• PNF and Movement
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• v.7 no.3
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• pp.17-27
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• 2009

The purpose of this study was to investigate the effect of close kinetic chain(CKC) and open kinetic chain(OKC) posion on proprioceptive neuromuscular facilitation applied to the unilateral upper extremity on the muscle activation of lower extremity. All subjects were randomly assigned to two groups: open kinetic chain group(n=5),closed kinetic chain group(n=5). All participants were PNF patterns applied on the unilateral upper extremity in all subjects were the kinetic chain(CKC) and open kinetic chain(OKC) posion on flexion/abduction/external rotation. The hold and approximation techniques for the irradiation were applied to end range. All measurements for each subject took the following tests: pre-test, post - test in 4weeks, post-testin 8weeks. EMG data was collected from the vastus medialis, tibialis anterior, biceps femoris, and gastrocnemius muscle of both lower extreamity using surface EMG system, Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed using Two-way analysis of variance(ANOVA) with repeated measures to determine the statistical significances. The results of this study are summarized as follows. First, during for close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application, all of the %MVIC values of close kinetic chain and open kinetic chain posion increased sign ificantly compared(p<0.05). Second, The close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application was significantly increased with in the intervention period(p<.05). Third, there was a no significant open kinetic chain posion on PNF pattern application of sing muscle group with in the intervention period.(p<0.05) there was a significant close kinetic chain posion on PNF pattern application of sing muscle group with with in the intervention period(p<0.05). Forth, interaction of the exercise position and muscle was also significant. Post-hoc tests revealed that the activation levels of vastus medialis muscle and tibialis anterior muscle was higher in the closed kinetic chain position(p<.05). that the activation levels of vastus medialis and gastrocnemius muscle was higher in the open kinetic chain position(p<.05). In conclusion, it was found that the application of PNF patterns to the unilateral upper extremity effect on the muscle activation of lower extremity and both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.475-483
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• 2014

PURPOSE: The purpose of the study was to determine the effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke patients. METHODS: The subjects were 50 patients who were diagnosed with cerebrovascular accident. They were randomly assigned either to a close kinetic chain resistant exercise of lower extremity group (study group)(n=25) or open kinetic chain resistant exercise of lower extremity exercise group (control group)(n=25). Gait abilities were measured by using Timed Up & Go (TUG) test, Functional Gait Assessment (FGA) and spatio-temporal gait variable that were velocity, cadence, stride length, double limb support by 3 axises wireless accelerometer and sway angle of center of mass by same instrument. RESULTS: Study group and control group before and after the intervention there were significantly difference in TUG, FGA, spatio-temporal gait variables and sway angle of center of mass (p<.05). There were significantly different between study group and control group for all variables at post-exercise. CONCLUSION: When all is said and done it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with stroke. In its final analysis when applying resistant exercise of lower extremity to stroke patients' gait, close kinetic chain is more effective than open kinetic chain.

• Journal of Korean Physical Therapy Science
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• v.25 no.1
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• pp.52-61
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• 2018

Background: The purpose of this study was to investigate the effect of open and close kinetic chain exercise on the muscle activity of pectoralis major and triceps. Method: Twenty healthy male college students were assessed three times over two weeks. The participants were randomly assigned to OKCE(Open Kinetic Chain Exercise) and CKCE(Close Kinetic Chain Exercise). On the first day, the 7th day and the last day, The MP(mean power) and PT(peak torque) of the PM(pectoralis major) and TR(triceps) during the exercise were measured with an electromyography device and the study was compared. Result: In the present study, it was found that Statistical analysis of the measured values at the end of experimental period revealed statistically significant differences in the MP and PT values of TR and PM. Conclusion: These findings suggest that CKCE and OKCE may be an effective physical therapy intervention for strengthening muscular activity in patients with low activity in the upper limb, including normal subjects, although it is not suitable for effective exercise by selecting either CKCE or OKCE.

• International Journal of Contents
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• v.9 no.1
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• pp.60-64
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• 2013

This study was performed for two of specific reasons, one is for exercise development for improving stroke patient's muscle power, balance and gait and, after verifying the effect of the exercise, the other is for showing that the appling this exercise was more effective on hemi-plegic stroke patients into the clinical trial. The subjects of this study were hemi-plegic patients by stroke, 51 patients were picked up, who were agreed with this research. Close kinetic chain leg exercise using mirrors was applied to study group I, Close kinetic chain leg exercise without mirrors was applied to study group II and general physical therapy was applied to comparison group. The results of this study are as follows. The difference of the groups, study group I showed more effective than study group II on checking rectus femoris, vastus lateralis, biceps femoris, Korean version of Berg Balance Scale, Center of pressure, Functional gait assessment. In this study, Close kinetic chain leg exercise showed more effective and significant on improving for muscle power, balance and gait on stroke patients. Especially, doing exercise using mirrors is considered as more effective method than without mirrors.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.4
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• pp.49-58
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• 2014

Purpose : The purpose of this study was to research the effects on resistance CKC & OCK exercise method on lower limb muscle activity, in chronic stroke patients. Method : In this study, 18 patients with stroke caused by hemorrhage or infarction were participated. resistance exercise method was conducted in tow different group : one is a close kinetic chain exercise(CKC) group and the other is an open kinetic chain exercise(OKC) group. CKC with physical therapy was applied to 9 patients, and OKC with physical therapy was applied to 9 patients. Under the researcher's guidance, exercise for CKC and OKC group carried out 3 times a week for 30 minutes during 4weeks. Result : There was significantly different for the vastus lateralis, tibialis anterior and gastrocnemius muscle activity within the intervention period both group. The vastus lateralis, tibialis anterior and gastrocnemius muscle activity was significantly increased within the CKC group. The vastus leteralis and tibialis anterior muscle activity was significantly increased within the OKC group. Conclusion : It was confirmed in this study that the CKC exercise was more effective than OKC exercise in improving lower limb muscle activity of chronic stroke patients. This study seggested that CKC may be suitable for individuals with a chronic stroke. furthermore study should be made a lot of researches regarding in other method and varying conditions for many hemiplegic patients.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.7-12
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• 2013

Purpose : The purpose of this study was to identify effects of virtual reality-based closed kinetic chain (CKC) exercise on lower extremity muscle activity in chronic stroke patients Methods : Subjects were assigned randomly either to VR+CKC exercise group (n=15) or the CKC exercise group (n=15). When the study began, both groups received conventional physical therapy five times per week. The VR+CKC exercise group received virtual reality programs and the CKC exercise group received close kinetic chain exercises. Each exercise program was performed for six weeks (5 times per weeks; 20 minutes per time). Participants were measured on lower extremity muscle activity using EMG. Results : There was a significant increase of muscle activity (%RVC) in vastus lateralis and vastus medialis. Conclusion : In this study, the virtual reality-based closed kinetic chain exercise program was an effective exercise for improving lower extremity muscle activity in chronic stroke patients.

• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.2
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• Physical Therapy Korea
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• v.27 no.4
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• pp.257-263
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• 2020

Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said "Go", the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many "touches" as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.

• PNF and Movement
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• v.15 no.1
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• pp.35-40
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• 2017

Purpose: The purpose of this study was to determine the immediate effects of using the proprioceptive neuromuscular facilitation (PNF) contract-relax technique in the close kinetic chain position on the gait ability and gastrocnemius muscle tone of stroke patients. Methods: The subjects were patients who had strokes due to cerebrum infarction and hemorrhage. The subjects participated in exercise with the PNF contract-relax technique in the standing-on-elbow position with a high table, and the affected lower leg was placed in the posterior position. The PNF contract-relax technique was applied at the position in which the ankle plantar-flexors were in a sufficiently elongated position. After performing twice in each range, while the muscle was elongated, the affected side was moved further back and a new range was set. In each session, the time of contraction was set to 8 seconds, and the resting time was set to 5 seconds; however, if the patient felt tired, they received more resting time during the intervention. The Myoton Pro and 10 m walking test were used to measure the muscle tone and gait ability both pre- and post-intervention. Results: After participating in the program, the muscle tone decreased and the gait ability improved in the ankle plantar-flexors, as determined by the Myoton Pro and 10 m walking test. Conclusion: The PNF contract-relax technique can help to decrease muscle tone in ankle plantar-flexors with hypertonus and increase the gait ability in stroke patients.