Korean Journal of Applied Biomechanics (한국운동역학회지)

Korean Society of Applied Biomechanics (한국운동역학회)
권호 표지
DOI QR코드

DOI QR Code

Tibial Rotation Influences Muscle Activity and Motion of Lower Extremity during The Stair Ascent

계단 오르기 시 정강이뼈 돌림이 하지의 역학과 근 활성도에 미치는 영향

  • Kang, Jeong-Il (Department of Physical Therapy, College of Health, Daebul University) ;
  • Lee, Yu-Kyung (Department of Physical Therapy, Graduate School of Daebul University) ;
  • Park, Seung-Kyu (Department of Physical Therapy, College of Health, Daebul University) ;
  • Lee, Joon-Hee (Department of Physical Therapy, College of Health, Daebul University) ;
  • Yang, Dae-Jung (Department of Physical Therapy, College of Health, Daebul University) ;
  • Choi, Hyun (Department of Physical Therapy, Graduate School of Daebul University)
  • 강정일 (대불대학교 보건대학 물리치료학과) ;
  • 이유경 (대불대학교 대학원 물리치료학과) ;
  • 박승규 (대불대학교 보건대학 물리치료학과) ;
  • 이준희 (대불대학교 보건대학 물리치료학과) ;
  • 양대중 (대불대학교 보건대학 물리치료학과) ;
  • 최현 (대불대학교 대학원 물리치료학과)
  • Received : 2011.10.31
  • Accepted : 2011.12.16
  • Published : 2011.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study was performed to investigate the effects of tibial rotation while going up stair on muscle activity of vastus medialis oblique and vastus lateralis, and on patellar displacement. The subjects included 30 people (male: 15; female: 15) who were randomly assigned to the tibial internal-rotation, neutral-rotation, and external-rotation groups. The subjects went up the stair while performing the assigned rotations, and the rotation of the hip and the displacement of the patella were measured using a 3D motion analyzer. In addition, the maximum voluntary isometric contraction (MVIC) of the vastus medialis oblique and vastus lateralis were measured using surface electromyogram. On the tibial internal rotation, the hip rotation significantly appeared in the same direction and so did on the tibial neutral and external rotations(p<.001). Although the MVIC of the vastus medialis oblique and vastus lateralis did not significantly differ by tibial rotation during the stair ascent, the MVIC of the vastus medialis oblique was higher than that of the vastus lateralis during the internal and neutral rotations (p<.05). In addition, during the stair ascent, the displacement of the patella was more significant during the tibial external rotation than during the tibial internal and neutral rotations(p<.001). Thus, patients with patellofemoral pain are required to be considered the effects of tibial rotation for their rehabilitation.

Keywords

References

  1. Aglietti, P., Given, F., & Cuomo, P.(2006). Disorders of the patellofemoral joint In: Scott WN, Install and Scott surgery of the knee, 4th ed. London: Churchill Livingstone Elsevier, 807-985.
  2. Alfonso, V. S., & Editor.(2006). Anterior knee pain and patellar instability, springer, 185-193
  3. Andreia, S., & Rui, Macedo.(2010). Effect of the contraction of medial rotators of the tibia on the electromyographic activity of vastus medialis and vastus lateralis, Journal of Electromyography and Kinesiology, 20(5), 967-972. https://doi.org/10.1016/j.jelekin.2010.01.007
  4. Bih-Jen, Hsue., & Fong, C., S.(2009). Kinematics and kinetic of the lower extremities of young and elder women during stairs ascent while wearing low and high-heeled shoes, Journal of Electromyography and Kinesiology, 19(6), 1071-1078. https://doi.org/10.1016/j.jelekin.2008.09.005
  5. Brechter, J. H., & Powers, C. M.(2002). Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain, Gait & Posture, 16(2) 115-123. https://doi.org/10.1016/S0966-6362(02)00090-5
  6. Bolqla, L. A., Malone, T. R., & Umberger, B. R. et al.(2008). Hip Strength and Hip and Knee Kinematics During Stair Descent in Females With and Without Patellofemoral Pain Syndrome Symptom Prevalence, Level 4, The Journal of Orthopaedic and Sports Physical Therapy, 38(1), 12-18. https://doi.org/10.2519/jospt.2008.2462
  7. Coqueiro, K. R. R., Bevilaqua-Grossi, Berzin F et al.(2005). Analysis on the activation of the VMO and VLL muscles during semisquat exercises with and without hip adduction in individuals with patellofemoral pain syndrome, Journal of Electromyography and Kinesiology, 15(6), 596-603. https://doi.org/10.1016/j.jelekin.2005.03.001
  8. Cowan, S. M., Bennell, K. L., & Hodges, P. W. et al.(2001). Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome, Archives of Physical Medicine and Rehabilitation, 82(2), 183-189. https://doi.org/10.1053/apmr.2001.19022
  9. Simon, & Donell.(2006). Patellofemoral dysfunction-extensor mechanism malignment, Current Orthopaedics, 20(2), 103-111. https://doi.org/10.1016/j.cuor.2006.02.016
  10. Dye, S. F.(2005). The pathophysiology of patellofemoral pain: A tissue homeostasis perspective, Clinical Orthopaedics Related Research, 436, 100-110.
  11. Earl, J. E., Schmitz, R. J., & Arnold, B. L.(2001). Activation of the vmo and vl during dynamic mini-squat exercises with and without isometric hip adduction, Journal of Electromyography and Kinesiology, 11(6), 381-386. https://doi.org/10.1016/S1050-6411(01)00024-4
  12. Elias, J. J., Mattessic, S. M., & Kumagai, M. et al.(2004). In vitro characterization of the relationship between the Q-angle and the lateral component of the quadriceps force, Proceedings of the Institution of Mechanical Engineers Part H, Journal of Engineering in Medicine, 218(1), 63-67. https://doi.org/10.1243/095441104322807767
  13. Fredericson, M., & Power, C. M.(2002). Practical management of patellofemoral pain, Clinical Journal of Sport Medicine, 12(1), 36-38. https://doi.org/10.1097/00042752-200201000-00010
  14. Fredericson, M., & Yoon, K.(2006). Physical examination and patellofemoral pain syndrome, The American Journal of Physical Medicine Rehabilitation, 85(3), 234-243. https://doi.org/10.1097/01.phm.0000200390.67408.f0
  15. Hanten, W. P., Schulthies, S. S.(1990). Exercise effect on electromyographic activity of the vastus medialis oblique and vastus lateralis muscles, Physical Therapy, 70(9), 561-565. https://doi.org/10.1093/ptj/70.9.561
  16. Herrington, L., & Nester, C.(2004). Q-angle undervalued? The relationship between Q-angle and mediolateral position of the patella, Clinical Biomechanics(Bristol, Avon), 19(10), 1070-1073. https://doi.org/10.1016/j.clinbiomech.2004.07.010
  17. Ireland, M. L., Willson, J. D., & Ballantyne, B. T.(2003). Hip strength in females with and without patellofemoral pain, The Journal of Orthopaedic Sports Physical Therapy, 33(11), 671-676. https://doi.org/10.2519/jospt.2003.33.11.671
  18. Lam, P. L., Ng, G. Y. F.(2001). Activation of the Quadriceps Muscle during semisquatting with different hip and knee positi-ons in patients with anterior knee pain, American Journal of Physical Medicine and Rehabilitation, 80(11), 804-808. https://doi.org/10.1097/00002060-200111000-00003
  19. Laprade, J., Culham, E., & Brouwer, B.(1998). Comparison of five isometric exercises in the recruitment of the vastus medialis oblique in persons with and without patellofemoral pain syndrome, The Journal of Orthopaedic and Sports Physical Therapy, 27(3), 197-204. https://doi.org/10.2519/jospt.1998.27.3.197
  20. Lee, T. Q., Sandusky, B. S., & Adeli, B. S.(2002). Effects of the simulated vastus medialis strength variation on patellofemoral joint biomechanics in human cadaver knees, Journal of Rehabilitation Research and Development, 39(3), 429-438.
  21. Levinger, P., Gilleard, W.L., & Sprogis, K.(2006). Frontal plane motion of the rearfoot during a one-leg squat in individuals with patellofemoral pain syndrome, Journal of the American Podiatric Medical Association, 96(2), 96-101. https://doi.org/10.7547/0960096
  22. Lin, F., Wang, G., & Koh, J. L.(2004). In vivo and noninvasive three-dimensional patella tracking induced by individual heads of quadriceps, Medicine and Science in Sports and Exercise, 36(1), 93-101. https://doi.org/10.1249/01.MSS.0000106260.45656.CC
  23. Lin, F, Wilson, N. A., & Makhsous.(2010). In vivo patellar tracking induced by individual quadriceps components in individuals with patellofemoral pain, Journal of Biomechanics, 43(2), 235-241. https://doi.org/10.1016/j.jbiomech.2009.08.043
  24. Livecchi, N., Armstrong, C., & Cordova, M.(2002). Vastus lateralis and vastus medialis obliques activity during a straight leg raise and knee extension with hip lateral rotation, Journal of Sports Rehabilitation, 11(2), 120-126. https://doi.org/10.1123/jsr.11.2.120
  25. Lun, V. M., Wiley, J. P., & Meeuwisse, W. H.(2005). Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome, Clinical Journal of Sport Medicine, 15(4), 235-240. https://doi.org/10.1097/01.jsm.0000171258.16941.13
  26. Marrten, P., Peter van der W.(2009). Females with patellofemoral pain syndrome have weak hip muscles: a systematic review, The Australian Journal of Physiotherapy, 55(1), 9-18. https://doi.org/10.1016/S0004-9514(09)70055-8
  27. McConnell, J.(2007). Rehabilitation and nonoperative treatment of patellar instability, Sports Medicine and Arthroscopy Review, 15(2), 95-104. https://doi.org/10.1097/JSA.0b013e318054e35c
  28. Michael, Chiacchiero.(2009). Patellofemoral syndrome motor task interventions evaluated, The Journal of Musculoskeletal Medicine, 26(12), 1-2.
  29. Miller, J. P, Sedory,Daniel, Ronald V.(1997). Leg rotation and vastus medialis oblique/ vastus lateralis electromyogram activity ratio during closed chain kinetic exercises prescribed for patellofemoral pain, Journal of Athletic Training, 32(3), 216-220.
  30. Mirzabeiqi, E., Jordan, C., Gronley, J. K.(1999). Isolation of the vastus medialis oblique muscle during exercise, The American Journal of Sports Medicine, 27(1), 50-53. https://doi.org/10.1177/03635465990270011601
  31. Nakagawa, T. H., & Muniz, T. B.(2008). The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: A randomized controlled pilot study, Clinical Rehabilitation, 22(12), 1051-1060. https://doi.org/10.1177/0269215508095357
  32. Neumann, D. A.(2002). Kinesiology of the Musculoskeletal System: Foundations for physical rehabilitation, 1st ed, ST.Louis, Mosby.
  33. Nyland, J., Kuzemchek, S., & Parks, M.(2004). Femoral anteversion influences vastus medialis and gluteus medius EMG amplitued; Composite hip abductor EMG amplitude ratios during isometric combined hip abduction-external rotation, Journal of Electromyography and Kinesiology, 14(2), 255-261. https://doi.org/10.1016/S1050-6411(03)00078-6
  34. O'Sullivan, S. P., Popelas, C. A.(2005). Activation of vastus medialis obliquus among individuals with patellofemoral pain syndrome, Journal of Strength and Conditioning Research, 19(2), 302-304.
  35. Pazit, Levinger, Wendy, Gilleard, Cliff, & Coleman.(2007). Femoral medial deviation angle during a one-leg squat test in individuals with patellofemoral pain syndrome, Physical Therapy in Sport, 8(4), 163-168. https://doi.org/10.1016/j.ptsp.2007.03.003
  36. Powers, C. M.(2003). The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective, The Journal of Orthopaedic and Sports Physical Therapy, 33(1), 639-646. https://doi.org/10.2519/jospt.2003.33.11.639
  37. Sakai, N., Luo, Z. P., & Rand, J. A.(2000). The influence of weakness in the vastus medialis oblique muscle on the patellofemoral joint: an in vitro biomechanical study, Clinical Biomechanics(Bristol, Avon), 15(5), 335-339. https://doi.org/10.1016/S0268-0033(99)00089-3
  38. Scudero, G. R., & McCann, P. D.(2005). Sports medicine. A comprehensive approach, 2nd edition, Phladelphia: Elsevier Mosby.
  39. Serrao, F. V., Cavrak, H. M. N., & Berzin, F.(2005). Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press, Physical Therapy in Sport, 6, 15-23. https://doi.org/10.1016/j.ptsp.2004.03.001
  40. Signorile, J. F., Kacsik, D., & Perry, A.(1995). The effect of knee and foot position on the electomyographical activity of the superficial quadriceps, The Journal of Orthopaedic Sports Physical Therapy, 22(1), 2-9. https://doi.org/10.2519/jospt.1995.22.1.2
  41. Slocum, D. B., & Larson, R. L.(1968). Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. The Journal of Bone and Joint Surgery American, 50(2), 211-225. https://doi.org/10.2106/00004623-196850020-00001
  42. Sykes, K., & Wong, Y. M.(2003) Electrical activity of vastus medialis oblique muscle in straight leg raise exercise with different angles of hip rotation, Physiotherapy, 89(7), 423-430. https://doi.org/10.1016/S0031-9406(05)60076-4
  43. Wilson, N. A., Press, J. M., & Koh, J. L.(2009). In vivo noninvasive evaluation of abnormal patellar tracking during squatting in pateints with patellofemoral pain, The Journal of Bone and Joint Surgery, 91(3), 558-566. https://doi.org/10.2106/JBJS.G.00572
  44. Wren, T. A. L., Patrick, D. K., Reiko, & Hara.(2008). Use of a patella marker to improve tracking of dynamic hip rotation range of motion, Gait & Posture, 27(3), 530-534. https://doi.org/10.1016/j.gaitpost.2007.07.006
  45. Aglietti, P., Givin, F., & Cuomo, P.(2006). Disorders of the patellofemoral joint, 4th ed. London: Churchill Livingstone Elsevier.