• The Journal of Korean Physical Therapy
• /
• v.28 no.2
• /
• pp.65-70
• /
• 2016

Purpose: The aim of this study was to determine the effects of electromyographic (EMG)-Biofeedback using closed kinetic chain exercise (EB-CKCE) on quadriceps angle (Q-angle) and quadriceps muscle activation and muscle activation ratio in subjects with patellofemoral pain syndrome and to provide fundamental information on rehabilitation exercise in patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included. The subjects were randomly divided into three groups: control group (Group I, n=10), semi-squat exercise group (Group II, n=10), and EMG-Biofeedback using closed kinetic chain exercise group (Group III, n=10). Intervention was provided to each group for eight weeks (three times per week; 30 minutes per day). Subjects were measured on Q-angle and quadriceps muscle activation. Results: Significant difference in Q-angle and quadriceps muscle activation was observed in groups II and III compared with control group I (p<0.01). Results of post-hoc analysis showed a significant difference in Q-angle and quadriceps muscle activation in on group III compared with groups I and II. Conclusion: Findings of this study suggest that closed kinetic chain exercise using EMG-Biofeedback that provides real-time biofeedback information on muscle contraction may have a beneficial effect on improvement of Q-angle and quadriceps muscle activation in patellofemoral pain syndrome.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.27 no.3
• /
• pp.89-98
• /
• 2021

Purpose: The purpose of this study was to determine the effects of electromyography (EMG)-biofeedback based closed kinetic chain exercise (CKCE) on quadriceps muscle activity and dynamic balance ability in patellofemoral pain syndrome (PFPS). Methods: Thirty subjects with PFPS were included and they were divided into EMG-biofeedback using CKCE (Group I) and squat exercise using CKCE (Group II), each group consisted of 15 patients. Group I and Group II was performed by the patients for three times a week, for six weeks. sEMG was used to measure quadriceps muscle activity and star excursion balance test (SEBT) was used to measure dynamic balance ability. Results: According to the results of the comparisons between the groups, after intervention, quadriceps muscle activity and dynamic balance ability were significantly higher in Group I than in the Group II. Conclusion: Findings of this study suggest that EMG-biofeedback using CKCE that provides real-time biofeedback information on muscle contraction may have a beneficial effect on selective muscle strength of vastus medialis oblique muscle and dynamic balance ability in PFPS.

• Physical Therapy Korea
• /
• v.15 no.2
• /
• pp.38-43
• /
• 2008

To reduce winging scapula, various exercise protocols have been widely used by clinicians. Selective serratus anterior strengthening, and restoring balanced function, are especially recommended to reduce winging scapula. The purpose of this study was to investigate visual biofeedback using a real time video camera display system for monitoring scapular winging during arm lowering. For this study, 13 males with winging scapular were recruited during arm lowering. Electromyography (EMG) activity was recorded from the serratus anterior (SA) and upper trapezius (UT) of the right side and compared with normal EMG activity using a paired t-test. The study showed, through visual biofeedback, that EMG activity significantly increased in the SA and significantly decreased in the UT (p<.05). These results suggest that visual biofeedback can be recommended as an effective method for scapular eccentric control, to prevent scapular winging during arm lowering.

• The Journal of Korean Physical Therapy
• /
• v.26 no.2
• /
• pp.68-73
• /
• 2014

Purpose: The purpose of this study was to investigate the effect of closed kinetic chain exercise using EMG-biofeedback for selective training of the vastus medialis oblique on functional ability and Q-angle in subjects with patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included in this study. Participants were randomly allocated to the control group (Group I, n=10), closed kinetic chain exercise group (Group II, n=10), and closed kinetic chain exercise using EMG-biofeedback group (Group III, n=10). Intervention was performed in three groups, three times per week, for a period of six weeks. Kujala patellofemoral score and Q-angle were measured before and after the experiment. Results: Some significant differences in kujala patellofemoral score were observed in group II and group III, compared with group I (p<0.01). There was no significant difference on in Q-angle at knee flexion angle $0^{\circ}$. However, some significant differences in Q-angle at knee flexion $60^{\circ}$ were observed in group III, compared with group I (p<0.01). Conclusion: Closed kinetic chain exercise using EMG-biofeedback that provides real-time biometric information on selected muscles in order to increase the efficiency of treatment may be helpful in improvement of functional ability and Q-angle in patellofemoral pain syndrome.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.3
• /
• pp.95-101
• /
• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Journal of Korea Multimedia Society
• /
• v.7 no.12
• /
• pp.1650-1656
• /
• 2004

In this paper, a multi-adaptive filter is proposed for removing EOG and the 60 Hz power supply noise from EEG measured in the frontal lobe and the feedback output control method is implemented for biofeedback. The multi-adaptive filter has been implemented on the TMS320C6711 DSP system and the feedback output control algorithm has been realized by calculating the ratio of alpha wave on the TMS320C31 DSP system with real time performance. Through the experiment using the implemented multi-adaptive filter and feedback output controller, we demonstrate that the proposed adaptive filter effectively removes EOG and the 60 Hz power supply noise from the measured EEG in the frontal lobe and the feedback algorithm controls the level of stimulation by the ratio of the alpha wave.

• Physical Therapy Korea
• /
• v.24 no.2
• /
• pp.66-75
• /
• 2017

Background: After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke. Objects: The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time. Methods: Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter. Results: The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention. Conclusion: VBF training may be distribute a patient's buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

• Progress in Medical Physics
• /
• v.25 no.2
• /
• pp.72-78
• /
• 2014

The aim of the study is to test a hypothesis that quasi-breath-hold (QBH) biofeedback improves the residual respiratory motion management in gated 3D thoracic MR imaging, reducing respiratory motion artifacts with insignificant acquisition time alteration. To test the hypothesis five healthy human subjects underwent two gated MR imaging studies based on a T2 weighted SPACE MR pulse sequence using a respiratory navigator of a 3T Siemens MRI: one under free breathing and the other under QBH biofeedback breathing. The QBH biofeedback system utilized the external marker position on the abdomen obtained with an RPM system (Real-time Position Management, Varian) to audio-visually guide a human subject for 2s breath-hold at 90% exhalation position in each respiratory cycle. The improvement in the upper liver breath-hold motion reproducibility within the gating window using the QBH biofeedback system has been assessed for a group of volunteers. We assessed the residual respiratory motion management within the gating window and respiratory motion artifacts in 3D thoracic MRI both with/without QBH biofeedback. In addition, the RMSE (root mean square error) of abdominal displacement has been investigated. The QBH biofeedback reduced the residual upper liver motion within the gating window during MR acquisitions (~6 minutes) compared to that for free breathing, resulting in the reduction of respiratory motion artifacts in lung and liver of gated 3D thoracic MR images. The abdominal motion reduction in the gated window was consistent with the residual motion reduction of the diaphragm with QBH biofeedback. Consequently, average RMSE (root mean square error) of abdominal displacement obtained from the RPM has been also reduced from 2.0 mm of free breathing to 0.7 mm of QBH biofeedback breathing over the entire cycle (67% reduction, p-value=0.02) and from 1.7 mm of free breathing to 0.7 mm of QBH biofeedback breathing in the gated window (58% reduction, p-value=0.14). The average baseline drift obtained using a linear fit was reduced from 5.5 mm/min with free breathing to 0.6 mm/min (89% reduction, p-value=0.017) with QBH biofeedback. The study demonstrated that the QBH biofeedback improved the upper liver breath-hold motion reproducibility during the gated 3D thoracic MR imaging. This system can provide clinically applicable motion management of the internal anatomy for gated medical imaging as well as gated radiotherapy.

• Journal of Sensor Science and Technology
• /
• v.12 no.3
• /
• pp.121-127
• /
• 2003

In this study, we carried out a study for implementation of the pre-amplifier and the digital signal processing part for the potable EEG biofeedback system. As we consider characteristics of the EEG signal, we designed the pre-amplifier to obtain the EEG signal to be reduced noise signal. Because the EEG signal include EOG, EMG, ECG signals etc, it is difficult to analyze of the EEG signal. Therefore, we developed DSP board and operation program which was embed the LMS adaptive filter algorithm and operate with the pre-amplifier in the real time. The simulation signal and pure EEG signal is used in the experiment. As the result, we confirmed good efficiency of developed system and possibility of application to the portable EEG biofeedback system.

• Journal of the Korean Society of Physical Medicine
• /
• v.16 no.3
• /
• pp.107-113
• /
• 2021

PURPOSE: Selective strengthening of the transverse abdominis muscle (TrA) during abdominal hollowing makes an important contribution to the stability and control of the spine. This study examined the effects of abdominal hollowing exercise (AHE) according to the visual feedback method on the external oblique, internal oblique, and transverse abdominis muscles. METHODS: Twenty healthy subjects were assigned randomly to an AHE with visual feedback from real-time ultrasound image (group A, n = 10), AHE with visual feedback with pressure biofeedback unit (group B, n = 10). Both groups underwent 20 min of AHE with visual feedback once daily, five days/week for two weeks. The changes in the muscle thickness of the TrA, internal oblique abdominal muscle (IO), and external oblique abdominal muscle (EO) were measured by ultrasonography. RESULTS: The thickness of TrA was changed significantly in both groups (p < .05). However, the lowest minimal detectable changes were achieved in Group A. The thickness of the IO and EO muscles in group A was changed significantly, but there were no significant changes in group B. CONCLUSION: Both visual feedback methods were effective for strengthening the TrA muscles selectively. Nevertheless, AHE with visual feedback using real-time ultrasound images may be more useful in trA muscle contraction.