• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.1
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• pp.55-61
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• 2013

Background: The purpose of this study was to investigate the immediate effects of mulligan's straight leg raise with traction technique on angle of passive straight leg raise and length of hamstring muscle in patients with low back and radiate pain. Methods: Thirty one subjects participated in this study. The subjects were assigned to either the low back pain group (n=17) or the radiate pain group (n=14). Subjects in both groups received 3 times mulligan's straight leg raise with traction. All subjects were examined for the range of motion of lower extremity. The range of motion of lower extremity was composed of angle on straight leg raise and 90-90 straight leg raise. The range of motion of lower extremity was measured using a goniometer. Results: After 3 times of mulligan's straight leg raise with traction, significant improvements on the angle of straight leg raise and 90-90 straight leg raise were observed in the both groups (p<.05). However, there are no significant difference was observed between groups. Conclusion: These results suggest that mulligan's straight leg raise with traction provides an immediately effective in range of motion of lower extremity in patients with low back pain as well as radiate pain. Although more research is required on the effects of long-term mulligan's straight leg raise with traction on range of motion of lower extremity, our results can be useful to establish the standard parameters for range of motion of lower extremity in the clinical setting.

• 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.

• Physical Therapy Korea
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• v.27 no.1
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• pp.30-37
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• 2020

Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

• PNF and Movement
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• v.10 no.4
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• pp.71-76
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• 2012

Purpose : The purpose of this study was to examine the effects of PNF of irradiation using an indirect treatment of the stroke patient's static weight support and walking speed. Methods : Was carried out a total of nine different the PNF method of treatment for patients with left hemiplegia stroke. PNF of treatment is not in the non-paralyzed side of the trunk and upper and lower extremities by applying resistance and increased strength of the affected side. Assessment of treatment weight support both feet measured and modified using the timed up and go test were compared before and after treatment. Results : Treatment of the paralyzed side of the quadriceps and hamstring, gluteus medius muscle strength increased, and both sides of the foot body weight support improved walking speed was increased. Conclusion : Irradiation using PNF indirect treatment improves the function of the gait of stroke patients.

• Korean Journal of Applied Biomechanics
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• v.20 no.1
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• pp.13-23
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• 2010

The purposes of this study was to investigate the biomechanical influence of the walking shoe with a plate spring in the heel and interchangeable heel cushioning elements. Eighteen subjects walked in three conditions: 1) the walking shoes Type A-1 with a soft heel insert, 2) the Type A-2 shoe with a stiff heel insert, 3) a general walking shoe(Type B). Ground reaction forces, leg movements, leg muscle activity and ankle, knee and hip joint loading were measured and calculated during overground walking. During walking, the ankle is a few degrees more dorsiflexed during landing and the knee is slightly more flexed during takeoff with the Type A shoes. As a result of the changes in the walking movement, the ground reaction forces are applied more quickly and the peak magnitudes are higher. Muscle activity of the quadricep, hamstring and calf muscles decrease during the first 25% of the stance phase when walking in the Type A shoes. The resultant joint moments at the ankle, knee and hip joints decrease from 30-40% with the largest reductions occurring during landing.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.455-464
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• 2011

Purpose : This study is to investigate difference in the isometric muscular function of knee joints according to the time of participation in rehabilitation exercise in patients who had anterior cruciate ligament reconstruction. Methods : The subjects of this study were patients by sports injury or accident in the sports rehabilitation center of G hospital. The early exercise program group (n=7) started functional ability exercise from 2 weeks after the surgery and the late exercise program group (n=7) from 6 weeks after the surgery. Statistical analysis was used repeated measure ANOVA to test mean difference by using SPSS 18.0 for windows. Results : First, as to quadriceps femoris muscle according to the time of participation in exercise program, significant difference was observed according to interaction and time. Second, as to hamstring muscle according to the time of participation in exercise program, significant difference was observed in muscle strength according to time. Conclusion : This results suggest that if the effect of exercise program is similar between the early starting group and the late starting group, it is not necessary to have a long period of fixation as in the late exercise program group but is desirable to start functional ability exercise early in order to relieve pains in the knee joints.

• Korean Journal of Applied Biomechanics
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• v.30 no.3
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• pp.275-283
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• 2020

Objective: The purpose of this study was to investigate the effect pf flexibility of hip flexor muscles on a conventional deadlift movement. Method: Eighteen healthy male were participated in this study and were divided into normal group (NG: age: 24.0±1.8 yrs, height: 174.5±2.37 cm, body mass: 74.4±5.5 kg, 1RM: 138.0±23.8 kg) and restricted group (RG: age: 24.6±1.7 yrs, height: 171.5±5.3 cm, body mass: 74.0±5.7 kg, 1RM: 137.5±18.3 kg) by Thomas test, which measure flexibility of hip flexor muscles. A 3-dimensional motion analysis with 8 infrared cameras and 3 channels of EMG was performed in this study. A two-way ANOVA (group x load) with repeated measure was used for statistical verification. The significant level was set at α=.05. Results: RG revealed significantly increased muscle activation in erector spinae on 70% and 90% of 1RM and decreased muscle activation in gluteus maximus on 90% of 1RM compared to NG (p<.05). For the muscle activation ratio for agonist to synergist, erector spinae showed the difference in 90% of 1RM while hamstring was observed differences in all loads (p<.05). Conclusion: Our results indicated that hip flexibility affects conventional deadlift movement. Therefore, it is necessary to assess the flexibility of the hip flexor muscles before performing the movement and, as needed, to train to address the lack of flexibility.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.101-106
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• 2015

PURPOSE: Application of an oscillating program for the lower extremities is an effective training method for increasing muscle strength. However, no oscillatory program has yet been identified to confirm the effectiveness of oscillation for balance ability and maximum muscle strength. We investigated the effects of an 8-week vibration exercise program on the maximum muscle strength and balance of the lower extremities. METHODS: Research subjects participating in the study were 22 male and female college students with no past history of diseases of the nervous or musculoskeletal systems. All subjects were randomly divided into two groups and performed their assigned experimental treatment 3 times a week over a period of 20 min for 8 weeks. Maximum strength of the quadriceps extension, flexion, and balance ability were measured using Biodex System 4 and Biodex balance systems. RESULTS: The 8-week oscillation program resulted in a significant increase in quadriceps extension and flexion strength in both male and female participants (p<.05). The balance ability also showed a significant improvement after the oscillation program (p<.05). The balance value was higher for male 17% than for female 21% (p<.05) participants. CONCLUSION: An 8-week oscillation program led to an increase in the strength of knee flexion and extension. The balance ability also improved significantly. This positive effect on balance ability was higher in female than in male subjects.

• Journal of Life Science
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• v.14 no.3
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• pp.484-489
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• 2004

Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.21-25
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• 2002

Purpose: To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw, which is newly designed for fixation of graft into femur. Materials and Methods: Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon and LA screw were included in this study. The graft was fixed with LA screw at femoral tunnel and with only bioabsorbable interference screw at tibial tunnel. The mean follow-up period was 28 months. The clinical results were evaluated by physical examination and Lysholm knee score. Widening of bony tunnel and anterior laxity difference compared with normal side by instrumented anterior laxity test with Telos(R) (Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results: The Lysholm knee score improved from 60.0 points preoperatively to 94.0 points at last follow up. On the Lachman test, there were mild (+) instability in 16 cases, moderate (++) in 24,severe (+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at postoperative follow up. On instrumented anterior laxity test with Telos(R), difference between normal and affected knee on 20 lb was 12.9 mm in average preoperatively, and was decreased to 3.1mm at last follow-up. The femoral tunnel was widened from 10.6 mm postoperatively to 12.7 mm (21.1$\%$) at follow up on antero-posterior plane and from 10.7 mm to 12.4 mm (16.5$\%$) on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm (20.7$\%$) on antero-posterior plane and from 9.9mm to 11.7 mm ($18.9\%$) on lateral plane. Complications were: anterior knee crepitus in 17 case, quadriceps muscle atrophy(>3 cm) in 6, penetration of screw over the lateral femoral cortex in 5, saphenous nerve paresthesia in 2.Conclusions: ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixation devices in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel and anterior knee pain