• Journal of the Korean Society of Physical Medicine
• /
• v.9 no.1
• /
• pp.125-132
• /
• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Physical Therapy Korea
• /
• v.20 no.4
• /
• pp.1-8
• /
• 2013

This study analyzes how different knee flexion angles affect the abdominal and pelvic muscle activity during supine bridging. Twenty healthy subjects participated in the study. We used surface electromyography (EMG) to measure how three different knee flexion angles ($100^{\circ}$, $70^{\circ}$, and $40^{\circ}$) affected the activity of the transverse abdominis/internal oblique (TrA/IO), external oblique (EO), biceps femoris (BF), rectus femoris (RF), and gluteus maximus (GM) muscles on the dominant side during supine bridging. The one-way repeated analysis of variance (ANOVA) was used to determine the statistical significance of TrA/IO, EO, BF, RF and GM muscle activity and the GM/BF activity ratio. For the TrA/IO, EO, BF, and GM muscles, supine bridging with different knee flexion angles resulted in significant differences in abdominal and pelvic muscle activity. For the TrA/IO muscles, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $70^{\circ}$; however, there were no significant differences between $100^{\circ}$ and $70^{\circ}$ or $100^{\circ}$ and $40^{\circ}$. For the EO muscle, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $100^{\circ}$ and $70^{\circ}$; no significant difference was observed between angles $100^{\circ}$ and $70^{\circ}$. For the BF muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($40^{\circ}$ > $70^{\circ}$ > $100^{\circ}$). For the GM muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). However, for the RF muscle, there was no significant difference. Additionally, the GM/BF activity ratio significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). From these results, we can conclude that bridging with a knee flexion of $100^{\circ}$ can strengthen the GM muscle, whereas bridging with a knee flexion of $40^{\circ}$ is recommended to strengthen the IO, EO, and BF muscles. We can also conclude that knee flexion angles should be modified during supine bridging to increase the muscle activity of different target muscles.

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

• Physical Therapy Rehabilitation Science
• /
• v.10 no.2
• /
• pp.205-211
• /
• 2021

Objective: This study aimed to identify the effects of assuming different knee angles and hip abduction during bridge exercise and hip thrust exercise on lower body muscle activity. Design: Cross-sectional study Methods: Thirty-three healthy adults (18 men and 15 women) were instructed to perform the bridge and hip thrust exercises while randomly assuming 120°, 90° and 60° of knee flexion and 0° and 30° of hip abduction. EMG data (%maximum voluntary isometric contraction) were recorded three times from the erector spinae (ES), gluteus maximus (GM) and biceps femoris (BF) muscles of participant's dominant side and the mean values were analyzed. Results: The results showed that, during the hip thrust compared to the bridge exercise, there was significantly greater gluteus maximus muscle activity in all hip conditions while the biceps femoris activity was significantly less, and the erector spinae muscle activity was significantly greater with 30° of hip abduction (p<0.05). With all exercises, the erector spinae and the biceps femoris exhibited significantly greater muscle activity with 60° of knee flexion compared to 90° and 120° of knee flexion (p<0.05), and significantly greater muscle activity with 90° compared to 120° of knee flexion (p<0.05). In the case of the gluteus maximus, greater muscle activity was exhibited with 120° compared to 60° of knee flexion with all hip abduction conditions (p<0.05). Conclusions: It was effective for muscle activation of main agonists such as the gluteus maximus and erector spinae during thrust exercise, and the change in knee flexion angle was effective for muscle activation of the gluteus maximus. Therefore, it is considered that this study can be used as a selective indicator of the target movement angle during hip strengthening exercise for specific muscles.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.4
• /
• pp.9-14
• /
• 2015

PURPOSE: Low-intensity exercise with restriction of blood flow has been proposed as an alternative exercise to secure the disadvantage of a high-intensity resistance exercise. However, studies of how affects the muscle using functional exercise are lacking. Thus, the purpose of this study was to investigate knee extensor muscle strength during stair exercise of functional exercise with leg blood flow restriction. METHODS: Twenty two healthy young adults with no history of musculoskeletal or neurogical disorder were participated in this study. participant were randomized into either non-restriction group(11 subject) or restriction group (11 subject). The restriction blood cuff attached to the proximal end of the leg. Measurement of knee extensor strength was used by cybex dynamometer. Data analyzed in independent t-test and paired t-test. RESULTS: Knee extensor muscle strength was significantly different between groups. Also, there were significant differences in the strength of knee extensor within the group. CONCLUSION: This study found that stair exercise with restriction of blood flow did influence to knee extensor muscle strength. These results will also be able to promote the effect of increasing the muscle power applied to functional exercise. Henceforth, studies will be made in the intervention method that can be applied to health vulnerable person.

• Biomedical Engineering Letters
• /
• v.8 no.4
• /
• pp.345-353
• /
• 2018

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg and EMG signals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in the AMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas the AMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.

• The Journal of Korean Physical Therapy
• /
• v.33 no.3
• /
• pp.162-167
• /
• 2021

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual's ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion: The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.

• Physical Therapy Rehabilitation Science
• /
• v.9 no.4
• /
• pp.281-286
• /
• 2020

Objective: This study examined the effects of dynamic tape applied to the patellofemoral joint on the knee valgus angle, muscle activity, and ground reaction force during a single leg squat (SLS) and single leg landing (SLL). Design: Cross-sectional study. Methods: Twenty-four subjects (11 male, 13 female) who met the inclusion criteria were screened by the knee palpation and patella compression tests. First, the knee valgus angle and muscle activity during SLS were measured. Second, the knee valgus angle and ground reaction force during SLL were measured. For the intervention, a patella joint loop using dynamic tape was used. The knee valgus angle, muscle activities in SLS and SLL after the intervention, and the ground reaction force were measured in the same way. A paired t-test was used to examine the difference between before and after the intervention. Results: The knee valgus angle showed a statistically significant improvement after dynamic taping application in SLS and SLL (p<0.05). The differences in muscle activity of the VL/VMO and ground reaction forces were not statistically significant after dynamic taping application in SLS and SLL. Conclusions: This study showed that dynamic taping applied around the patellofemoral joint was effective in improving the knee valgus angle in SLS and SLL and had a reduced risk of secondary injury during sports activity.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.1
• /
• pp.101-108
• /
• 2021

Purpose : The purpose of this study is to verify the effect of selective muscle strengthening of the knee joint extensor muscles using a pressure biofeedback unit to improve knee extensor strength and the balance ability of total knee replacement patients. Through this, we tried to provide clinical information. Methods : In this study, 12 patients with total knee replacement were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n=6) and a control group (n=6). All patients received 30 minutes of continuous passive motion and leg-strengthening exercises for 15 minutes five times a week for two weeks. Subjects performed knee extension exercises with or without biofeedback units in the sitting position. The knee extensor strength and balance ability were measured before and after exercise. Knee extensor strength was measured by Biodex system 3 and balance ability was measured by Balancia software. Results : Both the experimental group and the control group showed a significant difference in the muscle strength of the knee joint extensor muscles after intervention (p<.05). In comparison, the experimental group showed a significant difference than the control group (p<.05). Both the experimental group and the control group showed a significant difference in the velocity average, path length, area 95 % center of pressure (COP), weight distribution, five times sit to stand test (FTSST) after intervention. In comparison, the experimental group showed a significant difference in velocity average, area 95 % COP, and FTSST than the control group (p<.05). Conclusion : In order to strengthen the knee extensor muscle and improve the balance ability in total knee replacement patients, it is necessary to consider providing pressure biofeedback unit during leg strengthening exercises.

• International Journal of Internet, Broadcasting and Communication
• /
• v.10 no.1
• /
• pp.40-47
• /
• 2018

This study was conducted to examine changes in the muscle activity of the triceps surae, specifically the gastrocnemius and the soleus, depending on the angle of the knee joint during the manual muscle test (MMT) of the plantar flexion of the ankle. The muscle activity of the medial and lateral heads of the gastrocnemius was statistically significantly reduced when the angle of the knee joint was $15^{\circ}$, $30^{\circ}$, and $45^{\circ}$ compared to when the angle was $0^{\circ}$. However, there was no statistically significant difference in muscle activity at the angles of $15^{\circ}$ and $30^{\circ}$ or $45^{\circ}$. There was no statistically significant difference in the muscle activity of the soleus depending on the angle of the knee joint. The ratio of the muscle activity of the soleus to that of the triceps surae showed a statistically significant increase when the angle was $15^{\circ}$, $30^{\circ}$ and $45^{\circ}$ compared to when the angle was $0^{\circ}$. However, there was no statistically significant difference in muscle activity at the angles of $15^{\circ}$ and $30^{\circ}$ or $45^{\circ}$. When the angle of the knee joint was $15^{\circ}$ or higher during the test of the isolated soleus, the muscle activity of the gastrocnemius was reduced. These results indicate that the angle is suitable for the test of the isolated soleus, but there was no statistically significant difference in the muscle activity of the gastrocnemius when the angle was higher than $15^{\circ}$. Therefore, it can be concluded that the most suitable angle of the knee joint for the isolated MMT test of the soleus is $15^{\circ}$.