001) and $60^{\circ}$ (p<.05). The H/Q ratios in the study and control groups differed significantly at all angles ($60^{\circ}$, p<.001, $90^{\circ}$, p<.001 and $120^{\circ}$, p<.001).

• Physical Therapy Korea
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• v.12 no.1
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• pp.45-54
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• 2005

The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.297-308
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• 2011

The purpose of this study was to investigate the relationship among isometric and isokinetic muscle strength, lean body mass(LBM) and bone mineral density(BMD) in the elderly. Eleven males(age, 70.27${\pm}$5.78yr; height, 167.36${\pm}$6.68 cm; weight, 68.34${\pm}$8.23 kg) and thirteen female(age, 69.77${\pm}$4.13yr; height, 152.80${\pm}$4.45 cm; weight, 56.86${\pm}$7.40 kg) participated in this study. In all subjects, LBM and BMD segments was measured by using Dual-energy x-ray absorptiometry(DEXA, Lunar DPS-DM, U.S.A.). Maximum isometric and isokinetic muscle strength of flexion and extension at the knee and elbow, ankle, trunk joints were measured by using an isokinetic dynamometer(CON-TREX(R) Multi Joint Testing Module, Switzerland). The results of this study showed that isometric and isokinetic muscle strength was significantly higher in extension than flexion. In the male and female, hamstring to quadriceps strength ratio(H:Q ratio) was increased as contraction velocity increased. BMD was correlated significantly with trunk extension in the male, but not in the female. LBM was correlated significantly in the male and female with knee extension strength. This study suggests that in the elderly muscle strength training program should put more weight on extensor muscles of the body.

• Physical Therapy Korea
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• v.26 no.2
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.