• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.21-28
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• 2022

PURPOSE: This study examined the effect of changes in the knee angle and weight shifting of the sole on the activity of the lower extremity muscles during bridge exercise. METHODS: The subjects of this study included 20 healthy adult women (mean age 29.8 ± 4.32). The subjects performed the bridge exercise under three weight-shifting conditions general bridge (GB), hindfoot press bridge (HPB), and fore-foot bridge (FPB) and at two knee angles (90° and 60°). During the bridge exercise, the activity of the quadriceps femoris (rectus femoris, vastus medialis oblique, and vastus lateralis) and biceps femoris muscles were measured using an electromyography sensor. RESULTS: In the quadriceps femoris, the muscle activity of HPB and FPB was significantly higher than that of the GB at knee angles of 90° and 60° (p < .05). In the biceps femoris, the muscle activity increased significantly in the order of GB < HPB < FPB, and the knee angle increased significantly at 60° rather than at 90° (p < .05). There was no significant difference according to the knee angle in all muscles except for the biceps femoris. CONCLUSION: These findings suggest that the weight-shifting bridge of sole bridge exercise was more effective in increasing the activation of the lower extremity muscles than the GB.

• Korean Journal of Applied Biomechanics
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• v.17 no.4
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• pp.107-113
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• 2007

The purpose of this study were to investigate the effects of knee brace on the knee muscular neuro-biomechanical variables during the rebound in female highschool basketball players. Twelve high school female ($17.9{\pm}0.8years$) basketball players rebound jumped for maximal vertical height to sufficiently stress the anterior cruciate ligament with and without knee brace. Kinematic data were collected to estimate the knee flexion, abduction angles and jump height. The EMG data from the biceps femoris and rectus femoris was used to estimate the ratio of quadriceps muscle activity. Female athletes with knee brace showed more reduced the knee abduction angle and the ratio of quadriceps muscle activity at foot contact phase than without knee brace. In conclusion, Female athletes with brace reduced knee anterior cruciate ligament loads.

• Physical Therapy Korea
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• v.19 no.1
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• pp.37-45
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• 2012

The purpose of this study was to assess the influence of patellar height on quadriceps muscles' electromyography (EMG) activity during a squat exercise in adults with patella baja. For the study, we recruited 15 volunteers who had patella baja on the right side. We measured the EMG activity of the right rectus femoris, vastus medialis oblique, and vastus lateralis muscles during squat exercises under two conditions, specifically with and without an infra-patellar strap. The infra-patellar strap was applied below the tested patella to elevate the patella to a normal height. A paired t-test was used to compare the effects of patella height on EMG activity of the quadriceps muscles. The EMG activity of the rectus femoris (RF), vastus medialis oblique (VMO), and vastus lateralis (VL) muscles were significantly decreased during the squat exercise with the infra-patellar strap compared to the same exercise without the infra-patellar strap (p<.05), while the VMO/VL ratio was not different significantly between two conditions (p>.05). The findings of this study suggest that an infra-patellar strap may benefit people with patellar baja, as changes in patellar height could improve the efficiency of the quadriceps muscles.

• PNF and Movement
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• v.17 no.2
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• pp.311-319
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• 2019

Purpose: This study was conducted to determine the structural change in knees caused by quadriceps angle and the muscle activity in lower limbs. Indirect intervention was provided by using taping for stability in the ankle joints, which affected patellofemoral pain. Methods: The subjects in this study were 20 patients with patellofemoral pain who visited ${\bigcirc}{\bigcirc}{\bigcirc} $ Hospital in Busan. The visual analogue scale measured the dynamic quadriceps angle and the degree of pain felt by the patients while walking down stairs, which was a known factor of patellofemoral pain. In addition, muscle activities in the rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, peroneus longus, and biceps femoris, which affect the knees and ankles, were measured using surface electromyography. The muscle activities were converted into %RVC for this study. The data obtained in this study were analyzed with the Wilcoxon signed-rank test using the SPSS Ver. 25.0 statistical program. The significance level ${\alpha}$ was 0.05. Results: The study results showed that the pain and dynamic quadriceps angle were significantly reduced statistically when applying the calcaneus fixation taping (p<0.05). Muscle activity in the lower limbs was significantly decreased in the vastus medialis, vastus lateralis, and tibialis anterior (p<0.05). Conclusion: The summary of the study results verified that the calcaneus fixation taping reduced the pain and dynamic quadriceps angle by providing stability in the ankle joints. It also produced efficient movement due to the difference in lower-limb muscle activity.

• Physical Therapy Korea
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• v.13 no.4
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• pp.1-9
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• 2006

The purpose of this research was to analyze the effects of the increase of the femoral anteversion angle on the unbalanced quadriceps femoris muscle causing the increase of the valgus force on the knee joints and patellofemoral pain syndrome by comparing with the group that shows the smaller femoral anteversion angle. The method for the research was to compare the femoral muscle's activity while the subjects were maintaining the knee joint flexed isometrically for 10 seconds. The evaluation tool for femoral muscle's activity was QEMG-4 (model LXM 3204). The results were as followings. Firstly, in case of the experimental group, the muscle strength of the vastus lateralis muscle was strong while the rectus femoris and vastus medialis were weak. In these facts, we can see the statistically meaningful difference in vastus medialis muscle activity. Secondly, in the muscle activity analysis for vastus lateralis and medialis of the two groups, we could see the vastus lateralis muscle was strong in anteversion wider for experimental group while the vastus medialis muscle contracted far more stronger in anteversion smaller for control group. From these results, we can see the significant differences in muscle recruitment between the two groups. Above results show that if the anteversion becomes wider, vastus medialis muscle will become seriously weaker, on the other hand, vastus lateralis act stronger.

• Journal of Korean Physical Therapy Science
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• v.16 no.3
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• pp.29-34
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• 2009

Background: The purpose of this study was to investigate the usefulness of quadriceps exercise for improvement of knee extensor muscular function after cruciate ligament reconstruction. Methods: Participate in 18 of patients with cruciate ligament reconstruction, ACL & PCL reconstruction was 9 of patients, respectively. All subjects instructed that quadriceps exercise repeated daily, composed to QSE(quadriceps femoris setting exercise) and SLR(straight leg raises). Knee extensor muscular function was measured before and after quadriceps exercise. Initial test was measured before cruciate ligament reconstruction, and retest was measured 6month after cruciate ligament reconstruction. Results: Knee extensor muscular function significantly increased in both ACL and PCL reconstruction(P<0.05). Conclusion: The results of this study indicated that quadriceps exercise useful for improve knee extensor muscular function in patients with cruciate ligament reconstruction.

• Physical Therapy Korea
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• v.23 no.2
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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.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.163-167
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• 2020

A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.43-54
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• 2008

Background : We aimed to determine the effect of a mental practice on the electromyography (EMG) activity of the quadriceps femoris muscle of the affected side in a hemiplegic patient during sit-to-stand and stand-to-sit tasks. Methods : We recruited a male patient who had suffered from right hemiplegia. A single-subject experimental A-B-A design was used. The reliability of visual analysis, which was primarily employed in this study design, was supported by using the "2- standard-deviation band" method. The target motions consisted of two activities: sit-to-stand and stand-to-sit. The EMG measurements of the quadriceps femoris muscles of the affected and unaffected sides were made in 8 sessions in the baseline (A), mental-practice (B), and follow-up (A) phases. During the mental practice phase, the 10-min mental practice was performed, and the mental practice was withdrawn in the follow-up phase in order to identify the carry-over effects of the treatment. Data was calculated as the percentage of the ratio of the quadriceps EMG activity values of the affected side on unaffected side. Result : The percentage EMG-activity ratio showed a greater increase in the mental-practice phase than in the baseline, and it was maintained during the follow-up phase. Most of the data points in the mental-practice and follow-up phases were positioned above the "2-standard-deviation band." Conclusion : These findings suggest that mental practice can be used to improve the physical function of hemiplegic patients.

• PNF and Movement
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• v.17 no.3
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• pp.441-450
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• 2019

Purpose: This study identified the co-activation of quadriceps and hamstring muscles during hamstring strengthening exercises in healthy adults. Methods: Twenty-one participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. Thus, this study recruited 21 healthy adults. All participants performed Nordic exercises, bridge exercises, and one-leg deadlifts randomly. The activity of the rectus femoris, vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (SM) were measured. In addition, the ratios of VM/VL and hamstring/quadriceps (HQ) were measured during the three hamstring strengthening exercises using electromyography. One-way ANOVA was used to compare the co-activation of quadriceps and hamstring muscles in the three exercises. Results: The activity of VM and VL during the performance of one-leg deadlifts was significantly higher than the other two exercises. The BF had significantly higher activity during the Nordic exercises compared to the other two exercises. In addition, the SM activation was significantly greater during Nordic exercises than one-leg deadlifts. Additionally, there was significant difference in HQ ratio among hamstring strengthening exercises. In specific, the one-leg deadlifts yielded a significantly lower HQ ratio. Conclusion: This study revealed that one-leg deadlifts are effective in rehabilitation for anterior cruciate ligament injury. In addition, Nordic exercises can be recommended to facilitate hamstring muscle activation.