• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.475-483
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• 2014

PURPOSE: The purpose of the study was to determine the effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke patients. METHODS: The subjects were 50 patients who were diagnosed with cerebrovascular accident. They were randomly assigned either to a close kinetic chain resistant exercise of lower extremity group (study group)(n=25) or open kinetic chain resistant exercise of lower extremity exercise group (control group)(n=25). Gait abilities were measured by using Timed Up & Go (TUG) test, Functional Gait Assessment (FGA) and spatio-temporal gait variable that were velocity, cadence, stride length, double limb support by 3 axises wireless accelerometer and sway angle of center of mass by same instrument. RESULTS: Study group and control group before and after the intervention there were significantly difference in TUG, FGA, spatio-temporal gait variables and sway angle of center of mass (p<.05). There were significantly different between study group and control group for all variables at post-exercise. CONCLUSION: When all is said and done it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with stroke. In its final analysis when applying resistant exercise of lower extremity to stroke patients' gait, close kinetic chain is more effective than open kinetic chain.

• PNF and Movement
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• v.7 no.3
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• pp.17-27
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• 2009

The purpose of this study was to investigate the effect of close kinetic chain(CKC) and open kinetic chain(OKC) posion on proprioceptive neuromuscular facilitation applied to the unilateral upper extremity on the muscle activation of lower extremity. All subjects were randomly assigned to two groups: open kinetic chain group(n=5),closed kinetic chain group(n=5). All participants were PNF patterns applied on the unilateral upper extremity in all subjects were the kinetic chain(CKC) and open kinetic chain(OKC) posion on flexion/abduction/external rotation. The hold and approximation techniques for the irradiation were applied to end range. All measurements for each subject took the following tests: pre-test, post - test in 4weeks, post-testin 8weeks. EMG data was collected from the vastus medialis, tibialis anterior, biceps femoris, and gastrocnemius muscle of both lower extreamity using surface EMG system, Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed using Two-way analysis of variance(ANOVA) with repeated measures to determine the statistical significances. The results of this study are summarized as follows. First, during for close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application, all of the %MVIC values of close kinetic chain and open kinetic chain posion increased sign ificantly compared(p<0.05). Second, The close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application was significantly increased with in the intervention period(p<.05). Third, there was a no significant open kinetic chain posion on PNF pattern application of sing muscle group with in the intervention period.(p<0.05) there was a significant close kinetic chain posion on PNF pattern application of sing muscle group with with in the intervention period(p<0.05). Forth, interaction of the exercise position and muscle was also significant. Post-hoc tests revealed that the activation levels of vastus medialis muscle and tibialis anterior muscle was higher in the closed kinetic chain position(p<.05). that the activation levels of vastus medialis and gastrocnemius muscle was higher in the open kinetic chain position(p<.05). In conclusion, it was found that the application of PNF patterns to the unilateral upper extremity effect on the muscle activation of lower extremity and both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed.

• Physical Therapy Korea
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• v.26 no.4
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• pp.20-28
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• 2019

Background: The wall squat exercise has been recommended for strengthening of the lower extremity muscles with maintaining lumbar lordosis. Although squat has been studied to be related to lower extremity extensor strength, the relationship between wall squat and lower extremity extensor strength unclear. Because squat and wall squat are biomechanically different, study on the relationship is needed. Objects: The purpose of this study was to determine the lower extremity extensor strength associated with wall squat performance. Methods: 74 healthy volunteers were recruited to participate in this study. The volunteers were measured hip and knee extensors strength and then performed wall squat exercise for maximum count. Results: We found significant relationships between wall squat performance and hip extensor strength normalized by body weight, knee extensor strength normalized by body weight and the composite value. In a regression analysis, hip extensor strength normalized by body weight explained 29% of the variation in wall squat performance in males and 35% in females. Conclusion: These results demonstrate that hip extensor strength normalized by body weight is critical to wall squat performance in both sexes.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.7-12
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• 2013

Purpose : The purpose of this study was to identify effects of virtual reality-based closed kinetic chain (CKC) exercise on lower extremity muscle activity in chronic stroke patients Methods : Subjects were assigned randomly either to VR+CKC exercise group (n=15) or the CKC exercise group (n=15). When the study began, both groups received conventional physical therapy five times per week. The VR+CKC exercise group received virtual reality programs and the CKC exercise group received close kinetic chain exercises. Each exercise program was performed for six weeks (5 times per weeks; 20 minutes per time). Participants were measured on lower extremity muscle activity using EMG. Results : There was a significant increase of muscle activity (%RVC) in vastus lateralis and vastus medialis. Conclusion : In this study, the virtual reality-based closed kinetic chain exercise program was an effective exercise for improving lower extremity muscle activity in chronic stroke patients.

• Physical Therapy Korea
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• v.26 no.2
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• PNF and Movement
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• v.8 no.3
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• pp.9-16
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• 2010

Purpose : The purpose of this study was to investigate effects of kinesio taping of thigh muscle on isokinetic muscular function during closed kinetic chain exercise of lower extremity. Methods : Twenty healthy males were participated in this study. The isokinetic muscular function of closed kinetic chain were measured for peak torque, peak torque % body weight, average power, max rep tot work before and after application of kinesio taping on thigh muscles. Results : At $60^{\circ}/s$ peak force and peak force % body weight were significant increased in both extension(p<0.01) and flexion(p<0.001) after applying kinesio taping. At $180^{\circ}/s$ average power was significant increased in both extension and flexion after applying taping(p<0.001). At $240^{\circ}/s$ max rep tot work was significant increased in both extension(p<0.001) and flexion(p<0.05). Conclusion : This study suggests that application of kinesio taping on thigh muscle was more effective to improve isokinetic muscular function in closed kinetic chain exercise of lower extremity.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.173-182
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• 2012

Purpose : This study was investigated the effect of lower extremity muscle activity during open kinetic chain exercise (OKC) and closed kinetic exercise (CKC) in normal young adults. Methods : The participants were consisted of forty-one. All subjects were randomly assigned to two groups of open kinetic chain exercise group (n=21) and closed kinetic chain exercise group(n=20). It was perform 3 sets, 3 times per week for 6 weeks both open kinetic chain exercise group and closed kinetic chain exercise group. Subjects were assessed for each subject took pre-test, post-test in 2 weeks, post-test in 4 weeks, post-test in 6 weeks measurement the surface EMG data for vastus medialis and lateralis, lateral and medial hamstring, lateral and medial gastrocnemius, tibialis anterior. Results : The vastus medialis and lateralis muscle activity was significantly increased within the intervention period both group(p<.05). The lateral and medial part of hamstring muscle activity was significantly increased with in the intervention period(p<.05). The tibialis anterior muscle activity of open kinetic chain exercise group and closed kinetic chain exercise group was significantly increased in the intervention period(p<.05). The lateral and medial part of gastrocnemius muscle activity of open kinetic chain exercise group and closed kinetic chain exercise group was significantly increased with in the intervention period(p<.05). Conclusion : It was found that both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed. these exercises can be selectively adapted not only as treatment exercise for patients but also as preventive exercise for normal person to improve balancing ability by conducting proper amount of exercise for each individual's condition and stage.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.105-108
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• 2011

The purpose of the present study was to analyze the lower stiffness over the difference between soft and stiff landings during hopping. Five male subjects performed hopping on two legs at 2.5 Hz. During the experiments, 3D motion capture system was used to obtain the kinematic data and two force plates were synchronized to calculate the kinetic data. We determined lower extremity stiffness of the knee and ankle from kinetic and kinematic data. Leg stiffness was approximately 1.2-times significantly higher in stiff landing than in soft landing_ There was no significant difference in knee joint stiffness between soft and stiff landings. Ankle joint stiffness was approximately 1.34-times significantly higher in stiff landing than in soft landing. These results suggest that humans adjust lower extremity stiffness over the comparison of two different landing methods we evaluated.

• Physical Therapy Korea
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• v.27 no.4
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• pp.257-263
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• 2020

Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said "Go", the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many "touches" as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.

• Korean Journal of Applied Biomechanics
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• v.16 no.2
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• pp.121-134
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• 2006

The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.