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

• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.77-83
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• 2018

Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.101-112
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• 2007

Purpose : The purpose of this study was to evaluate influence of sacroiliac joint mobilization on lower extremity muscle strength. Methods : The subjects were consisted of thirty patients who had Leg length inequality(LLI) of more than 10mm(16 females. 14 males) from 21 to 41 years of age(mean aged 24.87). All subjects randomly assigned to sacroiliac joint mobilization group(n=15), control group(n=15). sacroiliac joint mobilization group received sacroiliac joint mobilization about 10 minutes for 3 times per week during 4 weeks period. Control group not received intervention during 4 weeks period. The tape measure method(TMM) was used to measure functional Leg length inequality. Biodex System 3 Pro was used to measure strength of Knee extension & flexion. All measurements of each subjects were measured at pre-test, 2weeks post-test and 4weeks post-test. Results : 1. The LLI of sacroiliac joint mobilization group was significantly reduced according to within treatment period(p<.05), most significantly reduced between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more reduced than control group(p<.05). 2. The knee extension strength of sacroiliac joint mobilization group was significantly increased according to within treatment period(p<.05), most significantly increased between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more increased than control group(p<.05). 3. The knee flexion strength of sacroiliac joint mobilization group was significantly increased according to within treatment period(p<.05), most significantly increased between pre-test and post-test(p<.05). sacroiliac joint mobilization group significantly more increased than control group(p<.05). Conclusion : sacroiliac joint mobilization can reduce LLI and increased lower extremity muscle strength.

• Physical Therapy Korea
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• v.22 no.4
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• pp.8-16
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• 2015

The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

• Korean Journal of Applied Biomechanics
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• v.18 no.4
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• pp.41-47
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• 2008

The purpose of this study was to provide foundations for proper stretching method not to lose muscle strength caused by shrink of muscle for preventing injury and improving performance when we make training programs. This study compared and analyzed isokinetic variables related to the static stretching frequency of knee joint extensor by isokinetic instruments applied to normal adults. 45 normal adults are randomly sampled into 3 different groups. All the measured variables were processed with SPSS and, means and standard deviations at each angle speed were calculated. The difference of means between before and after stretching of each groups were processed by paired t-test. One-way ANOVA and after test(Duncan) This study was able to see that stretching decrease acute isokinetic muscle strength High frequency stretching group showed more efficient decrease of muscle strength than low frequency stretching group. As a result, making training program for a game requiring strong muscle strength should consider proper stretching method not to lose muscle strength.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.7
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• pp.4395-4403
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• 2014

The purpose of study was to compare the effectiveness of sling exercise on the muscle strength and range of motion in female patients who received a total knee replacement. The participants were allocated randomly into 2 groups: sling exercise group (n=15) and control group (n=15). The subjects were evaluated using the Biodex system for the muscle strength test and a goniometer for the range of motion test. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. As a result, the sling exercise group before and after intervention showed a statistical significance difference in the flexion angle, quadriceps femoris, and hamstring muscle strength. The control group before and after the intervention revealed a statistically significant increase in the flexion & extension angle, quadriceps femoris, and hamstring muscle strength. Muscle strength test and flexion range of motion test in the sling exercise group showed statistical significance differences compared to the control group (p<.05). Therefore, the sling exercise group has a positive influence on the muscle strength and ROM in patients with a total knee replacement.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.296-301
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• 2014

Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.4
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• pp.231-244
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• 2001

This study was conducted to observe the effect on appendage muscle strength according to increase in occlusal vertical dimension. For this study, ten males with a mean age of 21 were selected. The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The tested occlusal splints were made at the position of increased occlusal vertical dimension of 2mm, 3.5mm, and 5mm from the ICP. Before and after wearing occlusal splints, the appendage muscle strength were tested by CybexII Dynamometer in each subject. The results were as follows : 1. When occlusal vertical dimension was increased, most of mean muscular strength values were increased except for those of supination and pronation of forearm at the position of 5mm increased occlusal vertical dimension. 2. The statistical analyses demonstrated that the increased occlusal vertical dimension position to be significantly stronger than intercuspal position for the muscle strength of the flexion and extension of hip, supination of forearm, external and internal rotation of knee, dorsiflexion and plantarflexion of ankle (p<0.05). 3. At the position of 3.5mm increased vertical dimension displayed the highest mean muscluar strength value than other positions. 4. Statistically demonstrated values, except for supination of forearm, internal rotation of shoulder, were related to lower appendage. Therefore splint was more effective on lower appendage than upper appendage to make muscle strength increased. 5. The mean increased rate of muscular strength tested on knee(57%), ankle(42%), and wrist(20%) were higher than hip(31%), elbow(14%), and shoulder(17%).

• Journal of muscle and joint health
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• v.23 no.3
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• pp.139-151
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• 2016

Purpose: The study was conducted to examine the effects of motivational interviewing intervention on exercise performance and maintenance, exercise and pain self-efficacy, functional status, and quality of life in the patients with total knee replacement. Methods: This study used a nonequivalent control group non-synchronized design. A total of 100 patients with total knee replacement (33 patients in motivational interviewing group (MG), 33 patients in exercise group (EG), 34 patients in comparison group (CG)) were participated in this study. MG and EG had 7 scheduled sessions for 4 weeks. Data were analyzed with repeated measures ANOVAs by using IBM SPSS Statistics 20. Results: MG showed better exercise maintenance, higher exercise and pain self-efficacy, higher muscle strength, and mental component of quality of life than the other groups. MG and EG showed better knee flexion, less knee extension, longer walking distance for 6 minutes, and better functioning than CG. Conclusion: The results showed that motivational interviewing intervention is an effective intervention for elderly patients with total knee replacement. Future study examining long term effects of motivation interviewing intervention is necessary.