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.
Background: This study examined the relationship between interhandle distances and upper limb exertion during simply pushing and pulling of a cart with four swivel wheels, defined by a roll box pallet (RBP) in a Japanese industrial standard. Methods: Six healthy young male participants were asked to push and pull an RBP at a distance of 5.2 m under six conditions corresponding to different interhandle distances (40 cm, 60 cm, and 80 cm) and weights (130 kg and 250 kg). The upper limb exertion was studied by shoulder abduction and flexion, and elbow flexion, as well as surface electromyogram (EMG) in shoulder extensor, and elbow flexor and extensor. Participants were required to provide subjective evaluations on operability after each trial. Results: Subjective operability indicated that a narrower interhandle distance had a better operability for pushing. Interhandle distance was also related to upper limb exertion especially for pushing. A narrow interhandle distance caused smaller shoulder adduction but larger elbow flexion. The normalized EMG data revealed that muscular activity became smaller with a narrow interhandle distance in shoulder extensor. During the pulling task, elbow flexion was smaller at a narrow interhandle distance, although subjective operability and normalized EMG were not significantly varied. Conclusion: A wider interhandle distance, such as 80 cm, was not suitable in the forwardbackward movement of the RBP. Therefore, this study concluded that an interhandle distance of 40 cm would be suitable for pushing and pulling an RBP to protect the workers' hands against the risk of injury by installing inner handles.
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.
To improve trunk stability, various exercise protocols were introduced into the clinical field. Trunk and lumbar stability exercises on unstable surfaces are especially recommended to improve lumbar stability. The purpose of this study was to compare abdominal oblique muscle activity during leg raising in hook-lying position among 3 different type of surface conditions (on floor (F), vestibular board (VB), and foam roll (FR)). Sixteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. Surface electromyography (EMG) activity was recorded from the internal and external oblique muscles of both sides. The normalized EMG activity was compared using a one-way repeated ANOVA. The results showed that the EMG activities of the internal oblique and external oblique of the lifted leg side during straight leg raising significantly increased under the FR condition when compared to the F condition. There was no significant difference of the EMG activity in abdominal oblique muscles between the VB and the FR conditions. The EMG activity of the internal oblique of supported leg side during the straight leg raising was significantly greater under the FR condition than the VB and F conditions (p<.05). The composition ratio of EMG activity of internal oblique muscles during straight leg raising was significantly increased under the FR condition. Therefore, straight leg raising exercise on foam roll in hook lying position could be beneficial to improve trunk and lumbar stability.
The purpose of this study was to assess the effect of applied pressure to abdomen on lumbar and abdominal muscle activation during upper limb exercise. The experimental group consisted of twenty-seven healthy male subjects (mean age=$22.40{\pm}2.19years$, mean height=$175.30{\pm}2.19cm$, mean weight= $67.67{\pm}7.44kg$, RM=$8.43{\pm}2.76kg$). In each different pressure condition (OmmHg, 30mmHg, 70mmHg, 100mmHg), upper limb exercise was performed in total of 10 trials with 10 RM dumb-bell exercise. Lumbar and abdominal muscle activity was measured using surface bipolar electrode electromyography(EMG). EMG activity was measured from upper rectus abdominis, external oblique abdominis, internal oblique abdominis, and elector spinae. The raw EMG signal was processed into the root mean square(RMS). All RMS EMG data were normalized and express as a percentage of the EMG(%EMG). Collected data were statistically analyzed by SPSS/PC Ver 10.0 using two-way analysis of variance for repeated measures($4{\pm}3$) and Bonferroni post hoc, test. Lumbar and abdominal muscle activation was significantly increased when 100 mmHg was applied(p<.05). Upper rectus abdominis activation was significantly increased compared as other muscles activation(p<.05). However, there were no interaction between pressure and muscles(p>.05). The findings of this study can be used as a fundamental data when lumbar orthosis is applied and external pressure can be used as a therapeutic tool.
The purpose of this study was to compare the change in electromyography (EMG) activity in the gluteus maximus (G-max) and the gluteus medius (G-med) in subjects with and without chronic ankle instability (CAI) during three functional postures. Twenty four females were recruited for this study. Subjects were assigned into two groups: with CAI ($n_1=12$) and without CAI ($n_2=12$). The assessment postures were rotational squat, one leg stand above a gradient and crossed leg-sway. Electromyographic activities of the G-max and the G-med were recorded using surface EMG and was normalized using the maximal voluntary isometric contraction elicited using a manual muscle testing. Independent t-test was used to determine the statistical differences between two groups during the three functional postures. The comparisons of the three posture between two groups were performed using a one-way repeated analysis of variance. A Bonferroni adjustment used for post hoc analysis. The activation of EMG on G-max performing the one leg stand above a gradient and crossed leg-sway in subjects with CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-max during the rotational squat was significantly increased, compared to those of the one leg stand above a gradient and crossed leg-sway (p<.05). The activation of EMG on G-med performing three exercise at CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-med during the crossed leg-sway was significantly increased, compared to the rotational squat (p<.05). This study provides valuable information for clinician who research CAI.
Objective: The purpose of this study is to compare the muscle activities of lumbar and lower extremity muscles between left and right sides using EMG(Electromyogram) when patients are transferred by physical therapists. Background: Asymmetrical lift was recognized as a major cause of musculoskeletal disorder. Several studies show that physical therapists' transferring patients needs caution as it could cause a lumbar pain to patients but there is not sufficient data to support. Method: Forty healthy rehabilitation hospital physical therapists joined for this study. The subjects were transferred from wheelchair to treatment mat(from left to right) by connecting the EMG device to the patients' body both on erector spine and rectus fermoris. At the moment when subjects were being transferred, the EMG device collected data from both erector spine and rectus femoris and it was normalized as %MVC. Then the EMG data was statistically analyzed using paired t-tests. Results: The EMG data show that the left erector spinae and rectus femoris are more activated than right erector spinae and rectus femoris in all position(p<.05) in a significant degree. Conclusion: The result implies that physical therapists' asymmetrical lifting when patients are transferred by them has a potential cause of musculoskeletal disorder of patients. Further studies will be conducted to find out a same tendency in other muscles of a body and to see if there are other factors to affect to patients during asymmetrical lifting. Application: These results can be used to provide baseline information for more understanding to asymmetrical lift loading.
Purpose: The study compared the muscle activity and ratio of upper trapezius (UT) to lower trapezius (LT) activity between acute and chronic whiplash-associated disorder (WAD) patients. Methods: Twelve healthy (male: 7), 14 acute WAD (male: 7), and 11 chronic WAD (male: 3) volunteers participated in this study. Electromyography using a surface EMG recorded the activity of the upper trapezius and lower trapezius of both shoulders (dominant and non-dominant) during $120^{\circ}$ elevation when standing and shoulder depression when sitting. The testing order was selected randomly. Subjects were asked to maintain each experimental position for 5 seconds at end range. EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle-testing technique. One-way repeated measures analysis of variance (ANOVA) was used to compare the average root mean square (RMS) value of EMG activity for each condition. Results: The EMG activity of the dominant UT for chronic WAD subjects was significantly higher than for acute WAD subjects during $120^{\circ}$ elevation (p<.05). The EMG activity of the dominant LT for acute WAD subjects was significantly lower than for the control group (p<.05) during $120^{\circ}$ elevation. The EMG activity of the dominant LT for WAD patients was significantly lower than for the control group during shoulder depression (p<.05), and the chronic WAD patients scored significantly the lowest (p<.01). The dominant UT/LT for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05); this result was higher than for the control group (p<.01). The non-dominant UT/LT (ratio) for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05). Conclusion: The UT for chronic WAD subjects was hyperactive when compared to the acute WAD subjects, and the was hypoactive for both acute and chronic patients, therefore intra-trapezius imbalance was more prevalent during shoulder depression.
The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.
PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.
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