• 한국전문물리치료학회지
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• 제23권4호
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• pp.9-15
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• 2016

Background: Squatting is one of the best functional exercises to strengthen the quadriceps muscle in independent gait and activities of daily living. Although the use of a gym ball during squat exercise is the most common way of strengthening the vastus medialis oblique (VMO) muscle, published data on this subject are limited. Objects: The purpose of this study was to compare the sequential muscle activation of the VMO and vastus lateralis (VL) muscles during squat exercise using a gym ball at different knee flexion angles. Methods: Forty healthy adults were randomly divided into experimental (squat exercise using a gym ball) and control (squat exercise alone) groups, in which squats were performed at $45^{\circ}$ and $90^{\circ}$ knee flexion. Electromyographic (EMG) activity data were collected over 10 seconds under the 2 angles of knee flexion ($45^{\circ}$ and $90^{\circ}$). Results: There was significant group and time interaction effect for VMO and VL muscle activation at $45^{\circ}$ knee flexion. This was similarly demonstrated at $90^{\circ}$ knee flexion. No significant group main effect and time main effect for VMO and VL muscle activation were noted at $45^{\circ}$ knee flexion, respectively. In contrast, there was significant group main effect and time main effect for VMO and VL muscle activation at $90^{\circ}$ knee flexion. These significant differences were demonstrated through two-way analysis of variance over repeated measurements, suggesting that the EMG activity of the VMO muscle during squatting with a gym ball showed remarkable improvement compared to that of the VL muscle. Conclusion: This research suggests that squat exercise using a gym ball may be more beneficial in improving the activity of VMO than of the VL muscle at both $45^{\circ}$ and $90^{\circ}$ of knee flexion, respectively. We highly recommend squat exercises with a gym ball for selective strengthening of the VMO muscle in knee rehabilitation.

• The Journal of Korean Physical Therapy
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• 제22권4호
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• pp.21-28
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• 2010

Purpose: The purpose of this study was to evaluate the electromyographic (EMG) activity of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles on foot position and knee angle for hemiplegia patients. Methods: Ten stroke subjects (10 males) participated in the study. Subjects were all right-hemiplegic patients. All subjects did $0^{\circ},\;20^{\circ}$ and $40^{\circ}$ knee flexion while maintaining the foot in a neutral position, or at $30^{\circ}$ adduction or at $30^{\circ}$ abduction. Surface EMG data were collected for VMO and VL muscles on the non-hemiplegic side and hemiplegic side. Collected data were analyzed using two-way ANOVA. Results: VMO and VL activities for the non-hemiplegic and the hemiplegic sides were highest for $40^{\circ}$ knee flexion while maintaining the three foot positions. There were no significant differences in EMG activity of the VMO and VL muscles with different foot positions. There were significant differences between VMO and VL activity for knee flexion angle while maintaining the foot in neutral (p<0.05), at $30^{\circ}$ adduction (p<0.05), or at $30^{\circ}$ abduction (p<0.05). Conclusion: Foot position does not influence VMO and VL activities. But, knee flexion exercise in a closed chain can increase VMO and VL muscle activity for hemiplegic patients. In particular, VMO and VL activities for both the non-hemi side and the hemi side were highest for $40^{\circ}$ knee flexion.

• 대한정형도수물리치료학회지
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• 제20권1호
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• pp.39-45
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• 2014

Background: The purpose of this study is to identify effects of neuro-muscular control training on vastus medialis oblique (VMO) after menisectomy of the knee. Methods: The subjects of this study are women aged 42 and 39 each who did menisectomy. Case 1 was applied quadriceps setting exercise and neuro-muscular contrlol training and case 2 was applied quadriecps setting. Intervention was done 5 times a week for 2 weeks. Measurement of muscle activity on VMO and vastus lateralis (VL) was standardized signals of each muscle to %RVC using surface EMG. Results: On comparison of exercise before and after on VMO and VL, VL activation of case 2 was increased more than case 1. Conclusion: Quadriecps-setting exercise and selective neuro-muscular control training of VMO is effective intervention on VMO activity and muscle activity ratio of VMO to VL.

• The Journal of Korean Physical Therapy
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• 제20권3호
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• pp.29-34
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• 2008

Purpose: The purpose of this study was to identify the effect of anterolateral (45$^{\circ}$) and lateral (90$^{\circ}$) direction resistance, with using an elastic band, on the electromyographic(EMG) activity ratio of the vastus medialis oblique (VMO) and the vastus lateralis (VL) during squat exercise. Methods: The study subjects were 19 active people with no history of patellofemoral pain, limitation of range of motion or pain when performing squat exercise. A 'repeated measures within subjects' design was used. The subjects were asked to perform three repetitions of a 90$^{\circ}$ knee flexion squat exercise with anterolateral (45$^{\circ}$) and lateral (90$^{\circ}$) resistance and without resistance, respectively. The EMG activity of the VMO and VL were recorded by surface EMG electrodes and the results were normalized by the % MVIC value. Results: Repeated measures ANOVA's revealed that squat exercise with anterolateral (45$^{\circ}$) resistance produced significantly greater VMO/VL EMG activity ratio than that with lateral (90$^{\circ}$) resistance and without resistance (p=.013). Yet the result of contrast testing revealed that squat exercise with lateral (90$^{\circ}$) resistance showed no significant difference of the VMO/VL EMG activity ratio, as compared with squat exercise without resistance (p>0.05). Conclusion: The findings of this study suggest that squat exercise combining anterolateral (45$^{\circ}$) resistance can contribute positively to the patients with patellofemoral pain as they increase the VMO/VL EMG activity ratio.

• 한국전문물리치료학회지
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• 제12권2호
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• pp.11-19
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• 2005

Patellofemoral pain syndrome (PFPS) is often attributed to malalignment and maltracking of patella within the patellofemoral joint. Most exercise for PFPS has focused on selectively strengthening the vastus medialis oblique muscle (VMO). This study was designed to identify the effect of medial, lateral wedge and difference of Quadriceps angle (Q-angle) on vastus medialis oblique/vastus lateralis muscle (VL) activity ratios. The subjects were twenty young adult males who had not experienced any knee injury. They were asked to perform isometric contraction exercises in three postures using medial and lateral wedge. The EMG activity of the VL and VMO were recorded in three postures by surface electrodes and normalized by %MVC values derived from seated, isometric knee extensions. The normalized EMG activity levels (%MVC) of the VL and VMO for the three postures of the lower extremities were compared using 2-way repeated measures ANOVA with 1 between-subject factor (group), and 1 within-subject factor (wedge). Results of repeated measures of ANOVA's revealed that the medial wedge isometric contraction exercise produced significantly greater EMG activity of VMO/VL ratios in Group I (Q-angle $18^{\circ}$ or less) (p<.05). But, the medial wedge isometric contraction exercise was no significant difference of VMO/VL ratios in Group II (Q-angle $19^{\circ}$ or more) (p>.05). These results have important implications for selective VMO muscle strengthening exercises in PFPS patients.

• 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.

• 대한임상전기생리학회지
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• 제8권2호
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• pp.7-12
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• 2010

Purpose : The purpose of this study was to determine the effects of hip adduction using a ball on the activation of the vastus medialis oblique (VMO) and the vastus lateralis (VL) during dynamic semisquat exercises. Methods : Twenty seven participants performed three repetitions of a double-leg semisquat and squeeze semisquat (semisquat with hip adduction using a ball) at $60^{\circ}$ knee flexion. The activation of the VMO and the VL was recorded at dominant leg during both semisquat exercises using surface electromyography (MP 100). EMG data were normalized to the maximal voluntary isometric contraction (MVIC) of the quadriceps produced during seated, isometric knee extension. Results : Results of paired t-test analyses revealed that there were no differences between activity of the VMO and the VL in both double-leg semisquat and squeeze semisquat. The activity of the VMO was significantly increased in squeeze semisquat whereas there was no difference in activity of the VL between double-leg semisquat and squeeze semisquat. Conclusion : Combining hip adduction using a ball with semisquat at $60^{\circ}$ knee flexion preferentially increases the activity of the VMO. We can conclude that semisquat at $60^{\circ}$ knee flexion with hip adduction using a ball selectively recruits the VMO. Rehabilitation for quadricep imbalance should consider these findings when selecting exercises which could preferentially activate the VMO.

• The Journal of Korean Physical Therapy
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• 제32권1호
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• pp.52-57
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• 2020

Purpose: This study compared the muscle activities of the Vastus medialis oblique (VMO) and the Vastus lateralis (VL) at three different knee extension angles: 90°, 135°, and 180° in the sitting position. Methods: Twenty subjects between 20 and 30 years of age participated in the study. A mobile phone application called the Clinometer was used to measure the knee joint angle. Electromyography (EMG) was performed to measure the muscle activities of the VMO and VL muscles during knee isometric extension exercises. The pulling sensor was used to maintain 70% of the maximum strength of the knee extensor continuously in the sitting position. After attaching the EMG sensor, the subjects were asked to perform isometric knee extension exercises randomly among three knee extension angles (90°, 135°, or 180°) in the sitting position. One-way repeated measures analysis of the variance and a Bonferroni post hoc test was used to identify the VMO and VL muscle activity during knee extension angles among 90°, 135°, and 180°. Results: The VMO and VL muscle activities increased with increasing knee extension angle in the sitting position (p<0.01). Conclusions: Knee extension exercise at a 180° angle in the sitting position can be recommended to increase the muscle activity of the VMO and VL muscle activities efficiently.

• 한국전문물리치료학회지
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• 제12권3호
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• pp.22-30
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• 2005

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 ($p_{adj}$<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 ($p_{adj}$<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

• 한국전문물리치료학회지
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• 제23권2호
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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.