• PNF and Movement
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• v.9 no.1
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• pp.21-29
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• 2011

Purpose : The purpose of this study was to assess the effects of the lower extremity muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected lower extremity muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system (LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine muscle ratio. Results : The biceps femoris of all bridging exercises showed significantly(p<.05). The vastus medialis and lateralis of all bridging exercises showed significant excepted $120^{\circ}$(p<.05). The rectus femoris of all bridging exercises showed no significant. Median of vastus medialis/rectus femoris ratio of $120^{\circ}$ was 2.03, $90^{\circ}$ was 2.16, $60^{\circ}$ was 2.67, $45^{\circ}$ was 4.10. Median of vastus lateralis/rectus femoris ratio of $120^{\circ}$ was 1.70, $90^{\circ}$ was 1.70, $60^{\circ}$ was 2.08, $45^{\circ}$ was 2.58. Median of vastus medialis/vastus lateralis ratio of $120^{\circ}$ was 1.26, $90^{\circ}$ was 1.50, $60^{\circ}$ was 1.52, $45^{\circ}$ was 1.47. Conclusion : Angular motion decreasing with knee joint flexion made increase biceps femoris and vastus medialis activation. This result will be use knee joint stabilizing exercises during bridging or unstable surface training and biceps femoris strength training.

• Physical Therapy Korea
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• v.29 no.2
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• pp.117-123
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• 2022

Background: Push-up are effective exercises for shoulder stability. Previous studies have documented the effects of support plane and hand position and width on muscle activities during a push-up. Objects: This study aimed to investigate the changes in muscle activities in the upper extremity when performing the standard and the knee-flexed push-up with different hand shapes. Methods: A total of twenty-six healthy males participated in this study. Three different hand shapes (finger abduction, finger adduction, and fists) and two types of push-up posture (standard and knee-flexed push-up) were set as the independent variables. Electrograms were used to measure the muscle activity of the upper trapezius (UT), triceps brachii (TB), pectoralis major (PM), and serratus anterior (SA). Each participant performed the randomly assigned push-up to the sound of the metronome. The mixed-effect linear regression model was used to detect the changes in muscle activities after changing the hand shape and push-up posture. Statistical significance was set at α = 0.05. Results: The UT muscle activity was statistically significantly higher when performing push-up with fists than finger abduction (p = 0.035) or finger adduction (p = 0.044). During the standard push-up, the muscle activity in all muscles was that the push-up with fists showed the highest muscle activity compared to the finger abduction (p < 0.01) and finger adduction (p < 0.01). Regardless of the shape of the hand, UT had the lowest muscle activity compared to other muscles (p < 0.001). In contrast, the SA muscle had the highest muscle activity among four muscles during the standard push-up. Conclusion: Based on the results of this study, we suggest hand shape is related to the difficulty level of push-up either in the standard or the knee-flexed push-up, especially in the push-up with fists. In addition, knee push-up can be recommended as shoulder muscle-strengthening exercises for individuals with low shoulder muscle strength.

• The Journal of Korean Physical Therapy
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• v.33 no.4
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• pp.202-209
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• 2021

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects' knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group. Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion: This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2279-2285
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• 2021

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.405-412
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• 2010

Purpose : The purpose of this study was to assess the effects of the trunk muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system(LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA with post-hoc Bonferroni's correction was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratio. Results : The internal oblique of bridging exercises $120^{\circ}$, $90^{\circ}$ showed significantly(p<.05). The erctor spinae of all bridging exercises showed significant excepted between $60^{\circ}$ and $45^{\circ}$(p<.05). Median of internal oblique/rectus abdominis ratio of $120^{\circ}$ was 4.41, $90^{\circ}$ was 3.94, $60^{\circ}$ was 3.58, $45^{\circ}$ was 3.39. Median of internal oblique/external oblique ratio of $120^{\circ}$ was 2.66, $90^{\circ}$ was 2.43, $60^{\circ}$ was 2.87, $45^{\circ}$ was 2.64. Conclusion : Angular motion decreasing with knee joint flexion made erector spinae activation increase. on the other hand, as decreasing abdomen muscle activation, the more performing motor learning is required for abdomen muscle strength and co-contraction for the trunk stabilization.

• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.429-444
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• 1999

This study was performed to explore the effects of a dance therapy on physical and psychological characteristics in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Suweon and Bucheon. Fifty eight subjects, aged between 65 and 93 years who had normal cognition, sensory function, balance, and resting blood pressure. They underwent tests of balance, flexibility, muscle strength, depression, and anxiety as baseline data before dance therapy, and at 6th week and at the end of the 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy between April and July, 1998. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consists of 50 minutes session, 3 times a week for 12 weeks. One session was consisted of warming-up, expression, catharsis, sharing, and closing stage. The intensity of the dance therapy was at the 40 % of age-adjusted maximum heart rates. Data were analysed with mead standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. 1. The results related to the physical characteristics were as follows : 1) The balance (standing on one leg, walking on the balancing bar), flexibility and muscle strength (knee extensor, knee flexor, ankle plantarflexor and dorsiflexor) of the experimental subjects significantly increased over time mere than that of the control subjects. 2) The experimental group had significantly higher score for balance, flexibility, muscle strength of knee extensor, and knee flexor than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly higher score for muscle strength of ankle dorsiflexor and plantarflexor than the control group at the 6th week and the 12nd week after dance therapy. 2. The results related to psychological characteristics were as follows : 1) Scores of Geriatric Depression Scale, Hamilton Depression Rating Scale, and Zung's Self-rating Anxiety Scale of the experimental group were significantly decreased over time more than that of the control group. 2) The experimental group had significantly lower score for depression than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly lower score for anxiety than the control group at the 6th week and the 12nd week after dance therapy. The findings showed that the dance therapy could be effective in improving the balances, flexibility, and muscle strength of lower limb, and effective in decreasing the depression and anxiety of the elderly. Additional merits of the dance therapy would be inexpensiveness, easy accessibility, and increasing interpersonal relationship. It can be suggested that the dance therapy is effective in the health promotion of the elderly.

• Korean Journal of Applied Biomechanics
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• v.16 no.1
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• pp.31-41
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• 2006

The primary purpose of a TKA is to restore normal knee function 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 climbing stairs; (b) provide adequate knee joint stability. A 16-channel MyoResearch XP EMG system was used to collect the differential input surface electromyography signals VM, VL, RF, BF, ST during climbing/descending stair tests. A Peak Motion Measurement System was used to collect the kinematic and kinetic data. AKIN-COM Ill isokinetic dynamometer was used for EMG of VM, VL, RF, BF and ST during maximal voluntary contraction. I Quadriceps EMG results for the VM of the passed 1year group limb demonstrated significant less RMS EMG than that of the passed 3year group limb $60^{\circ}-15^{\circ}$ of knee flexion(p<0.05). The VL of the passed 1year group limb also demonstrated significants less RMS EMG than that of the passed 3year group limb from $60^{\circ}-45^{\circ}$ of knee flexion(p<0.05). Similar to the VM and VL, the RF of the passed 1year group limb showed less RMS EMG than that of the passed 3year group limb from $60^{\circ}-30^{\circ}$ do knee flexion(p<0.05). Hamstring EMG results for the BF of the passed 1year group limb demonstrated less RMS EMG than that of the passed 3year group limb from $75^{\circ}-15^{\circ}$ of knee flexion(p<0.05). The passed 1year group limb tended to have less ADD displacement(p<0.071) than that of the passed 3year group limb. There was no significant difference of the ABD displacement between the passed 1year group and the passed 3year group limbs(p<0.73). The passed 3year group used compensatory adaptation movement strategies to compensate for the strength deficit of passed 3year group limbs. The passed 3year group limb also increased the quadriceps muscle activation level to produce more knee extension moment to compensate for the short quadriceps moment arm. The passe 3year group limb might have an unstable knee joint in the medio-Iateral direction during the climbing/descending by showing a tendency of more ADD displacement and greater hamming co-activation EMG than the passed 1year group limbs. The TKA design was not able to help the knee joint to produce adequate knee extension moment with less quadriceps muscle effort. I think that old man needs continuous exercise for muscle strength.

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.967-976
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• 2001

The purpose of the present study was to the investigate the effect of aging in men and women on muscle strength of knee extensor and flexors by using the cybex 6000 isokinetic dynamometer. A total of 100 volunteers participated in this study and were divided into five groups according to their chronological age as follows: 20s, 30s, 40s, 50s, 60s, 10 men and 10 women in each decade respectively. Isokinetic ($60^{\circ}{\cdot}s-l$) knee extensor and flexor peak torque, peak torque to body weight ratio, opposing muscles(flexor/extensor) peak torque ratio, deficit of peak torque between dominant and non-dominant were measured. The results obtained were as follows: 1) In men, While the aged increased. the peak torque of the knee flexor and extensor statistically sig nificant decreased in the dominant and non-dominant side. 2) In women, Statistically significant difference of knee extensor peak torque was found as the aged increased in the dominant and non-dominant side, but significant difference of knee flexor peak torque did not that. 3) In men, No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side, but statistically significant difference in the peak torque of knee flexor to body weight weight ratio was found as the aged increased in the dominant side. 4) In women. No significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the dominant side, but statistically significant difference in the peak torque of knee flexor to body weight ratio was found as the aged increased in the non-dominant side. 5) In men and women, While the aged increased, statistically significant difference was found the dominant and non-dominant side in the peak torque of knee extensor to body weight ratio. 6) Peak torque of hamstring to quadriceps ratio of dominant and non-dominant side in men and women were not significantly different as the age increases. 7) Mean deficit of peak torque between dominant and non-dominant side in men and women were not significantly different as the age increases. From these results we conclude a proper exercise program is need before 50s decade to preserve in muscle strength of knee flexors and extensors.

• Journal of Biomedical Engineering Research
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• v.27 no.2
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• pp.73-77
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• 2006

Prolonged immobilization leads to significant weakness and atrophy of the skeletal muscle and can also impair the recovery of muscle strength following injury. Therefore, it is important to minimize the period under immobilization and accelerate the return to normal activity. This study examined the effects of combined heat treatment and rest-inserted exercise on the muscle activity of the lower limb during knee flexion/extension. Twelve healthy subjects were assigned to 4 groups that included: (1) heat treatment + rest-inserted exercise; (2) heat treatment + continuous exercise; (3) no heat treatment + rest-inserted exercise; and (4) no heat treatment + continuous exercise. Heat treatment was applied for 15 mins prior to exercise. Continuous exercise groups performed knee flexion/extension at 0.5 Hz for 300 cycles without rest whereas rest-inserted exercise groups performed the same exercise but with 2 mins rest inserted every 60 cycles of continuous exercise. Changes in the rectus femoris and hamstring muscle activities were assessed at 0 and 2 weeks of treatment by measuring the electromyography signals of isokinetic maximum voluntary contraction. Significant increases in both the rectus femoris and hamstring muscles were observed after only 2 weeks of treatment when both heat treatment and rest-inserted exercise were performed. These results suggest that combination of various treatment techniques, such as heat treatment and rest-inserted exercise, may accelerate the recovery of muscle strength following injury or immobilization.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2090-2095
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• 2020

Background: Spinal Mobilization is one of the manual therapy technique that clinicians have used to treat pain, however, there is still a lack of research on changes in strength in healthy people. Objectives: To investigate the effect of posterior-anterior lumbar mobilization on lower limb strength in healthy individuals. Design: Two-group pretest-posttest design. Methods: In this study, 23 healthy subjects aged 20 years were assigned to 12 lumbar mobilization group (LMG) and 12 sham group (SG) to perform intervention and measurement through pre- and post-design. Intervention was performed in LMG with grade III~IV on L3-5 of the lumbar spine, and lumbar mobilization was performed for each segment. After intervention, knee flexion and extension strength were measured. To measure the main effect on muscle strength, a comparative analysis was conducted using paired t-test and independent t-test. Results: In LMG, knee flexor and extensor strength were increased significantly at 60°/s (P<.05). In addition, the extensors of LMG and SG were significantly different only at 60°/s, and the flexors were significantly different between groups at both 60°/s and 180°/s (P<.05). Conclusion: In healthy individuals, lumbar mobilization results in improvement of strength of knee flexor and extensor, and additional experiments on the effect of mobilization on the lumbar spine on functional changes in the lower limbs will be needed.