• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.40-46
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• 2021

Purpose: This study compared the muscle activity of the lower limb according to the three types of fixed angles of the ankle joint during a lunge exercise. Methods: Twenty healthy subjects performed the lunge motion in a trial including the three types of fixed angle. The lunge motion with a neutral, 20° dorsiflexion, and 20° plantarflexion of the ankle joint were randomized and measured repeatedly. The muscle activity of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) was measured by surface electromyography. Results: In the change in ankle joint angle, the RF, VL, BF, and ST muscle activity showed significant differences (p<0.05). In the 20° dorsiflexion position, the muscle activity of VL, BF, and ST showed a significant decrease compared to that in the neutral position (p<0.017). The muscle activity of RF and VL in the neutral position was greater than that in the 20° plantarflexion position (p<0.017). Only the muscle activity of the BF in the 20° plantarflexion position was significantly greater than the 20° dorsiflexion position (p<0.017). Conclusion: These results revealed a difference in the muscle activity of lower extremities in the proximal region according to the angle of the ankle joint during the lunge.

• Korean Journal of Applied Biomechanics
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• v.15 no.1
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• pp.207-219
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• 2005

The purpose of this study was to determine the effect of the foot rotation on the lower limb muscles. Fourteen subjects performed step-up/step-down at a cadence of 80 beats/min, exercises with the foot neutral, $35^{\circ}$ internally rotated, and $35^{\circ}$ externally rotated, respectively. For each variable, a one-way analysis of variance (ANOVA) was used to determine whether there were significant differences between genders and among the eight types of jump. When a significant difference was found in jump type, post hoc analyses were performed using the Tukey procedure. A confidence level of p < .05 was used to determine statistical significance. The results showed that significant changes in averaged IEMG values occurred with the internal rotation of the foot in the lateral gastrocnemius during the knee extension, and in the semitendinosus during the knee flexion. During the knee extension, however, the internal rotation of the foot produced a significantly lower Averaged IEMG values than the neutral foot position in the medial gastrocnemius. The results also found that the peak IEMG activity of the rectus femoris during the knee extension for the external rotation of the foot was Significantly higher than the corresponding values in the neutral position of the foot, while the intenal rotaion of the foot exhibited a significant difference with the neutral position of the foot in the semitendinosus during the knee flexion. In general, the foot rotation position did not influence the average IEMG and Peak IEMG values of most muscles. The practice of adopting foot rotation to selectively strengthen individual muscles of the lower limb was not supported by this study. The external rotation of the foot produced high muscle activities in the quadriceps during the knee extension. For the knee extension, therefore, maintaining a laterally rotated position should be need for stable and comfortable position.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.131-138
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• 2018

PURPOSE: This study was conducted to compare the muscle activity of the proximal muscles of the lower limb according to the distance between the front and rear foot during lunge and to determine the most effective foot position for activation of the proximal muscle in the limb. METHODS: A total of 49 young adults were enrolled in this study. All subjects performed lunge by positioning the big toe of the back foot and the heel of the front foot at intervals of 40%, 60%, and 80% of the subject's own leg length. Muscle activity of the vastus medialis oblique, rectus femoris (RF), vastus lateralis oblique (VLO), gluteus medius, biceps femoris, and semitendinosus (ST) was then measured during three intervals of lunge operation. Each operation was measured three times for 10 seconds each, after which the average value was calculated and analyzed. RESULTS: There were significant differences in muscle activities of RF, VLO, and ST among the three intervals of the foot (p<.05). Post hoc, comparisons revealed lunge at 40% intervals resulted in higher RF and VLO activity than at 60% and 80% intervals (p<.05). In the semitendinosus muscle, 80% leg length intervals showed higher muscle activity than 40% (p<.05). CONCLUSION: Strengthening of the proximal muscles of the lower extremities during lunge exercise is considered to be most effective when placing the fore- and rear foot at intervals corresponding to 40% of the leg length.

• Journal of Korean Academy of Nursing
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• v.37 no.6
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• pp.844-854
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• 2007

Purpose: This study was to verify the effect of muscle strengthening exercises using a Thera-Band on the lower limbs. Methods: The design utilized for this study was a nonequivalent control group pretest-posttest design. A control group (16) and experimental group (16) were selected from stroke patients of K Oriental Medicine Hospital who were hospitalized for 5 months from December 2005 through April 2006. While only acupuncture therapy and physical therapy were used on the control group, acupuncture, physical therapy and additional muscle strengthening exercises using a red thera band were used on the experimental group. Muscle strengthening was performed 20 minutes per session, more than one session a day for 4 weeks. Hypotheses for this study were verified using Two-way repeated ANOVA and ANCOVA using a pre test score as a covariate. Results: The experimental group with thera band muscle strengthening exercises showed a decrease in asymmetry weight loading percentage(F=14.704, P= .010), range of knee (Z=-3.15, P= .001) & deep tendon reflex score(Z=-2.52, P= .012) and moving performance(F=12.328, P= .001)compared to the control group. Conclusion: It is confirmed that muscle strengthening exercises using a Thera-Band can be used as an effective nursing intervention to improve the function of the lower limb of hemiplegic stroke patients.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.19-36
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• 2005

Muscle atrophy is defined as a decrease in muscle mass, cross-sectional area, and myofibrillar protein content. Causes inducing muscle atrophy may be inactivity, denervation, undernutrition and steroid. Inactivity may decrease protein synthesis and increase protein breakdown of skeletal muscle. The muscle atrophy due to inactivity was induced by bed rest, hindlimb suspension, cast, total hip replacement arthroplasty, anterior cruciate ligament reconstruction. Denervated atrophy may be induced by the loss of innervation from lower motor neuron. The atrophy was apparent in the lower limb of hemiplegic patients following ischemic stroke and in the hindlimb of ischemic stroke rats. Protein breakdown of skeletal muscle in the undernourished state results in muscle atrophy. The atrophy due to undernutrition was evident in cancer and leukemia patients and in the undernourished rats. Steroids have been used to treat allergies, inflammatory diseases, autoimmune diseases and to inhibit immune function following transplantation. Steroids may induce muscle atrophy by protein breakdown of skeletal muscle. Muscle Physiology Laboratoryat College of Nursing, Seoul National University proved that dexamethasone may induce hindlimb muscle atrophy in rats and exercise and DHEA may attenuate hindlimb muscle atrophy induced by the steroid in rats. Nurses working with patients undergoing steroid treatment need to be cognizant of steroid induced muscle atrophy. They need to assess whether muscle atrophy is being occurred during and after the steroid treatment. Moreover, they need to apply exercise and DHEA to the patients undergoing steroid treatment in order to attenuate the steroid induced muscle atrophy.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.23-31
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• 2021

PURPOSE: This study was conducted to identify the effects of altering foot position on quadriceps femoris including vastus medialis obliques (VMO), vastus lateralis (VL) and rectus femoris (RF) activation during wall squat exercises. METHODS: All subjects (n = 15) were selected and randomly performed three kinds of wall squats: 1) GWS (General Wall Squat), 2) WSS1/4 (Wall Squat Short 1/4), and 3) WSS1/2 (Wall Squat Short 1/2). Each subject completed all three kinds of wall squatting exercises at three different times and recorded the muscle activity data of vastus medialis obliques, vastus lateralis and rectus femoris. RESULTS: Compared with GWS exercise, VMO and RF muscle activity significantly increased under WSS1/2 exercise (p < .05), while only RF muscle activity significantly increased under WSS1/4 exercise (p < .05). CONCLUSION: The results of the present study indicate that moving the foot toward the wall during wall squats has a positive effect on quadriceps activation. The exercise of wall squat short can not only be used as the lower limb muscle strengthening training for normal people, but also as the recovery training for patellofemoral pain syndrome patients in the rehabilitation stage. Besides, Anterior cruciate ligament patients can also try this exercise according to the advice of doctors and therapists.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.259-268
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• 2022

Objective: The purpose of this study was to measure the immediate effect of hip hinge exercise stretching on hamstring flexibility, pelvic tilting angle, proprioception, and dynamic balance in individual with tightness of the hamstring. Design: A randomized controlled trial. Methods: A total of 35 healthy young adults (27 males, 8 females) volunteered for this study and randomly divided into three groups (Hip hinge exercise stretching group, passive stretching group, and PNF stretching group). The hamstring flexibility, pelvic tilting angle, knee joint proprioception, dynamic balance was conducted for 3 times. In order to evaluate the hamstring flexibility, the active knee extension test was performed. Forward bending test was performed to examine pelvic tilting angle.The proprioception was tested by the joint position sense test and dynamic balance was evaluated by Y balance test. Results: The hamstring flexibility, pelvic tilting angle and dynamic balance were significantly improved between three groups before and after intervention (p<0.05). Dynamic balance was significantly difference between the three groups in the posterolateral direction (p<0.05). Conclusions: This study result showed that hip hinge exercise stretching was the most effective method for increasing hamstring flexibility, pelvic tilting angle and dynamic balance. In addition, it is necessary to study whether hamstring stretching is effective in low back pain patient with hamstrings tightness.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.97-102
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• 2008

Purpose : The purpose of this study was to find the effect of foot bath on blood pressure(BP) following treadmill exercise. Methode : Subject of study were forty healthy males without any cardiovascular, musculoskeletal, and neurologic diseases. Following twenty minutes walking at a speed of 5m/s on the treadmill, ten twenty subjects in experimental group received foot bath, on the dominant lower limb while sitting in chair. Foot bath was applied to the level of the lateral and medial malleoli keeping the temperature of the paraffin bath at $40{\pm}0.5^{\circ}C$. Twenty subjects in control group took a rest sitting in chair in a comfortable position. BP was measured in right brachial artery. BP was measured five times(before exercise, immediately after exercise, 5 minutes, 10 minutes, and fifteen minutes after exercise). Results : The study showed that for diastolic blood pressure, there was no significant difference between the experimental and the control group. However, systolic blood pressure(SBP) increased significantly after exercise compared with SBP before exercise (p<.05). In addition, SBP in five minutes after exercise decreased significantly compared with SBP in immediately after exercise (p<.05). On the other hand, the control group had significant difference between SBP measured before exercise and SBP measured at the other measure time (p<.05). In five minutes after exercise, SBP in experimental group had significant difference with SBP in control group (p<.05). Similarly, in ten and fifteen minutes after exercise, SBP in experimental group had significantly difference with SBP in control group (p<.05). Conclusion : Consequently it was confirmed that when foot bath was applied, the increased BP induced by the exercise returned to normal range rapidly.