• Physical Therapy Korea
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• v.23 no.2
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• pp.75-83
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• 2016

Background: Several studies have discussed diverse exercise methods considered to be useful for the selective contraction of the vastus medialis oblique (VMO) muscle for the treatment of patellofemoral pain syndrome. Some studies have reported that exercise methods, including hip adduction, in closed kinetic chain exercises are more effective in terms of the muscle activation of the VMO and the timing of the muscle's initial contraction. We focused on isometric contraction during a closed kinetic chain exercise with hip adduction. Objects: The purpose of this study was to examine muscle activation in the VMO and the vastus lateralis (VL) and the onset time difference between their initial contractions via closed kinetic chain isometric quadriceps femoris exercises including hip adduction. Methods: In total, 36 healthy subjects adopted two hip positions during isometric contraction of the quadriceps femoris in a closed kinetic chain exercise (hip neutral and hip adduction position). Statistical analyses were conducted using a paired t-test (${\alpha}=.05$). Results: Isometric contraction of the quadriceps femoris in a closed kinetic chain exercise caused a greater increase in VMO muscle activity in the hip adduction position [$52.68{\pm}22.21$ percentage of maximal voluntary isometric contraction (%MVIC)]than the hip neutral position ($43.43{\pm}19.85%MVIC$). The onset time difference (VL-VMO) decreased more in the hip adduction position ($-82.14{\pm}34.2ms$) than the hip neutral position ($73.94{\pm}2.94ms$). Conclusion: We recommend this exercise as a clinically useful therapeutic method for patients with patellofemoral pain syndrome due to weakening of the VMO muscle and lateral inclination of the patella.

• 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.

• 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.

• PNF and Movement
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• v.21 no.3
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• pp.291-298
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• 2023

Purpose: This study aimed to suggest an effective exercise for treating anterior cruciate ligament (ACL) and hamstring injuries based on the dynamic control ratio (DCR) for the hamstring and quadriceps during eccentric hamstring exercises. Methods: Twenty-four healthy participants participated in this study. The participants performed three eccentric hamstring exercises, including the Nordic exercise, the supine leg curl, and single-leg deadlifts. During the eccentric hamstring exercises, the vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) were measured using surface electromyography. Results: The DCR was significantly lower during the supine leg curl and single-leg deadlift than during the Nordic exercise (p < 0.05). The activity of the VMO and VL was significantly greater during the supine leg curl than during the Nordic exercise and the single-leg deadlift (p < 0.05). VL activity was significantly higher during the single-leg deadlift than during the Nordic exercise (p < 0.05). ST activity was significantly higher during the supine leg curl and Nordic exercise than during the single-leg deadlift (p < 0.05). BF activity was significantly higher during the supine leg curl than during the Nordic exercise and single-leg deadlift (p < 0.05). Finally, the BF showed significantly higher activity during the Nordic exercise compared to during the single-leg deadlift (p < 0.05). Conclusion: Based on the DCR ratio and quadriceps activity, the supine leg curl should be introduced early in rehabilitation for ACL injuries.

• Physical Therapy Korea
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• v.8 no.3
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• pp.27-34
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• 2001

Physical therapists have been using biofeedback training to induce improvements in various circumstances. The purpose of this study was to compare the effects of visual and tactile feedback using electrical stimulation on quadriceps strength. Nineteen women without known impairment of the neuromusculoskeletal system volunteered for this study. Subjects were randomly allocated into three groups: visual feedback, tactile feedback, and control group. The torque of isometric knee extension force was measured. Subjects were asked to exert the maximal isometric contraction force of quadriceps over a 30 second period. The resting period of 10 minutes was given after the maximal isometric contraction to avoid the muscle fatigue. In between groups comparison, significant differences of the peak torque and the torque area were found on the performance of the maximal isometric contraction of quadriceps (p<.05). The values peak of torque and torque area were significantly higher during visual feedback than tactile feedback. The results of this study suggest that visual feedback is more powerful than tactile feedback (p<.01).

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.9-17
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• 2018

PURPOSE: This study was conducted to compare the effects of the Graston-based massage method and microcurrent application on muscle fatigue after causing muscle fatigue of the quadriceps femoris by applying high-intensity exercise. METHODS: Study subjects (56 healthy subjects in their 20s) were randomized into a microcurrent group (MG), Graston group (GG), and control group (CG). To induce fatigue of the quadriceps femoris, the subjects performed squats 100 times without a break within about 5 minutes. Muscle fatigue was measured immediately after performing squats and 15 minutes after intervention. To measure muscle fatigue, surface electromyogram (EMG) was used to obtain and compare the median frequency. Microcurrent or Graston massage was applied to their quadriceps muscles 15 minutes after performing the squats. RESULTS: Muscle fatigue increased significantly in the vastus lateralis before and after intervention in the Graston group (p<.05), while no significant difference was observed in the rectus femoris and vastus medialis (p>.05). There were also no significant differences in the microcurrent group or the control group. CONCLUSION: Both the microcurrent group and Graston group showed a tendency for increasing median frequency values compared to the control group, but there was no significant difference except in the vastus lateralis treated with the Graston technique. Although there was no significant difference, the Graston technique could be utilized to reduce the occurrence of DOMS by preventing muscle fatigue in clinical practice or sports medicine.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.21-28
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• 2022

Background: Hamstring shortness results in the inappropriate activation of the quadriceps femoris because of the loss of the reciprocal inhibition mechanism. The purpose of this study was to investigate the effects of that activation during lunge exercises on the vastus medialis, vastus lateralis, medial, and lateral hamstrings in participants with hamstring shortness and normal length. Design: Quasi-experimental design Methods: Participants were divided into a hamstring shortness group(n=20) and a hamstring normal length group(n=23), based on a hamstring length test. During lunge exercises, muscle activation of the vastus lateralis, vastus medialis, medial, and lateral hamstrings were measured by electromyography. Results: Each muscle tested was less activated in the hamstring shortness group than in the hamstring normal length group. However, there was no statistically significant difference between the groups (p>.05). Conclusion: Although there was no significant difference between the shortness and normal hamstring groups during short lunge exercise time, longer exercising periods will result in the inappropriate activation of the quadriceps femoris. During lunge exercise, hamstring shortness causes an imbalance activation of quadriceps femoris and hamstring, and continuous hamstring shortness can cause damage on joints of lower limb.

• Korean Journal of Applied Biomechanics
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• v.22 no.2
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• pp.201-208
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• 2012

The purpose of this study was to investigate the effect of leg extension exercises performed on outdoor resistance exercise machines on knee extension muscle strength and quadriceps muscle group cross sectional area (CSA) in elderly women. Two groups were recruited for this study, including an exercise group (EG: n=13, $71.38{\pm}2.79$ yrs) and a control group (CG: n=5, $73.4{\pm}5.94$), In all subjects, maximum isometric and isokinetic muscle strength of knee flexion and extension were measured using an isokinetic dynamometer (Cybex(R) Humac Norm Testing & Rehabilitation System, USA). Quadriceps muscle group CSA were measured using MRI (Philps, Intera 1.5 T, NE Netherlands). The results of this study showed that post-intervention isometric knee extension peak torque value were higher than pre-intervention measures in the EG. However, the EG did not show improvement in quadriceps muscle group CSA, Also, no differences in the shift of optimal knee joint angle were observed between pre and post-intervention exercise. Outdoor leg extension exercise showed small increases in muscle strength in comparison to other resistance training exercises. The results of this study suggest that because outdoor leg extension exercise machines lack a progressive loading mechanism, significant increases in muscle strength may not be obtained.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.2
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• pp.9-14
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• 2014

Background: This study aims to examine correlations between quadriceps angle, lower extremity muscle strength and leg length discrepancy. Methods: This study selected 96 healthy women university students as the subjects of research. Quadriceps angle, lower extremity muscle strength and leg length discrepancy were measured. The statistical analysis of the data SPSS/window (version 12.0) were analyzed using the pearson correlation analysis. Results: There were negative correlations between the muscle strength of the right hamstring muscles and the right quadriceps angle in supine and standing positions. Functional leg length discrepancy of left and right quadriceps angle in supine and standing position showed positive correlations. Conclusions: The quadriceps angle affect the knee. An abnormal angle caused weakening of balance. Muscle strength, leg length discrepancy, and affected lower extremity alignment and knee function. These conclusions may prevent exercise limitation or disorders in the subjects and treating the patients with knee injury or patellofemoral pain syndrome with basic therapy intervention.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.351-355
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• 2015

Purpose: This study was conducted to determine how stimulation using Russian current changes isokinetic exercise performance of quadriceps muscle and its antagonist muscles. Methods: Subjects were 20 20-year-old healthy adults who were instructed in the flexion to extension of knees in angular velocity $60^{\circ}/sec$ and $180^{\circ}/sec$ using a Biodex (Biodex system 3). We measured the difference in muscle performance between the Russian current stimulated at the same time during the flexion to extension of knees and not stimulated. Results: The results showed that when Russian current stimulation was applied at the angular velocity $60^{\circ}/sec$, the flexed and extended muscles and the angular velocity $180^{\circ}/sec$ increased significantly, but the peak torque of flexing muscles at the angular velocity $180^{\circ}/sec$ did not increase. Conclusion: These findings suggest that Russian current stimulation with isokinetic exercise of the knee joint could affect the quadriceps muscle and its antagonist muscle performance of muscle strength and endurance.