• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.339-348
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• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• Physical Therapy Korea
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• v.26 no.3
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• pp.91-98
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• 2019

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

• The Journal of Korean Physical Therapy
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• v.21 no.1
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• pp.57-63
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• 2009

Purpose: We determined the recruitment pattern of lumbar elector spinalis, gluteus maxims, inner and outer hamstring muscle during trunk flexion and extension. Methods: Thirty healthy subjects(male; 15, female; 15) without low back pain and other problems in lower extremities participated in this study. To measure the recruitment pattern, the onset times of electromyographic activity of the muscles were recorded during trunk flexion and return(extension) to standing position. Results: The medial and lateral hamstring muscle was activated first, next elector spinalis, the last, gluteus maximus in trunk flexion. In trunk extension to standing position, the order of recruitment was similar to trunk flexion although the frequency is different. There were different between male and female in flexion and extension movement. Conclusion: The recruitment order of lumbar extensor and hip extensors in trunk flexion and extension will provide database in evaluation and intervention of lower back pain and lumbo.pelvic rhythm disorder.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.23-32
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• 2017

PURPOSE: Flexibility and range of motion are very important factors in sports performance, rehabilitation, and musculoskeletal pain. The purpose of this study was to measure the effects of cupping therapy on flexibility, muscle activity, and pain threshold of hamstring muscle compared to passive stretching in healthy subjects. METHODS: Thirty healthy subjects were randomly assigned in a crossover design to cupping therapy and passive stretching. Subjects were tested to compare their effects according to the intervention such as Passive range of motion (PROM) (straight leg raising) and active range of motion (AROM). And algometer (pain) testing and MVC assessment using EMG were performed as dependent variables. RESULTS: The cupping therapy group and passive stretching group showed significant differences in all variables including PROM (p=.00, p=.00), AROM (p=.00, p=.03), Pain Threshold (p=.03, p=.08), Semitendinosus MVC (p=.01, p=.00), and Biceps femoris MVC (p=.01, p=.16). There were no significant differences between the two groups in all variables. CONCLUSION: These findings of this study suggested that cupping therapy has as much positive effect on flexibility, pain threshold, and muscle contraction as passive stretching. Also, it is more convenient and easier to work on patients than passive stretching. Therefore, cupping therapy should be considered as another option to treat range of motion, pain, and muscle activity in the clinical field.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.47-52
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• 2009

Purpose: To examine the correlation between the gait speed and muscle activation or foot pressure in stroke patients. Methods: Twenty five functionally ambulant stroke patients (male/female: 15/10, mean age: $57.65\pm2.30$) were enrolled in this study. The patients were asked to walk on a plate at a self-selected and comfortable speed. Three walking trials were obtained and then averaged for data analysis. The gait speed and foot pressure were measured from a RS-Scan system. Activation of the quadriceps femoris muscle and biceps hamstring muscle (%RVC) were recorded using ProComp $Infiniti^{TM}$. Results: There was a significant positive correlation between Hamstring muscle activation (%RVC) and gait speed. The gait speed correlated with the foot pressure of the lateral metatarsal zone (M3-5) in the affected side. There was a correlation between the gait speed and the foot pressure of the lateral metatarsal (M3-5) and heel (medial, lateral) zone in the less-affected side. Conclusion: The gait speed is related to hamstring muscle activation and the characteristics of foot pressure. This information was observed in both the affected and less-affected sides, suggesting that rehabilitation programs should be implemented on both sides.

• Physical Therapy Korea
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• v.25 no.4
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• pp.46-52
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• 2018

Background: The hamstring muscles in the lower extremity are highly important for knee joint stability and can be classified into medial and lateral hamstrings according to the anatomical position, which have some different functions. To measure the strength of the individual hamstring muscles, manual muscle testing is clinically performed by dividing rotation postures into internal and external postures. However, this has no sufficient scientific background. Objects: This study aimed to test the difference that the tibial rotation would cause in the muscle activity of the medial and lateral hamstrings. Methods: The muscle activities of the biceps femoris, semitendinosus, and semimembranosus were measured in a total of three different postures (neutral position and internal and external rotations) with 3 replications. During the maximal isometric contraction, resistance was constantly provided by the string attached to the strap, not by manual resistance of the examiner. Before and after electromyography measurements, the participants underwent hamstring flexibility measurement using the active knee extension test in the supine position on the treatment table. Results: The semitendinosus had a 12.56% reduction in muscle activity in external rotation as compared with that in neutral position. The biceps femoris and semimembranosus showed reduced muscle activities in both external and internal rotations as compared with those in neutral position. Only the women showed significant decreases in the comparison between pre and post-active knee extension. Conclusion: Only the semitendinosus muscle was consistent with the anatomical speculation. However, the reduction in the muscle activity of the semitendinosus as compared with that in neutral position was only 12.56%, the clinical value of which may be difficult to justify.

• PNF and Movement
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• v.21 no.3
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• pp.291-298
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• 2023

Purpose: This study aimed to suggest an effective exercise for treating anterior cruciate ligament (ACL) and hamstring injuries based on the dynamic control ratio (DCR) for the hamstring and quadriceps during eccentric hamstring exercises. Methods: Twenty-four healthy participants participated in this study. The participants performed three eccentric hamstring exercises, including the Nordic exercise, the supine leg curl, and single-leg deadlifts. During the eccentric hamstring exercises, the vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) were measured using surface electromyography. Results: The DCR was significantly lower during the supine leg curl and single-leg deadlift than during the Nordic exercise (p < 0.05). The activity of the VMO and VL was significantly greater during the supine leg curl than during the Nordic exercise and the single-leg deadlift (p < 0.05). VL activity was significantly higher during the single-leg deadlift than during the Nordic exercise (p < 0.05). ST activity was significantly higher during the supine leg curl and Nordic exercise than during the single-leg deadlift (p < 0.05). BF activity was significantly higher during the supine leg curl than during the Nordic exercise and single-leg deadlift (p < 0.05). Finally, the BF showed significantly higher activity during the Nordic exercise compared to during the single-leg deadlift (p < 0.05). Conclusion: Based on the DCR ratio and quadriceps activity, the supine leg curl should be introduced early in rehabilitation for ACL injuries.

• Journal of Korean Physical Therapy Science
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• v.12 no.4
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• pp.69-77
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• 2005

The purpose of this study is to estimate how much the motility of affected and unaffected lower limb respectively would have effects on their ambulation through comparing the difference between their affected and unaffected lower limb and studying the correlation between such difference and their ambulation. In addition, the study also intends to find out remedial measures suitable for improving their ambulation with relevant physical treatment. To do this, a quantitative electromyogram(QEMG) test was done to hamstring of affected and unaffected lower limb so as to yield IP values. Based on such IP values, RMS(root mean square) values as the total sum of IP values were found with QEMG analysis system (made by Medelec Co.) and then the ambulation depending on the difference in muscular strength were analyzed by ink-foot print method as well as the corresponding statistics were processed by T-test through SPSS. The differences in muscular strength of hamstring in unaffected limbs of hemiplegic patients only affect stride length. It was statistically significant. The effect of difference in muscular strength of the hamstring in affected limb of hemiplegic patients on their ambulation was very different between strong and weak group in terms of walking velocity, step per minute, stride and step length, showing statistically significant difference(p<.05). Although there was a difference in the step length of the affected limb, it was not statistically significant(p>.05). For the unaffected hamstring, there were significant differences of stride length between in unaffected limb and in affected limb. For the affected hamstring, there were also significant differences in walking velocity, step per minute, stride and step length. Besides, it was found that the difference of the muscular strength between strong and weak group was at the highest.

• Physical Therapy Korea
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• v.28 no.3
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• pp.215-226
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• 2021

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

• PNF and Movement
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• v.22 no.1
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• pp.55-70
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• 2024

Purpose: The purpose of this study was to investigate the effects of three relaxation techniques, namely, Static Stretching Exercise (SSE), Eccentric Contraction Exercise (ECE), and Suboccipital Muscle Release (SMR) on the flexibility and balance of the lower limb in adults with hamstring shortening. Methods: The participants were 45 adults in their 20s with hamstring shortening. They performed three exercises (i.e., SSE, ECE, and SMR) for two weeks. We measured flexibility, muscle tone and stiffness, proprioception, and balance before and after the intervention, applying each relaxation technique. Data were analyzed using two-way repeated measures analysis of variance (ANOVA). The significance level was set at α=0.05. Results: Flexibility increased in the SSE, ECE, and SMR groups, with the SSE group showing the greatest improvement. Muscle tone and stiffness decreased in all groups, with the ECE group exhibiting the highest reduction. Proprioception increased in the SSE, ECE, and SMR groups, with SSE demonstrating the greatest enhancement. Balance also increased in all groups, with the ECE group showing the most pronounced improvement. Conclusion: Overall, all three relaxation techniques for hamstring shortening resulted in improved flexibility, muscle tone and stiffness, proprioception, and balance of the lower limb in adults with hamstring shortening. The findings of this study underscore the importance of selecting an appropriate technique according to the purpose of treatment and the condition of the patient.