• Korean Journal of Applied Biomechanics
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• v.21 no.4
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• pp.467-477
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• 2011

This study was performed to investigate the effects of tibial rotation while going up stair on muscle activity of vastus medialis oblique and vastus lateralis, and on patellar displacement. The subjects included 30 people (male: 15; female: 15) who were randomly assigned to the tibial internal-rotation, neutral-rotation, and external-rotation groups. The subjects went up the stair while performing the assigned rotations, and the rotation of the hip and the displacement of the patella were measured using a 3D motion analyzer. In addition, the maximum voluntary isometric contraction (MVIC) of the vastus medialis oblique and vastus lateralis were measured using surface electromyogram. On the tibial internal rotation, the hip rotation significantly appeared in the same direction and so did on the tibial neutral and external rotations(p<.001). Although the MVIC of the vastus medialis oblique and vastus lateralis did not significantly differ by tibial rotation during the stair ascent, the MVIC of the vastus medialis oblique was higher than that of the vastus lateralis during the internal and neutral rotations (p<.05). In addition, during the stair ascent, the displacement of the patella was more significant during the tibial external rotation than during the tibial internal and neutral rotations(p<.001). Thus, patients with patellofemoral pain are required to be considered the effects of tibial rotation for their rehabilitation.

• Physical Therapy Korea
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• v.11 no.3
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• pp.1-9
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• 2004

Most exercise for Patellofemoral pain syndrome (PFPS) has focused on selectively strengthening the vastus medialis oblique muscle (VMO). Although open chain knee extension exercises are effective for increasing overall quadriceps strength, they are not always indicated for PFPS rehabilitation. This study was designed to identify the effect of combined posture of lower extremity on Electromyographic (EMG) activity of the vastus lateralis muscle (VL) and VMO during static squat exercises. The subjects were twenty young adult males who had not experienced any knee injury and their Q-angle was within a normal range. They were asked to perform static squat exercises in five various postures using their lower extremities. The EMG activity of the VL and VMO were recorded in five exercises by surface electrodes and normalized by %MVC values derived from seated, isometric knee extensions. The normalized EMG activity levels (%MVC) of the VL and VMO for the five postures of the lower extremities were compared using one way ANOVA with repeated measures. Results of repeated measures of ANOVA's revealed that exercise 3 and exercise 5 produced significantly greater EMG activity of VMO/VL ratios than exercise 1 (p<.05). When the static squat exercise was combined with hip adduction and toes pointed outwardly, the EMG activity of VMO/VL rates was increased. The EMG activity of VMO/VL ratio was highest during static squat exercises performed on a decline squat. These results haveimportant implications for progressive and selective VMO muscle strengthening exercises in PFPS patients.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.41 no.3
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• pp.153-160
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• 2017

Gait analysis has been conducted in various environments, but the biomechanics during the transition from uphill walking to downhill walking have not been reported. The purpose of this study is to investigate the knee and ankle joint kinematics and kinetics during walking on a triangle-shaped slope compared with those during level walking. Kinematic and kinetic data of eighteen participants were obtained using a force plate and motion capture system. The greater peak ankle dorsiflexion angle and moment and the peak knee extension moment were observed (p<0.05) during both uphill and downhill walking on the triangle-shaped slope. In summary, uphill walking on a triangle-shaped slope, which showed a peak knee flexion of more than $50^{\circ}$ with greater peak knee extension moment, could increase the risk of patellofemoral pain syndrome. Downhill walking on a triangle-shaped slope, which involved greater ankle dorsiflexion excursion and peak ankle dorsiflexion, could cause gastrocnemius muscle strain and Achilles tendon overuse injury.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.192-204
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• 2004

The surface electromyographic(sEMG) analyses were knee joint angle during open kinetic chain exercise (OKC) and close kinetic chain exercise (CKC) in vastus medialis (VM), vastus lateralis (VL), and rectus femoralis (RF). Ten subjects with normal , aged 20 to 30(X=27.4, SD=3.23), were randomized Statistical techniques for data analysis were applied paired t-test. The 0.05 level of significane was used as the critical level for rejection of the null hypotheses for the study. And the results were: 1) Both OKC and CKC improved the strength of quadriceps muscle as the knee joint flexion was increased. 2) In OKC, the strength of VM was improved the most at the 30 degree angle. 3) In CKC, the strength of VM was improved the most at the 30 degree angle. 4) The VM/VL ratio was the largest at the 10 and 20 degree angles in OKC and CKC. 5) The VM/VL ratio at 10, 20, and 30 degree angles was significantly different between OKC and CKC (P < 0.05). Base on the results, the OKCE is recommended for the knee joint patients, especially for the patellofemoral pain syndrome patients, during the early phase of rehabilitation. In order to improve strength of the quadriceps, muscle strength training at 30 degree angle is recommended. In order to improve VM/VL ratio, 10 and 20 degree angles are recommended during OKCE and CKCE, respectively. Future researches are warranted comparing electromyographic analysis between OKCE and CKCE in the quadriceps at a certain work lead, and muscle strength performance in the quadriceps at different positions of foot.

• Physical Therapy Korea
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• v.8 no.2
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• pp.65-72
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• 2001

The purpose of this study was to investigate the effect of knee exercises on the onset times of vastus medialis oblique muscle (VMO) and vastus lateralis muscle (VL) and in healthy subjects. Fifteen subjects (7 men, 8 women) in a mean age of 26.4 years participated in the study. Electromyographic (EMG) signals were recorded from the VMO and VL under four exercises. Knee exercises consisted of open kinematic terminal knee extension, straight leg raising, isometric hip adduction exercise, and closed kinematic terminal knee extension. No significant differences were found in the onset times of EMG activities of VMO and VL in the four exercises. There were also no significant differences among the exercises. These results coincided with previous studies that found no difference between onset of VMO and VL. However, it is difficult to say that there is no difference between onset of VMO and VL in healthy subjects. To confirm this results, further researches that follow same on set determination metod and exercises are needed. Not only is the study of onset time of muscle needed, but also the studies of the amount of activation and the rate of increase of muscle activation are needed.

• PNF and Movement
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• v.20 no.3
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• pp.443-449
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• 2022

Purpose: This study aims to identify the differences in the muscle activity of the ankle joint muscle depending on the type of footwear (sneakers, mule sneakers, slippers) worn while walking on a slope. Methods: The subjects wore each shoe (sneakers, mule sneakers, and slippers) and walked on an 18-degree slope at a speed of 110 beats/min. While walking, the muscle activities of the tibialis anterior and medial gastrocnemius were measured. Of the three walking cycles, the second walking cycle was measured except for the first and third walking cycles, which are the beginning and end, and a three-minute break was taken to prevent muscle fatigue when the type of footwear was changed. Results: When walking on a slope, there was no significant difference in the muscle activity of the tibialis anterior according to the type of footwear. However, when walking on a slope, the difference in muscle medial gastrocnemius muscle activity was significant between sneakers and mule sneakers. There was also a significant difference between sneakers and slippers, but there was no significant difference between slippers and mule sneakers. Conclusion: There was no significant statistical difference between sneakers and mule sneakers, but there was a numerical difference. Therefore, the presence or absence of the shoe collar may affect the muscle activity of the medial gastrocnemius when walking on a slope. This can lead to patellofemoral pain syndrome caused by the excessive use of the quadriceps, so it must be considered that caution is needed.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.117-122
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• 2000

Purpose : To compare the mid term with long term follow up results of the anterior cruciate ligament(ACL)> reconstruction using patellar tendon. Materials and Methods : Seventy-six cases, which could be followed up more than 2 years were included in this study. They were classified into two groups, mid-term group(41 cases) with mean follow-up periods of 2 years and 10 months and long-term group(35 cases) off years and 6 months. Clinical and radiological results and peripatellar complications were evaluated & compared. Results . There was no statistically significant difference in radiological finding and anterior instability between two groups. However, the incidence of anterior knee pain, paresthesia at incision site, kneeling pain, crepitus and quadriceps weakness was lower in long-term group than in mid-term group. Conclusion : ACL reconstruction using patellar tendon graft could successfully restone the stability of knee joint, but there are some complications in donor site and patellofemoral joint. However this complications were gradually decreased with long term follow-up.

• Physical Therapy Korea
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• v.15 no.2
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• pp.54-63
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• 2008

The purpose of this study was to examine the effect of the hip internal rotation on knee extensor and hip abductor electromyographic (EMG) activity during stair up and stair down mobility. Eighteen healthy subjects were recruited. All subjects performed stair up and down movements on a step of 30cm height while maintaining the hip in neutral (condition 1) and hip in internal rotation (condition 2). Surface EMG activity was recorded from five muscles (gluteus maximus, vastus lateralis (VL), vastus medialis oblique (VMO), posterior gluteus medius (Gmed), and tensor fascia latae (TFU)) and hip internal rotation angle was measured using a three dimensional motion analysis system The time period for stair up and down was normalized using the MatLab 6.5 program, and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities according to the hip rotation (neutral or internal rotation) during the entire time period of stair up and down in each phase were compared using a paired t-test. During the entire period of stair up, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). During the entire period of stair down, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). However, the EMG activities of the other muscles were not significantly different between the conditions (p>.05). These results suggest that the stair up and down maintaining hip internal rotation was could be a contributing factor on patellar lateral tracking.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.1-6
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• 2002

Purpose : Evaluation and analysis of the incidence and causes of intraoperative and postoperative complications after arthoscopic anterior cruciate ligament(ACL) reconstruction using bone-patella. tendon-bone (BPTB) auto graft. Materials and Methods : We reviewed 85 cases of arthroscopic ACL reconstruction using BPTB autograft which had been followed up for more than 1 year. Intraoperative complications had been recorded and corrected during the operation. Postoperative complications were analyzed and compared between 3 groups which were classified by the last follow-up period after the operation. Results : There were a few intraoperative complications including patellar fracture(1 case), contamination of harvested graft(1 case), impingement of graft(2 cases), blow-out of tile posterior wall of the femoral tunnel(1 case) and intraarticular retraction of the screw(1 case). The result of the comparison of postoperative complications among the groups shows that the incidence of anterior knee pain, donor site pain and patellofemoral crepitation were significantly decreased after 2 years. But there was no significant decrease in these complications after 3 years. Conclusion : Intraoperative complications after arthroscopic ACL reconstruction using BPTB autograft were due to incorrect technique and carelessness of the operation team, and can be prevented by improvement of surgical technique and accumulation of experience. Postoperative complication were somewhat unavoidable but gradually improved with time; hence, we should consider it for the selection of graft donor.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.498-504
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• 2018

Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.