• 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.12 no.2
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• pp.11-19
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• 2005

Patellofemoral pain syndrome (PFPS) is often attributed to malalignment and maltracking of patella within the patellofemoral joint. Most exercise for PFPS has focused on selectively strengthening the vastus medialis oblique muscle (VMO). This study was designed to identify the effect of medial, lateral wedge and difference of Quadriceps angle (Q-angle) on vastus medialis oblique/vastus lateralis muscle (VL) activity ratios. The subjects were twenty young adult males who had not experienced any knee injury. They were asked to perform isometric contraction exercises in three postures using medial and lateral wedge. The EMG activity of the VL and VMO were recorded in three postures 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 three postures of the lower extremities were compared using 2-way repeated measures ANOVA with 1 between-subject factor (group), and 1 within-subject factor (wedge). Results of repeated measures of ANOVA's revealed that the medial wedge isometric contraction exercise produced significantly greater EMG activity of VMO/VL ratios in Group I (Q-angle $18^{\circ}$ or less) (p<.05). But, the medial wedge isometric contraction exercise was no significant difference of VMO/VL ratios in Group II (Q-angle $19^{\circ}$ or more) (p>.05). These results have important implications for selective VMO muscle strengthening exercises in PFPS patients.

• Physical Therapy Korea
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• v.16 no.3
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• pp.32-41
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• 2009

The purpose of this study was to suppose basis data the influence of different chair type and pelvic control on quadriceps muscle activity and strength during knee joint extension isometric exercise in hemiplegic patients. This research were investigated in ten healthy adults and tens hemipelgic patients. Surface electromyography (EMG) and Biodex system were used to collect kinematic data and muscle activity, respectively. Independent t-test, paired t-test and one-way repeated ANOVA were used to determine a statistical significance. The results showed as follows: (1) Posterior pelvic angles in healthy group and hemiplegic group were significantly different on isokinetic equipment (p<.05). (2) Different chair type and pelvic control on quadriceps muscle activity and strength were significantly different in hemiplegic patients (p<.05). From the result of this research, posterior pelvic angle control during knee joint extension isometric exercise in hemiplegic patients on isokinetic equipment is necessary to increase quadriceps muscle strength in hemiplegic patients.

• Physical Therapy Korea
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• v.23 no.1
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• pp.20-30
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• 2016

Background: Total knee arthroplasty (TKA) recovers the alignment of the knee joint, but fails to automatically restore the alignment and function of the hip and ankle joints. It may affect the alignment and stability of the knee joint, therefore therapeutic intervention in hip and ankle joint is necessary for the rehabilitation process after TKA. Objects: The aim of this study was to comparison of the effects of the two exercise methods on the coronal plane alignment after TKA. This study conducted an experiment by dividing subjects into a lower extremity isometric co-contraction group (LEIC) and a quadriceps isolated isometric contraction (QIIC) group. Methods: A total of 37 subjects were randomly assigned to the LEIC ($n_1$=19) or the QIIC ($n_2$=18). Exercise was applied to five times per week for three weeks, starting on the eighth day after surgery. Range of motion exercises were performed as a common intervention and then each group performed quadriceps isometric contraction exercises with 10 sets of 5 repetitions. Radiological imaging was performed prior to surgery, one month and six months after surgery. In addition, the hip-knee-ankle angle (HKA) and tibiotalar angle (TTA) were measured. Results: The HKA was close to neutral in the LEIC rather than the QIIC (p<.05). The LEIC showed varus and the QIIC exhibited valgus TTA (p<.05). In a comparison of HKA and TTA over time, there was no significant change in either group (p>.05). According to the comparison of the TTA before surgery, the LEIC showed significant changes in the varus direction (p<.05), while there was no significant change in the QIIC (p>.05). Conclusion: The LEIC method triggered changes in the TTA and brought the HKA close to the neutral. Thus, LEIC is more effective than QIIC in creating stability in the coronal plane alignment of the knee and ankle joints after TKA.

• Journal of the Korea Convergence Society
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• v.7 no.2
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• pp.43-52
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• 2016

The purpose of this study was to suggest the effective squat exercise position to strengthening vastus medialis oblique, and vastus lateralis in quadriceps. Subjects were twenty patients with patellofemoral pain syndrome (PFPS) volunteered to participate in this study. All subjects were applied to static squat convergence exercise with knee flexed $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ for 30 seconds total 5 times. Measurement variables were maximal voluntary isometric contraction (MVIC) of the quadriceps, Q angle and length of thigh. Those were measured before and after the squat exercise on knee joint angle, change rate of which were used for statistical analysis. As a result, squat exercise with knee flexed $90^{\circ}$ increase significantly among knee joint angle in the MVIC change rates of quadriceps (p<.05), however the rates of Q-angle and length change of thigh showed no significant difference. Therefore, this findings suggest that squat exercise with knee flexed $90^{\circ}$ strengthen quadriceps effectively in patients with PFPS.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.93-105
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• 2016

PURPOSE: The purpose of this study was to determine the effect of corrective exercise on hip joint range of motion, lower limb alignment, radiographs of hip and knee joints, and quadriceps muscle activity in a patient with knee joint valgus deformity. METHODS: A single-subject A-B-A experimental design was used to determine the effects of therapeutic exercise. The single-subject was a 27-year-old male, who presented with knee joint valgus deformity. Corrective exercise program was performed for 40 min/day twice a week for 12-week. Range of motion (hip flexion, extension, abduction, adduction, internal rotation, and external rotation), lower limb alignment test (Q-angle, rear foot alignment, and leg length), standing anterior-posterior radiographs (neck shaft angle and knee joint space), and quadriceps muscle activity of both lower limbs were measured before (A 1), after 6 weeks (B 1) and after 12-weeks (B 2) of corrective exercise and after 6 weeks of exercise completion (A 2). RESULTS: Hip range of motion increased in all directions of both sides at B 2 and A 2 compared to at A 1. Q-angle of both side and leg length discrepancy decreased at B 2 and A 2 compared to at A 1. Neck shaft angle and knee joint space of both sides improve at B 2 and A 2 compared to at A 1. Quadriceps of both side muscle activities improved at B 2 and A 2 compared to at A 1. CONCLUSION: We demonstrated that corrective exercise increases range of motion, and improves lower limb alignment and muscle activity in a patient with knee joint valgus deformity.

• PNF and Movement
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• v.10 no.3
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• pp.25-31
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• 2012

Purpose : This study was intended to compare muscle activity in relation to knee joint angles on closed kinetic chain. Methods : A total of 13 subjects consisting of 5 adult males and 8 adult females were made to make movements maintaining knee joint angles at $30^{\circ}$, $45^{\circ}$ and $90^{\circ}$ on closed kinetic chain and the muscle activity occurring in their vastus medialis, rectus femoris and vastus lateralis was measured. Statistical data were analyzed using oneway ANOVA. Results : On closed kinetic chain, the muscle activity of the vastus medialis, rectus femoris and vastus lateralis increased the most at $90^{\circ}$ among the knee joint angles with statistically significant differences(p<0.05). Conclusion : On closed kinetic chain, it could be seen that as the angle of the knee joint increased, the muscle activity increased.

• The Journal of the Korea Contents Association
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• v.12 no.1
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• pp.329-337
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• 2012

The purpose of this study was to investigate the functional changes of the vastus medialis while the neuromuscular electrical stimulation(NMES) was performed in elderly women with knee osteoarthritis. The subjects of this study were 30 women who were diagnosed degenerative arthritis, 15 in the experimental group and 15 in the control group. The experimental group performed conventional physical therapy and neuromuscular electrical stimulation, and the control group received only conventional physical therapy, five times per week for four weeks. Outcome measures were assessed before and after 4weeks using the VAS(pain), quadriceps femoris strength, thigh circumference, and Q-angle. The data of the quadriceps femoris strength and thigh circumference were significantly increased in experimental group(p<0.05). The data the pain was significantly decreased in both the two groups(p<0.05). There were statistically significant differences in quadriceps femoris strength and thigh circumference between the two groups(p<0.05). As the result, the application of neuromuscular electrical stimulation of the vastus medialis could be more effective for decrease pain and improving muscle function in patients with knee osteoarthritis.

• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.278-282
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• 2013

This study was performed in 41 dogs with unilateral or bilateral medial patella luxation (MPL) and/or cranial cruciate ligament rupture (CCLR). These dogs were classified into 4 groups according to MPL grading system. Radiographic evaluation was performed for pelvis and stifle joint in the dogs. Norberg, inclination, quadriceps and femoral varus angle were measured and analyzed with MPL grading and the existence of cranial cruciate ligament rupture. The Norberg and inclination angle showed no differences between 4 grading groups and between CCLR and no CCLR groups. However, quadriceps and femoral varus angle were statistically different between grade 1, 2 and grade 3, 4 groups. They also have shown the statistical difference between CCLR and no CCLR group. Further studies for how these parameters affect the prognosis and the results of surgical treatment of MPL should be needed.

• Physical Therapy Korea
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• v.13 no.4
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• pp.1-9
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• 2006

The purpose of this research was to analyze the effects of the increase of the femoral anteversion angle on the unbalanced quadriceps femoris muscle causing the increase of the valgus force on the knee joints and patellofemoral pain syndrome by comparing with the group that shows the smaller femoral anteversion angle. The method for the research was to compare the femoral muscle's activity while the subjects were maintaining the knee joint flexed isometrically for 10 seconds. The evaluation tool for femoral muscle's activity was QEMG-4 (model LXM 3204). The results were as followings. Firstly, in case of the experimental group, the muscle strength of the vastus lateralis muscle was strong while the rectus femoris and vastus medialis were weak. In these facts, we can see the statistically meaningful difference in vastus medialis muscle activity. Secondly, in the muscle activity analysis for vastus lateralis and medialis of the two groups, we could see the vastus lateralis muscle was strong in anteversion wider for experimental group while the vastus medialis muscle contracted far more stronger in anteversion smaller for control group. From these results, we can see the significant differences in muscle recruitment between the two groups. Above results show that if the anteversion becomes wider, vastus medialis muscle will become seriously weaker, on the other hand, vastus lateralis act stronger.