• 한국체육학회지인문사회과학편
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• v.54 no.1
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• pp.535-544
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• 2015

This study was performed to determine the effect of low-intensity resistance training with blood flow restriction (BFR) on muscle volume and strength in elderly women. Sixteen elderly women (70.9±4.6 years) were divided into low (30% 1RM) and high (75% 1RM) intense resistance training groups. Tourniquet cuff (Zimmer, Germany) for BFR was applied only to the right leg during the training period. All subjects performed unilateral leg press, leg extension and leg curl (3 sets×12 repetitions) for 10 weeks (2d/wk). Blood pressure was increased from 110 to 240 mmHg during the training period at the most proximal region of exercised leg. Muscle volume and cross-sectional area (CSA) were measured by MRI and body composition was monitored by dual-energy X-ray absorptiometry (DEXA) and isokinetic muscular strength were analyzed in both legs. The quadriceps CSA (15.2%, p<.001) and muscle volume (13.8%, p<.001) were increased in high-intense trained leg with BFR and the increased rate was highest among groups. The quadriceps CSA (9.8%, p<.001) and muscle volume (6.9%, p<.001) were increased in low-intensity training group with BFR and their increased rates were higher than control groups. The strength by exercise training was significantly improved in all groups and tended to be higher in BFR groups. These results demonstrate low-intensity resistance training with blood flow restriction could be an effective way to improve muscle volume and strength in elderly women.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.326-333
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• 2016

This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.

• Journal of Biomedical Engineering Research
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• v.19 no.1
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• pp.69-80
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• 1998

This research was designed to investigate how the exercise program affects paraplegic standing and walking employing functional electrical stimulation(FES). Emphasis was also given to fatigue of major lower extremity muscles induced by different types of electrical stimulation. We applied continuous and intermittent rectangular pulse trains to quadriceps of 10 normal subjects and 4 complete paraplegic patients. The frequencies were 20Hz and 80Hz, and the knee angle was fixed at 90$^{\circ}$and 150$^{\circ}$to investigate how muscle fatigue is related to muscle length. The knee extensor torque was measured and monitored. We have been training quadriceps and gastrocnemius of a male paraplegic patient by means of electrical stimulation for the past two year. FES standing was initiated when the knee extensors became strong enough to support the body weight, and then the patient started FES walking utilizing parallel bars and a walker. We used an 8-channel constant-voltage stimulator and surface electrodes. The experimental results indicated that paralyzed muscles fatigued rapidly around the optimal length contrary to normal muscles and confirmed that low frequency and intermittent stimulation delayed fatigue. Our exercise program increased muscle force by approximately 10 folds and decreased the fatigue index to half of the initial value. In addition, the exercise enabled the patient to voluntarily lift each leg up to 10cm, which was of great help to the swing phase of FES walking. Both muscle force and resistance to fatigue were significantly enhanced right after the exercise was applied every day instead of 6 days a week. Up to date, the patient can walk for more than two and half minutes at 10m/min while controlling the on/off time of the stimulator by pushing the toggle switch attached to the walker handle.

• Korean Journal of Applied Biomechanics
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• v.17 no.2
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• pp.113-121
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• 2007

The purpose of this study was to determine the effect of three different plates($0^{\circ}$, $10^{\circ$}, $20^{\circ}$)under heels on the lower limb muscles and erector spinae during squat exercise. Ten high school korean traditional wrestling players(age: $18.5{\pm}0.7$, weight: $1972.2{\pm}128.5N$, height: $177.8{\pm}6.0cm$, weight of barbell: $1004.5{\pm}132.4N$) performed squat exercise using three different tilting plates under heels at a cadence of 40beats/sec with 80% one repetition maximum load. Surface electrodes were placed on the participants' left and right erector spinae, and rectus femoris, vastus medialis, vastus lateralis, tibialis anterior, biceps femoris, medial gastrocnemius, and lateral gastrocnemius in the right lower extremity. One S-VHS camcorder(Panasonic AG456, 60fields/s) was placed 10m to the side of the participant. To synchronize the video and EMG data, a synchronization unit was used for this study. Average and Peak IEMG values were determined for each participant. For each variable, a one-way analysis of variance was used to determine whether there were significant differences among three different tilting plates under heels. When a significant difference was found in plates type, post hoc analyses were performed using the Tukey procedure. A confidence level of p<.05 was used to determine statistical significance. As a result of this study, maximum nEMG values of the tibialis anterior in $0^{\circ}$ plates was significantly higher than the corresponding values for the other plates during the knee extension. This increased activation in the tibialis anterior muscle indicates an increase in displacement of center of gravity of body. It is very likely that additional muscle activation are needed to stop the forward and backward movement. The results also showed that muscular activities of quadriceps femoris and erector spinae were decreased with increasing angle of plates. This suggests that increasing angle of plate may help to sustain the balance and posture of squat exercise. It is considered that very few significant differences were found among three different plates($0^{\circ}$, $10^{\circ}$, $20^{\circ}$) since elite players with much experience in squat exercise, were chosen as a participant of this study. In order to obtain meaningful results regarding the tilting angle of heel plates in squat exercise, kinetic and 3D kinematic analysis will be needed in the future study.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.35-43
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• 2008

Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

• Physical Therapy Korea
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• v.23 no.1
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• pp.11-19
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• 2016

Background: Investigation in gender differences of kinetics and kinematics for individuals with patellar femoral pain syndrome (PFPS) was not sufficiently performed. Objects: The purpose of this study is that whether there is a difference depending on gender from muscle activity and strength and knee valgus angle during controlled single-leg squat which is widely used as clinical movement test for the patient with PFPS. Methods: 20 young adults (10 men, $20.0\pm}2.1$years; 10 women, $20.4{\pm}2.1$years) with PFPS were voluntarily recruited in this study. Muscle activity and strength and knee valgus angle were collected during single-leg squat. Independent t-test and Mann-Whitney test were used to compare the differences between groups of male and female. Results: Rectus femoris (t=-2.204, p=.041) and vastus medialis oblique (t=-2.151, p=.045) muscle activity of women were significantly higher than male group. Normalized muscle strength of hip and knee muscles showed a significant difference between men and women (p<.05). Valgus angle of the knee in women (t=-2.450, p=.025) were increased significantly than men. Conclusion: The therapist would consider the characteristics of these gender differences during performing movement test, exercise, and education for the individuals with PFPS.

• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.207-219
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• 2005

The purpose of this study was to determine the effect of the foot rotation on the lower limb muscles. Fourteen subjects performed step-up/step-down at a cadence of 80 beats/min, exercises with the foot neutral, $35^{\circ}$ internally rotated, and $35^{\circ}$ externally rotated, respectively. For each variable, a one-way analysis of variance (ANOVA) was used to determine whether there were significant differences between genders and among the eight types of jump. When a significant difference was found in jump type, post hoc analyses were performed using the Tukey procedure. A confidence level of p < .05 was used to determine statistical significance. The results showed that significant changes in averaged IEMG values occurred with the internal rotation of the foot in the lateral gastrocnemius during the knee extension, and in the semitendinosus during the knee flexion. During the knee extension, however, the internal rotation of the foot produced a significantly lower Averaged IEMG values than the neutral foot position in the medial gastrocnemius. The results also found that the peak IEMG activity of the rectus femoris during the knee extension for the external rotation of the foot was Significantly higher than the corresponding values in the neutral position of the foot, while the intenal rotaion of the foot exhibited a significant difference with the neutral position of the foot in the semitendinosus during the knee flexion. In general, the foot rotation position did not influence the average IEMG and Peak IEMG values of most muscles. The practice of adopting foot rotation to selectively strengthen individual muscles of the lower limb was not supported by this study. The external rotation of the foot produced high muscle activities in the quadriceps during the knee extension. For the knee extension, therefore, maintaining a laterally rotated position should be need for stable and comfortable position.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.1-9
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• 2020

PURPOSE: This study examined the effects of different external loads on the muscle activities around the hip during prone hip extension with knee flexion (PHEKF) exercise in healthy young men. METHODS: Sixteen healthy adult males participated in the study. A pressure biofeedback unit was used to provide feedback to the participants during the abdominal drawing-in maneuver (ADIM) with PHEKF. Sandbags (0 kg, 1 kg, 2 kg, and 3 kg) were used to provide external resistance. The quadriceps was contracted to maintain knee flexion 90° against resistance. Each resistance condition using a sandbag weight was given in random order. Surface electromyography (sEMG) was used to measure the electrical activity of the gluteus maximus, biceps femoris, and erector spinae during PHEKF. RESULTS: The muscle activity of the gluteus maximus was highest with the 3 kg resistance and lowest with 0 kg (F = 128.46, P = .00). The muscle activities of the biceps femoris and erector spinae were highest with 0 kg and lowest with 3 kg (F = 29.49, P = .00). The muscle activity rate of the gluteus maximus/biceps femoris was highest with 3 kg and lowest with 0 kg (F = 37.49, P = .00). CONCLUSION: The activity of the gluteus maximus was increased using a higher external weight load during PHEKF, while the activity of the biceps femoris decreased. These findings suggest that an external weight is needed during hip extensor exercise to strengthen the gluteus maximus and inhibit the biceps femoris.

• Journal of Biomedical Engineering Research
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• v.40 no.6
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• pp.223-229
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• 2019

The number of knee-related disease patients and knee joint surgeries is steadily increasing every year, and for knee rehabilitation training for these knee joint patients, it is necessary to strengthen the muscle of vastus medialis and quadriceps femoris. However, because of the cost and time-consuming difficulties of receiving regular hospital treatment in the course of knee rehabilitation, we developed knee exoskeleton using rapid prototype for knee rehabilitation with feedback from the electromyogram (EMG) and inertia motion unit (IMU) sensor. The modules was built on the basis of EMG and an IMU sensor applied complementary filter, measuring muscle activity in the vastus medialis and the range of joint operation of the knee, and then performing the game based on this measurement. The IMU sensor performed up to 97.2% accuracy in experiments with ten subjects. The functional game contents consisted of an exergaming platform based on EMG and IMU for the real-time monitoring and performance assessment of personalized isometric and isotonic exercises. This study combined EMG and IMU-based functional game with knee rehabilitation training to enable voluntary rehabilitation training by providing immediate feedback to patients through biometric information, thereby enhancing muscle strength efficiency of rehabilitation.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.29-37
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• 2019

PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.