The purpose of this study was to examine the isokinetic moment of quadriceps and hamstring strength ratio among women of different ages. The study population consisted of 1,184 women referred to the Health Promotion Center at the S district. All subjects were aged 20 to 69 years old and divided into 5 groups; 20s (n=248), 30s (n=255), 40s (n=248), 50s (n=228), and 60s (n=205). The strength of the knee extensor and flexor, quadriceps, and hamstring of all the participants were assessed at 60 degrees/second with an isokinetic machine. We calculated the peak torque, peak torque %BW (%Body Weight), deficit of peak torque and hamstring/quadriceps ratio of the knee. The data were analyzed by one way ANOVA to investigate statistical differences in strength variation between different age groups and were computed by ${\Delta}%$ difference from women in their 20's. The results were obtained as follows: 1. Peak torque of the knee extensor, quadriceps, were significantly reduced in women older than 30, but peak torque of the knee flexor, hamstring, were significantly reduced in women older than 50 compared to women in their 20's. (p<.05). 2. Peak torque %BW of the knee extensor, quadriceps, were significantly reduced in women older than 20, but peak torque %BW of knee flexor, hamstring, were significantly reduced in women older than 40 compared to women in their 30's (p<.05). 3. Compared to the women in their 20's, there was no significant difference among any of the age groups in the deficit of peak torque of the knee extensor and flexor, but the deficit of peak torque of knee extensor among women between 30 and 50showed significant difference within the normal range of deficit. 4. Compared to the women in their 20's, there was no significant difference among any of the age groups in the hamstring/quadriceps ratio These results showed that peak torque, peak torque %BW, deficit of peak torque, and hamstring/quadriceps ratio of the knee were reduced in each age group, but especially among the women over 50. Further longitudinal study may be needed to see if volume of muscle mass and intervention of exercise affect knee strength in spite of aging.
Background: This study aimed to investigate the effects of muscle energy technique (MET) and instrument assisted soft tissue mobilization (IASTM) on knee extension ROM, knee extensor/flexor strength and muscle thickness immediately and after 24 hours. Methods: A total of 30 subjects participated in this study. The participants were assigned to either MET (n=15) or IASTM (n=15). 90-90 straight leg raise, knee extensor/flexor muscle strength, muscle thickness test were measured before, immediately after and 24 hours after the intervention. Results: Both groups significantly improved knee extension ROM on immediate (MET 10.7°, IASTM 10.21° increased) and after 24 hours assessment (MET 5.61°, IASTM 5.47° increased)(p<.05). In the MET group, knee extension and flexion muscle strength increased immediately after intervention (p<.05). In the IASTM group, knee extension muscle strength increased and knee flexor muscle strength decreased immediately after intervention (p<.05). Furthermore, both groups showed a pattern of returning to the initial strength after 24 hours. In both groups, no significant difference in muscle thickness immediately and after 24 hours was observed (p>.05). Conclusion: According to the results of the present study, MET and IASTM technique showed lasting effectiveness in flexibility of shortened hamstring immediately after and in 24 hours after the intervention. In both groups, MET increased muscle strength and increased ROM, while IASTM decreased muscle strength and increased ROM, with no change in muscle thickness.
Objective : Compare the results of CPM and PNF in recovery rates when applied as an initial physical therapy. Methods : Randomly selected 19 patients who underwent through total knee replacement surgery. 23 cases were studied and divided into 12 CPM and 11 PNF cases. CPM case was carried out for 60 minutes, a maximum allowed exercise without pain. PNF case was carried out for 20 minutes by a therapist to a patient as 'one on one'. Result : Result showed that PNF treatment was increased significantly at P<0.05 in flexor muscle strength in 8 days after the surgery. Conclusion : The study revealed that in comparison with CPM, PNF was more effective treatment increase of flexor muscle strength in rehabilitation on after total knee replacement surgery.
Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.
Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.
Purpose: This study was to compare the effects among Tai-Chi exercise, aquatic Exercise, and a self-help program for knee osteoarthritis patients on symptoms of arthritis, muscle strength, balance, and difficulty of performing activities. Method: There were 50 final subjects50. A non-equivalent pretest-posttest design was used. The collected data was analyzed using SPSS for Window. One-way ANOVA and Scheffe's multiple comparison test were used 8weeks after each program. Result: There were significant differences in joint pain(p=.000), stillness (p=.001), knee extensor peak torque(p=.006), knee flexor(p=.002), and difficult of performing activity (p=.000), but there was no significant difference in balance(p=.648). The Tai-Chi group was significantly different from the self-help group for knee extensor peak torque, knee flexor and stiffness on Scheffe's multiple comparison tests. In addition, the Tai Chi group or aquatic group were significantly different from the self-help group for difficulty of performing activities(p<0.05). Conclusion: There are significant differences in the effects of the nursing intervention among the three groups. The Tai Chi group and aquatic group were significantly different from the self-help group. However, it seems that Tai-chi exercise may be more suitable than aquatic exercise in osteoarthritis exercise programs. Further studies with a longitudinal study are necessary to confirm the longer exercise period.
Purpose: The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities. Method: a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0 Result: Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor. Conclusion: RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.
Purpose: The purpose of this study was to determine how the position of tibial rotation affects peak force and hamstring muscle activation during isometric knee flexion in healthy women. Methods: Seventeen healthy women performed maximum isometric knee flexion at 30˚ with three tibial rotation positions (tibial internal rotation, neutral position, and tibial external rotation). Surface electromyographic (EMG) activity was recorded from the medial hamstring (MH) and lateral hamstring (LH) muscles. The strength of the knee flexor was measured with a load-cell-type strength-measurement sensor. Data were analyzed using one-way repeated analysis of variance. Results: The results showed that MH and LH activities and peak force were significantly different among the three tibial rotation conditions (p < 0.01). The post-hoc comparison revealed that the MH EMG activity in tibial neutral and internal rotation positions were significantly greater than tibial external rotation (p < 0.01). The LH activity in tibial external rotation was significantly greater than the tibial neutral position and internal rotation (p < 0.01). The peak force of the knee flexor was also greater in the external tibial rotation position compared with the tibial neutral and internal rotation positions (p < 0.01). Conclusion: Our findings suggest that hamstring muscle activation could be changed by tibial rotation.
Background: More women than men experience genu recurvatum, which can lead to knee pain and arthritis if left unattended. Pilates combined with taping is a suitable rehabilitation method for women with genu recurvatum. Objectives: To aimed the effect of taping and Pilates stabilization exercise on physical alignment and improvement of genu recurvatum in women with genu recurvatum. Design: A Randomized controlled trial. Methods: Twenty-one women were divided into three groups: taping group (back of knee taping and quadriceps femoris taping, n=7), Pilates exercise group (hip, knee and abdominal muscles exercise, n=7), and combined group (taping with pilates exercise, n=7). The measured variables were sagittal plane alignment and back and abdominal muscle, knee flexor and extensor strength. Results: After the intervention, all sagittal plane alignments were significantly improved in both the Pilates and combined groups. Sagittal plane alignment was significantly improved in the combined group compared with the taping group. Back and abdominal muscle strength were significantly improved in the Pilates and combined groups compared with the taping group. Knee flexor and extensor were significantly improved in the combined group compared with the Pilates group and in the Pilates group compared with the taping group. Conclusion: Pilates exercise with taping or Pilates exercise alone was effective intervention methods to improve physical alignment and strength in women with genu recurvatum.
Purpose : The clinical scale to assess spasticity of muscle was wildly used the modified Ashworth scale (MAS). But reliability of the MAS has been controverted for ambiguity among the grades. The purpose of this study was to establish the inter-rater reliability of the modified MAS (MMAS) translated into Korean in stroke patients. Methods : Twenty-five patients (sixteen men and nine women) with hemiplegia (ten right and fifteen left) were measured by two raters who were physical therapist in the rehabilitation hospital. The raters assessed spasticity of shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor in the same patients according to ratings criteria of the MAS and the MMAS. Results : For the inter-rater reliability of the MAS, two raters agreed on 57.3% and the Kappa values were moderate ($\kappa$=0.41) between two rater. The inter-rater reliability of the MAS was fair for the wrist flexor and the hip adductor and moderate for the other muscles. The intra-rater reliability was good for the shoulder adductor and the knee extensor and moderate for the other muscles. For the inter-rater reliability of the MMAS, two raters agreed on 84.7% and the Kappa values were good ($\kappa$=0.78) between two rater. The inter-rater reliability of the MMAS was moderate for the hip adductor, and good for the shoulder adductor and the wrist flexor, and very good for the other muscles. The intra-rater reliability was good for the wrist flexor and the hip adductor and very good for the other muscles. Conclusion : This study suggests that the MMAS translated into Korean is reliable test scale for the spasticity with stroke patients in the clinical field.
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