Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual's ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion: The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.
Purpose: This study aims to verify the effectiveness of sit-to-stand training with visual feedback to improve balance ability and knee extensor strength of total knee replacement patients. Methods: In this study, 15 patients with total knee replacement participated in this study. Subjects were assigned to two groups: a feedback group (experimental group)(n = 8) and a control group (n = 7). They all received 30 min of continuous passive motion (CPM) and sit-to-stand training for 15 min five times per week for two weeks. Knee extensor and balance ability were measured. Knee extensor was measured by Biodex system 3; balance ability was measured by Balancia software. Results: After the intervention, there was a significant difference in the strengthening of the knee extensor muscles in the feedback group, area 95%, weight distribution of the affected side, and the sit-to-stand test repeated five times (p < 0.05). Conclusion: The results of this study showed that sit-to-stand training with visual feedback was more effective in increasing knee extensor muscle strength and balance ability than the sit-to-stand training without visual feedback. Therefore, in order to improve the knee extensor muscle and the balance of total knee replacement patients, it is necessary to consider providing visual feedback during sit-to-stand training.
Objective: The objective of this study is to evaluate various research that have examined dynamic knee valgus and to pinpoint a straightforward, clinically practical 2D assessment method for dynamic knee valgus that is user-friendly. Design: A literature review Methods: This literature review was conducted in Pubmed, MEDLINE® and Google Scholar with the following key words: Knee valgus angle, Knee valgus evaluation, Knee valgus assessment, Dynamic knee valgus. After removing duplicate studies, 53 articles were initially chosen using this method, with 17 studies ultimately meeting the selection criteria. Results: Based on the comprehensive review of various studies, the Single Leg Squat (SLS) was identified as the most popular test method, followed by the Single Leg Landing (SLL) as the next most common test method. The Frontal Plane Projection Angle (FPPA) method was the most representative method for measuring dynamic knee valgus (DKV) during these tests. SLS was found in a total of 10 studies, while SLL was found in 7 studies. Conclusions: The most commonly proposed test for assessing DKV is measuring the SLS using the FPPA method. However, when applied to individuals without knee pathology, the discriminative power of this method may be limited. This suggests the need for further research to explore alternative methods for assessing DKV in this population.
The purposes of this study were investigated physical compensation for gait on induced knee stiffness in normal subjects. Ten subjects were participated in the experiment(age: $26.0{\pm}6.3$ yrs, height: $175.5{\pm}5.3$ cm, weight: $69.1{\pm}6.1$ kg). The study method adopted 3D analysis with five cameras and ground reaction force with two force-plate. Induced knee stiffness level were classified as gait pattern on ROM of knee(free level, $30^{\circ}$ restriction level, fix level). The results were as follows; In angular displacement of hip joint, left hip joint was the more extended in mid-stance on induced right knee stiffness. In angular displacement of knee joint, there was no physical compensation on induced right knee stiffness, but free knee level gait was more flexed in swing phase of right knee joint. In angular displacement of ankle joint, right ankle joint was the more dorsiflexed on induced right knee stiffness, and $30^{\circ}$ restriction level and fix level gait were less plantarflexed in TO2. In trunk tilt, free and $30^{\circ}$ restriction level gait was more backward tilt on induced right knee stiffness. In ROM of each joint, right knee joint was more larger and trunk tilt was more lower on induced right knee stiffness. In GRF, Fx was more bigger lateral force in free and $30^{\circ}$ restriction level gait, and was more bigger medial force in fix level gait. Fy was more bigger propulsion force in free level gait, and was was more bigger braking force in $30^{\circ}$ restriction level gait. Left braking force in $30^{\circ}$ restriction level gait was more bigger. Fz was no significant.
Objective: Anterior cruciate ligament reconstruction (ACLR) has been considered the primary treatment for anterior cruciate ligament (ACL) injured patient. However, there is little biomechanical evidence regarding bilateral knee joint biomechanics during landing and cutting task after ACLR. Method: Eighteen females with ACLR participated in this investigation. Double leg jump landing (DLJL) and single leg jump cut (SLJC) biomechanics were assessed. Results: During DLJL, the healthy knee showed greater knee valgus angle at initial contact ($^{\circ}$) compared to the injured knee (Injured: $2.93{\pm}2.59$, Healthy: $4.20{\pm}2.46$, t=2.957, p=0.009). There was a significant difference in anterior tibial shear force ($N{\times}N^{-1}$) with greater in the injured knee (Injured: $1.41{\pm}0.39$, Healthy: $1.30{\pm}0.35$, t=2.201, p=0.042). During SLJC, injured knee showed greater knee extension moment ($N^*m{\times}[N^*m]^{-1}$) compared to healthy knee (Injured: $0.51{\pm}0.19$, Healthy: $0.47{\pm}0.17$, t=2.761, p=0.013). However, there was no significant differences between the knees in the other variables. Conclusion: ACLRfemales exhibited a greater knee valgus angle at initial contact and lesser anterior tibial shear force on the healthy knee during double leg jump landing. In addition, ACLR females showed a greater knee extension moment on the injured knee during single leg jump cut.
The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.
Journal of The Korean Society of Integrative Medicine
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v.9
no.1
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pp.101-108
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2021
Purpose : The purpose of this study is to verify the effect of selective muscle strengthening of the knee joint extensor muscles using a pressure biofeedback unit to improve knee extensor strength and the balance ability of total knee replacement patients. Through this, we tried to provide clinical information. Methods : In this study, 12 patients with total knee replacement were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n=6) and a control group (n=6). All patients received 30 minutes of continuous passive motion and leg-strengthening exercises for 15 minutes five times a week for two weeks. Subjects performed knee extension exercises with or without biofeedback units in the sitting position. The knee extensor strength and balance ability were measured before and after exercise. Knee extensor strength was measured by Biodex system 3 and balance ability was measured by Balancia software. Results : Both the experimental group and the control group showed a significant difference in the muscle strength of the knee joint extensor muscles after intervention (p<.05). In comparison, the experimental group showed a significant difference than the control group (p<.05). Both the experimental group and the control group showed a significant difference in the velocity average, path length, area 95 % center of pressure (COP), weight distribution, five times sit to stand test (FTSST) after intervention. In comparison, the experimental group showed a significant difference in velocity average, area 95 % COP, and FTSST than the control group (p<.05). Conclusion : In order to strengthen the knee extensor muscle and improve the balance ability in total knee replacement patients, it is necessary to consider providing pressure biofeedback unit during leg strengthening exercises.
Journal of International Academy of Physical Therapy Research
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v.12
no.1
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pp.2279-2285
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2021
Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.
The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.
The Journal of Korean Academic Society of Nursing Education
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v.11
no.1
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pp.30-38
/
2005
Purpose: The purpose of this study was to testify effects of Balance Taping Therapy on the pain and range of motion of the knee joint in the female elderly with degenerative knee arthritis. Method: The research design was one group pretest-posttest design. The data were collected from November 15 to December 25, 2004. The subjects were 23 female elderly with degenerative knee arthritis who were registered at one public health center in Busan. Balance Taping Therapy was conducted twice a week for 5 weeks. The data were analyzed such as the number, percentage, paired t-test, Kolmogorov-Smirnov test using SPSS 10.0 WIN Program. Result: The pain in the female elderly with degenerative knee arthritis significantly decreased from 8.82 to 6.04 after Balance Taping Therapy(t=16.781, p=0.001). The knee flexion joint range of motion in the female elderly with degenerative knee arthritis significantly increased from 119.73 to 123.13 after Balance Taping Therapy (t=-6.003, p=0.001). The knee extention joint range of motion statistically significantly increased from 112.74 to 117.83 after Balance Taping Therapy(t=-8.940, p=0.001). Conclusion: Balance Taping Therapy proved an effective nursing intervention in decreasing pain and increasing the range of motion of the knee joint in the female elderly with degenerative knee arthritis.
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