• The Journal of Korean Physical Therapy
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• 제18권2호
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• pp.35-45
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• 2006

Purpose: This study was to investigate the effect of isometric exercise and active stretching on joint function in patient with osteoarthritis. Methods: 30(M=1, F=29) subjects with osteoarthritis were divided in three groups: control group, quadriceps isometric exercise group, and hamstring active stretching group. After 6 weeks treatment, ROM(range of motion) and LSS(lysholm scoring scale) were measured. Results: There was a significant increase in knee flexion, extension in post-treat of quadriceps isometric exercise group and hamstring active stretching group(p<0.05). There was a significant increase in LSS in post-treat of quadriceps isometric exercise group and hamstring active stretching group(p<0.05). Conclusion: This study shows that both the active stretching exercise and the quadriceps isometric exercise effectively promote the range of knee extensions for osteoarthritis patients. Also, as measuring the ROM of knee flexion and extension by exercise methods, there is significant increase from knee flexion and extension in both hamstring stretching exercise group and quadriceps isometric exercise group. The increase of the range of knee is more effective in the exercise of knee extension with hamstring stretching exercise groups. And it is found that there are some difference between the experimental group and controlled group in statistics. As it is concerned with the function of knee extension, supporting and squatting are more effective to promote the both knee extension and flexion in its range. Therefore, this shows that the hamstring stretching exercise is required in general with enforcing the quadriceps at a sickbed in the present.

• 한국전문물리치료학회지
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• 제7권3호
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• pp.81-89
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• 2000

The purpose of this study was to determine the effect of electrical stimulation biofeedback on motor learning of quadriceps muscle isometric exercise in 3 patients who have undergone total knee replacement surgery. A multiple baseline design across subjects was used. The electrical stimulation biofeedback was provided with each patient during quadriceps isometric exercise, which last 10 to 14 sessions with 10 repetitions each sessions. After training patients received 4 retention tests. Maximum muscle activity was measured pre- and post- electrical stimulation biofeedback training and retention test to evaluate the effect of biofeedback training. Maximum isometric muscle activity of quadriceps was increased after electrical stimulation biofeedback training in all subjects. The results indicate that a electrical stimulation biofeedback training is a useful method to improve motor learning of quadriceps isometric exercise in total knee replacement.

• The Journal of Korean Physical Therapy
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• 제28권3호
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• pp.212-216
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• 2016

Purpose: The current study seeks to identify the relationship between torque values of the quadriceps and muscle activity during isometric and isokinetic exercises. Methods: The subjects of the study included 29 healthy individuals 17 men and 12 women) who took part in isometric and isokinetic exercises that utilized the quadriceps. The isometric exercises were performed three times each at 4 different angles (0, 30, 60, and 90 degrees). For the isokinetic exercises, concentric contraction and eccentric contraction were undertaken three times each at two angular velocities (30 and 60 degrees). Results: The muscle activity of the quadriceps during the isometric exercises showed significant differences at the 30, 60, and 90 degree angles. During the concentric contractions and eccentric contractions, muscle activity at the peak torque of the quadriceps indicated significant differences in vastus medialis, vastus lateralis, and rectus femoris at angular velocities of 30 and 60 degrees. Conclusion: When applied clinically based on the biomechanical analysis of the current study, it is possible to anticipate and selectively strengthen muscles with isometric and isokinetic exercises for not only healthy adults and professional athletes, but also for those who experience limited knee movement for long periods following knee surgeries.

• 한국전문물리치료학회지
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• 제8권3호
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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).

• The Journal of Korean Physical Therapy
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• 제12권1호
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• pp.9-13
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• 2000

The purpose of this study was to determine the overflow effect and cross training effect of isometric quadriceps training that performed in specific angle of unilateral let. Ten healthy students with an average age of 24 years$(24.1\pm1.3)$, were participated in this study. Then 5 subjects in each group were chosen at random to train using only right quadriceps muscle two time per day(group 2), five times a week and the other 5 subjects(group 1) were chosen to train one times per day, five times a week for 2 weeks at only 50 degrees (contract 6 seconds, rest 10 seconds, 3 sets). Before and after the training, isometric quadriceps muscle testing of the both leg was Performed at three different angles, 60, 50 and 40 degrees respectively by BHN-COM (isokinetic dynamometer) in sitting position. The data was analyzed with paired t-test to determine significant difference between before and after training. In this study, we have found that the isometric quadriceps muscle training on specific angle of right side produced overflow effect In healthy subjects. However, increasing the peak torque of specific angle(training angle) of trained limb did not have an effect on increasing the peak torque of contralateral limb. These results demonstrate that the cross training effect did nut found in this study but a alight increase of peak torque of the untrained limb would recognized the possibility of cross training effect.

• 한국전문물리치료학회지
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• 제16권3호
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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.

• The Journal of Korean Physical Therapy
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• 제26권1호
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• pp.9-14
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• 2014

Purpose: The purpose of this study was to investigate how different knee alignments (genu varum and genu valgum) affected activations of quadriceps muscles with measurements of onset-time differences between vastus medialis and vastus lateralis during isometric contractions at both 30 and 60 degree knee flexion. Methods: Fifty-two adults (20 genu varum, 12 genu valgum, and 20 control) were enrolled in this study. Subjects with over 4cm distance between knee medial epicondyles were assigned to Genu varum, while subjects with over 4cm distance between ankles medial malleolus were considered as genu valgum group. Surface EMG was used to measure onset time of both vastus medialis and vastus lateralis during isometric contraction at 30 and 60 degree knee flexion. Results: The onset time of vastus lateralis was delayed in genu varum group, and that of vastus medialis was delayed in genu valgum group at both 30 and 60 degree knee flexions. Moreover, onset time difference at $30^{\circ}$ knee flexion between muscles was larger in genu valgum group than genu varum group. Conclusion: Subjects with genu varum or valgum activated quadriceps muscles with different orders pending on flexion degrees. Therefore, when quadriceps training program were planned to prevent pain or deformities, the findings that quadriceps were activated with different orders affected by knee alignments and joint degree at which trainings were performed, must be considered. If the selective training programs of quadriceps femoris are planned to prevent pain or deformities due to poor knee alignments, these should consider the subject's knee alignment condition.

• 대한정형도수물리치료학회지
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• 제14권1호
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• pp.31-38
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• 2008

Purpose : The purpose of this study was to compare the effectiveness of both neuromuscular electrical stimulation(NMES) and isometrical exercise(IE) to strengthen the quadriceps femoris muscle. The relationships between the strength changes and the relative force and duration of training contractions were also studied. Methods : The subjects were divided into three group. The control group(n=6) received no exercise and/or stimulation. The isometric exercise (IE) group(n=6) performed maximum isometric contractions, and the neuromuscular electrical stimulation(NMES)(n=6) engaged electrically stimulated isometric contractions, three days a week for four weeks. Results : Results showed that both IE group and NMES group were found to have an increase in strength significantly greater(p<0.05) than the control group at 4 week. But between IE group and NMES group were not found to have an difference in strength significantly. Conclusion : The relative increase in isometric strength, using IE and NMES, may be determined by the ability of the subjects to tolerate longer and more forceful contractions. Suggestions for further research and implications for the clinical of IE and NMES for strength-training are discussed.

• 한국전문물리치료학회지
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• 제17권2호
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• pp.1-9
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• 2010

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was $0^{\circ}$, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was $90^{\circ}$, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.287-294
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• 2020

Objective: This study aimed to investigate the effects of an ultrasound-based bar graph proportional to the quadriceps muscle thickness as a real-time visual feedback training tool in the elderly. Design: Cross-sectional study. Methods: Twenty-four elderly persons participated in this study and were randomly divided into three groups: oral training group (n=8, group 1), ultrasound imaging group (n=8, group 2), and graph group (n=8, group 3). In the pre condition, all participants performed maximal voluntary isometric contraction (MVIC) of the quadriceps with knee extension three times with oral training. In the post condition, group 1 performed MVIC of the quadriceps with oral training, group 2 performed MVIC of the quadriceps with real-time visual feedback using ultrasound imaging, and group 3 performed MVIC of the quadriceps with real-time visual feedback using a bar graph proportional to the quadriceps muscle thickness, three times for all groups. Muscle thickness, activity (mean, peak), tone, stiffness, logarithmic decrement, relaxation, and creep were measured in both conditions in all participants. Results: Visual feedback with a bar graph showed significant effects on muscle thickness, mean muscle activity, and peak muscle activity compared with oral training and visual feedback with ultrasound imaging (p<0.05). Conclusions: Isometric training of the quadriceps with real-time visual feedback using a bar graph proportional to the quadriceps muscle thickness may be more effective than other methods in improving muscle thickness and muscle activity. This study presented a tool that can help increase muscle thickness in the elderly.