• Journal of the Korean Society of Physical Medicine
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• v.6 no.2
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• pp.165-175
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• 2011

Purpose: This study examined the effect of the strengthening exercise and stretching exercise to decrease symptom patellofemoral pain syndrome (PFPS). Methods: The Anterior Knee Pain Scale (AKPS) and Clark's test performed for diagnosis of intrinsic PFPS among young adults. Selected thirty young adults subjects who aged 20~26 years participated in the study. Participants were randomly assigned to strengthening, stretching, or control groups. Strengthening group consisted of quadriceps, hamstring and iliotibia band training used elastic band. Stretching group consisted of quadriceps, hamstring and iliotibia band trainings used stretching exercises program. Participants received 50-minute individualized exercise sessions, 3 times a week for 6 weeks. Results: The results were as follow: there were significantly difference stretching exercise group by all muscles on muscular strength test (p<.05). there were significantly difference both strengthening and stretching exercise group by all muscles on flexibility test (p<.05). There were significantly difference stretching exercise group by all muscles on step-down test (p<.05). There were significantly difference both strengthening and stretching exercise group by all muscles on visual analog scale (p<.05). Conclusion: Results suggest important implications for exercise programs of PFPS that stretching exercise is more improved knee pain, functional performance, patella mobility than strengthening exercise.

• Physical Therapy Korea
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• v.26 no.3
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• pp.32-41
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• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.14-19
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• 2022

Background: Plank exercise (PE) is an effective exercise to enhance lower back stability by strengthening the core and lower limb muscles. However, in patients with a shortened hamstring muscle (HAM), PE may cause abnormal movement of the pelvis and lower back due to HAM hyperactivity. Therefore, the objective of this study was to investigate the effects of PE on the core muscles and HAM in subjects with a shortened HAM. Design: Cross-sectional study. Methods: Subjects were divided into a normal length of HAM group (NHG; 9 subjects) and a shortened length of HAM group (SHG; 14 subjects). The activities of the erector spinae (ES), rectus abdominis (RA), external oblique (EO), and HAM muscles were measured using surface electromyography. Results: The results showed that RA, EO, and ES muscle activities were higher in the NHG than in the SHG; however, no significant differences were detected. Conclusion: HAM activity was significantly higher in the SHG than in the NHG. In subjects with a shortened HAM, PE may hyperactivate the HAM, adversely affecting the pelvis and lower back.

• 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.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.296-301
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• 2014

Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.

• Physical Therapy Korea
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• v.30 no.1
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• pp.8-14
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• 2023

Background: Excessive hamstring (HS) activation due to the weakness of the gluteus maximus (GM) causes pain in the hip joint. A single-leg deadlift is a hip extensor exercise, especially GM, that includes functional movements in daily life and complex multi-joint training. In single-leg deadlift, the muscle activity depends on the forward trunk lean angle, and it's necessary to study which muscles are used dominantly depending on the angle. Objects: The purpose of this study was to compare the effect on the muscle activity of the GM and HS during single-leg deadlift according to different forward trunk lean angles and the ratio of the GM vs HS (GM/HS). Methods: Twenty-one healthy female participants were recruited. The muscles activities of the GM, HS and the GM/HS ratio were measured through electromyography during single-leg deadlift according to three condition of forward trunk lean angles (30°, 60°, and 90°). Results: The GM and HS activities significantly differed among three conditions (p < 0.05). GM/HS ratio was significantly higher at 30° and 60° of forward trunk lean compared to 90°. Moreover, the GM activity was significantly higher at 60° of forward trunk lean than at 30° (p < 0.05). Conclusion: The single-leg deadlift at 60° of forward trunk lean is a proper GM muscle strengthening exercise.

• PNF and Movement
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• v.14 no.2
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• pp.113-120
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• 2016

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.79-86
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• 2015

Objective: This study was carried out to compare changes in pain, swelling and range of motion (ROM) between the two groups according to physical therapy intervention. Design: Randomized controlled trial. Methods: There were a total of 20 elderly subjects ages 65-75 years old who have been admitted to the hospital for a total knee arthroplasty. After surgery, the experimental group (n=10) carried out quadriceps femoris muscle strengthening exercise, hamstring stretching exercises and gastrocnemius stretching exercise with a physical therapist for 30 minutes and additionally, received ice pack therapy for 20 minutes once a day. The control group (n=10) carried out continuous passive motion for 30 minutes and received ice pack therapy for 20 minutes once a day. The experimental group and control group carried out each intervention program for 2 weeks 3 times a week. The Visual Analogue Scale was used to assess pain, tape measurements were taken to assess swelling, and a steel goniometer was used to assess knee joint ROM. Results: As a result, the experimental group showed a statistically significant decrease in the pain and swelling, and a significant increase in knee flexion ROM after the intervention, compared to the control group (p<0.05). There was a significant improvement in pain, edema, and knee flexion and extension ROM in all subjects after intervention (p<0.05). Conclusions: According the results of this study, exercise in the experimental group is effect on the pain, swelling and ROM for total knee arthroplasty.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.244-250
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• 2021

Objective: The purpose of this study was to investigate the effect of sprinter pattern bridging exercise using theraband on activation of lower extremity and abdominal muscle and to find out postures that can effectively improve abdominal and lower extremity muscle strength and increase abdominal stability. Methods: This study was designed as a cross-sectional study. The following research was done with applicants attending S university in Seoul to compare the difference in muscle activity between one-leg-Support bridging exercise and sprinter-pattern bridging exercise using theraband. For 48 study participants, we first measured their MVC. Then, we applied one-leg-support bridging exercise and sprinter-pattern bridging exercise at random order. These data were expressed as the percentage of maximal voluntary contraction (%MVC).Electromyography analysis was performed by measuring the external obliques, internal obliques, biceps femoris, and gluteus maximus. Results: There was a statistically significant increment of muscle activity in external and internal oblique muscle(p<0.001)by sprinter-pattern bridging exercise using theraband. On the lower body, statistically significant increment of muscle activity in biceps femoris and gluteus maximus was found(p<0.05). On the other hand, on erector spinae, there was statistically significant decrease in muscle activity(p<0.05). Conclusions: Efficient treatment is expected when sprinter-pattern bridging exercise using theraband is applied clinically.For patients with chronic knee and ankle pain who have difficulty bearing weight, including low back pain and internal rotation of the femur, starting with a low weight bearing, we think it will be helpful in planning systematic training aimed at progressively strengthening the lower extremities.

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.935-944
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• 2001

The patellofemoral pint is formed by the articulation of the patella and femoral condyles in the trochlear groove. The complexity of the patellofemoral pint is magnified by the fact that the tibiofemoral pint works in conjunction with the patellofemoral pint. Additionally, other pints such as the subtalar pint., hip and sacroiliac pints indirectly contribute to the function of the patellofemoral pint. This pint has little bony stability, Soft tissue surrounds the pint to increase stability. The patellofemoral pint increases the mechanical advantage of the quadriceps muscles and resists mechanical loading. In patellofemoral dysfunction, patellofemoral contact pattern is disrupted. leading to excessive compression at the pint. When you treat the patellofemoral dysfunction, you should evaluate anatomic and biomechanic components and find factors of patellofemoral dysfunction. Hamstring tightness. weakness of VMO and tightness of lateral retinaculum lead to flexed knee and abnormal patella tracking and patellofemoral pint reaction force and patellofemoral dysfunction. A through understanding of the anatomy and biomechanics may assist the clinician in the recognition and treatment of patients with patellofemoral pain. Therefore physical therapists should apply modality as well as therapeutic exercise, stretching and strengthening. In this paper, I will discuss the germane anatomical structures and biomechanics of the patellofemoral pint.