• 한국전문물리치료학회지
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• 제14권2호
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• pp.29-36
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• 2007

Muscle tone (stiffness/hardness) or muscle compliance changes during muscle contraction. The purposes of this study were to assess the intrarater and interrater reliabilities of the Myotonometer$^{(R)}$, electronic device that quantifies muscle tone. Two raters used the Myotonometer to assess the right bicep brachia and quadriceps muscles of 30 voluntary persons without any orthopedic or neurological problems (age range, 18~21 yrs). Muscles were measured in a relaxed state and during brief sustained voluntary maximal isometric contraction. Intrarater correlation coefficients were calculated for each muscle and for each condition (relaxed and contracted). Intrarater reliabilities (intraclass correlation coefficients, ICCs) ranged from .778 to .954, relaxed, biceps brachia), .926 to .963 (contracted, biceps brachia), .935 to .990 (relaxed, quadriceps) and .679 to .952(contracted, quadriceps). Interrater reliabilities ranged from .652 to .790 (relaxed, biceps brachii), .813 to .907 (contracted, biceps brachii), .831 to .950 (relaxed, quadriceps) and .849 to .937 (contracted, quadriceps). Myotonometer measurements had high to very high intrarater and interrater reliability for measurements of the biceps brachia and quadriceps muscles.

• 한국전문물리치료학회지
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• 제28권3호
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• pp.215-226
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• 2021

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.37-45
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• 2012

The purpose of this study was to assess the influence of patellar height on quadriceps muscles' electromyography (EMG) activity during a squat exercise in adults with patella baja. For the study, we recruited 15 volunteers who had patella baja on the right side. We measured the EMG activity of the right rectus femoris, vastus medialis oblique, and vastus lateralis muscles during squat exercises under two conditions, specifically with and without an infra-patellar strap. The infra-patellar strap was applied below the tested patella to elevate the patella to a normal height. A paired t-test was used to compare the effects of patella height on EMG activity of the quadriceps muscles. The EMG activity of the rectus femoris (RF), vastus medialis oblique (VMO), and vastus lateralis (VL) muscles were significantly decreased during the squat exercise with the infra-patellar strap compared to the same exercise without the infra-patellar strap (p<.05), while the VMO/VL ratio was not different significantly between two conditions (p>.05). The findings of this study suggest that an infra-patellar strap may benefit people with patellar baja, as changes in patellar height could improve the efficiency of the quadriceps muscles.

• 한국전문물리치료학회지
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• 제27권4호
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• pp.241-249
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• 2020

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

• The Journal of Korean Physical Therapy
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• 제35권2호
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• pp.53-57
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• 2023

Purpose: The purpose of this study was to compare the changes in the muscle activation of the quadriceps muscle (rectus femoris, vastus lateralis, vastus medialis) during the stand-to-sit (StandTS) movement according to the plantar flexion angle of the ankle joint. Methods: A total of 22 healthy young females participated in this study. During the StandTS under the three conditions (plantarflexion angle 0°, 20°, and 45° of the ankle), electromyography (EMG) data (% maximum voluntary iso¬metric contraction) of the rectus femoris, vastus lateralis, and vastus medialis were recorded using a wireless surface EMG system. Results: There was a significant difference in the muscle activation of rectus femoris, vastus lateralis, and vastus medialis according to the plantar flexion angle (0°, 20°, and 45°) of the ankle. The muscle activation of the quadriceps was the highest at a 45° angle of plantarflexion and the lowest at 0°. One-way repeated ANOVA was used to analyze the muscle activation data of the lower extremity muscles according to the angle of the ankle joint. Conclusion: Based on the results of our study, it was confirmed that the muscle activity of the quadriceps can be increased even in the StandTS movement, which involves the eccentric contraction of the quadriceps muscle. This suggests that maintaining a plantar flexion posture for a long time, say by wearing high-heeled shoes, can quickly cause muscle fatigue in the lower-limb muscles, which can cause a decrease in balance ability leading to falls.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.367-373
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• 2021

Objective: Short foot exercise(SFE) is frequently used to increase the medial longitudinal arch of the foot, as well as the intrinsic foot muscles. This studyinvestigated the effects of SFE onmuscular activity and the onset of contraction of the quadriceps femoris muscle during squats in healthypeople. It also aimed to compare and analyze the results with those of the general squat method and propose a more efficient squat method. Design: Cross-sectional study. Methods: This study compared 20 adults (male=10, female=10) who statisfied the inclusion criteria for the muscle activity and onset of the muscle contraction of the quadriceps femoris using surface EMG under two conditions: general squats and SFE squats. Results: Separate analyses and comparisons of the outcomes of the SFE squat and the general squat, showed a significant increase in the muscle activities of the rectus femoris and vastus medial muscles in both males and females (p<0.05). The onset of muscle contraction was significantly delayed for the vastus lateralis relative to that for the vastus medialis (p<0.05). However, it delayed significantly in females, but not in males. Conclusions: The SFE squats induced selective muscular activities of the rectus femoris and vastus medialis muscels and affected the onset of contraction of the vastus medialis and lateralis muscles.

• 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.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.140-146
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• 2022

Background: The superimposed technique (ST) involves the application of electrical muscle stimulation (EMS) during voluntary muscle action. The physiological effects attributed to each stimulus may be accumulated by the ST. Although various EMS devices for the quadriceps muscle are being marketed to the general public, there is still a lack of research on whether ST training can provide significant advantages for improving quadriceps muscle strength or thickness compared with EMS alone. Objective: To compare the effects of eight weeks of ST and EMS on the thicknesses of the rectus femoris (RF) and vastus intermedius (VI) muscles and knee extension strength. Methods: Thirty healthy subjects were recruited and randomly assigned to either the ST or EMS groups. The participants underwent ST or EMS training for eight weeks. In all participants, the thicknesses of the RF and VI muscles were measured before and after the 8-week intervention by ultrasonography, and quadriceps muscle strength was measured using the Smart KEMA tension sensor (KOREATECH Co., Ltd.). Results: There were significant differences in the pre- and post-intervention thicknesses of the RF and VI muscles as well as the quadriceps muscle strength in both groups (p < 0.05). RF thickness was significantly greater in the ST group (F = 4.294, p = 0.048), but there was no significant difference in VI thickness (F = 0.234, p = 0.632) or knee extension strength (F = 0.775, p = 0.386). Conclusion: EMS can be used to improve quadriceps muscle strength and RF and VI muscle thickness, and ST can be used to improve RF thickness in the context of athletic training and fitness.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.63-70
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• 2005

To compare the effects of forward walking and backward walking on surface electromyographic analysis of quadriceps muscles at treadmill grades of 0%, 5% and 10%, subjects were randomized to eleven athletics (5 females, 6 males), with a mean age of 17.8 years, and a SD of 4.66 years. The values of the surface electromyographic (SEMG) activity of the rectus femoris (RF), vastus lateralis (VL) and vastus medialis oblique (VMO) were measured during forward walking and backward walking on a treadmill at grades of 0, 5 and 10%. The subjects walked for approximately 10 seconds at 4.0 km/h. The data were analyzed by repeated measuring of the two-way ANOVA and analyzed by a paired t-test between forward walking and backward walking. The SEMG activity levels of the RF, VL and VMO were the highest when both the forward walking and backward walking increased incrementally for treadmill grades of 0% to 10%, but the VMO/VL ratio had no significant changes. The SEMG activity levels of the RF, VL and VMO were significantly different between directions. However, SEMG activity levels of the RF, VL, VMO and VMO/VL ratio did not show significant difference among the treadmill grades. No statistically significant interactions were detected between the direction of walking and treadmill grade. Backward walking on the treadmill at 4 km/h and grades of 0%, 5%, 10% elicited a greater SEMG activity on the quadriceps muscles than did forward walking under the same conditions. The results suggest that the quadriceps may be effectively activated by performance at treadmill grades of 10%. This investigation confirms that backward walking up an incline may place additional muscular demands on individuals.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.16-22
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• 2006

Sporadic inclusion body myositis (s-IBM) is an aquired slowly progressive inflammatory myopathy with unknown etiology. Although light microscopic abnormalities and characteristic histopathology on muscle biopsy distinguishes from other inflammatory myopathies, vacuolated muscle fibers, intracellular amyloid deposits or tubulofilaments in electromicroscopic findings are not definite in some patients. This review shows the prominently involved muscles in s-IBM and specific or nonspecific electrophysiologic manifestations from reported data for helping the diagnosis of definite-or probable-IBM patients. In lower limbs, the quadriceps is predominantly involved, as is iliopsoas, and tibialis anterior is common. In the upper limbs, the greatest weakness is in forearm finger flexors. Finger extensors, biceps and triceps also are moderately to prominently involved. The majority of patients demonstrate polyphasic MUAPs that are short in duration. An additional striking feature is the concomitant documentation of long-duration, large-amplitude, polyphasic MUAPs. In spite of the frequent mixed myopathic-neurogenic electromyographic findings of IBM, just like that of chronic myositis, asymmetric, slowly progressive weakness of flexor digitorum profundus or quadriceps femoris muscles after age of 50 is very necessary condition for the diagnosis of IBM.