• Journal of Advanced Technology Convergence
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• v.1 no.1
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• pp.33-42
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• 2022

The flexors and extensors of the knee joint are essential for maintaining body stability. The purpose of this study was to investigate the correlation between the isokinetic parameters of the knee flexor and extensor muscles and the function of the lower extremity muscles. Twenty-two healthy adults participated in this study. The time to peak torque (TTP), acceleration time (AT), and peak torque (PT) of the knee flexor and extensor muscles were measured. A 20m sprint, Sargent jump, one leg hop test, and side shuffle were measured to evaluate lower extremity function. The correlation between each variable was analyzed using Pearson correlation coefficient. PT of the knee flexor showed a significant correlation with single leg hops and 6M hops in a single leg. PT of knee extensors was found to be significantly correlated with Sargent jumps and triple hops. Based on the results of this study, we suggest that the strength of the knee flexor and extensor muscles has the potential to be used to predict lower extremity function.

• Journal of Biomedical Engineering Research
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• v.26 no.2
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• pp.111-116
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• 2005

This study was designed to apply the stimulation system developed in our laboratory to investigate how the stimulation conditions affect the muscle contractile characteristics in the isometric condition as well as during the FES standing/walking. Four paraplegic and ten healthy subjects participated in this study, and their knee extensors were voluntary contracted or electrically stimulated to measure the muscle force and the fatigue index for different waveforms of the pulse train. We also investigated different combinations of the electrode positions during standing/walking. It was confirmed that continuous and high-frequency stimulation causes faster fatigue than intermittent and low-frequency stimulation. Fatigue resistance was higher around the optimal muscle length than at a stretched position in healthy subjects, whereas the opposite was observed in paralyzed subjects. The paired t-test results with the level of significance at 0.01 indicated that the sinusoidal waveform generated the largest torque among the four typical waveforms. Although statistically not very significant, the sinusoidal waveform also generated, in general, the highest fatigue resistance at an intensity level below the supramaximal stimulation. One of the paraplegic subject who participated in the standing/walking program can now stand up for 1 minute and 50 seconds with the knee extensors, and walk for about 5 minutes at the speed of 12m/sec.

• Physical Therapy Korea
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• v.26 no.4
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• pp.20-28
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• 2019

Background: The wall squat exercise has been recommended for strengthening of the lower extremity muscles with maintaining lumbar lordosis. Although squat has been studied to be related to lower extremity extensor strength, the relationship between wall squat and lower extremity extensor strength unclear. Because squat and wall squat are biomechanically different, study on the relationship is needed. Objects: The purpose of this study was to determine the lower extremity extensor strength associated with wall squat performance. Methods: 74 healthy volunteers were recruited to participate in this study. The volunteers were measured hip and knee extensors strength and then performed wall squat exercise for maximum count. Results: We found significant relationships between wall squat performance and hip extensor strength normalized by body weight, knee extensor strength normalized by body weight and the composite value. In a regression analysis, hip extensor strength normalized by body weight explained 29% of the variation in wall squat performance in males and 35% in females. Conclusion: These results demonstrate that hip extensor strength normalized by body weight is critical to wall squat performance in both sexes.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.117-122
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• 2014

Purpose: The purpose of this study was to compare the effects of force of ipsilateral versus contralateral cane usage on knee moments in healthy young adults. Methods: A convenience sample of 10 subjects volunteered for this study. Subjects walked over a force plate under three different conditions; unaided and ipsilateral cane and contralateral cane. Analysis of data on moment of the knee joint and ground reaction force was performed using the OrthoTrak program. Results: Flexion moment of the knee was decreased with the contralateral cane, but increased with the ipsilateral cane compared with normal gait. Extension moment of the knee was decreased with the contralateral cane compared with normal gait(p<0.05) and it was showed a greater decrease with the contralateral cane than with the ipsilateral cane gait(p=0.00). Valgus moment of the knee joint was increased with the ipsilateral cane but decreased with the contralateral cane. Vertical ground peak force was decreased with the ipsilateral cane compared with normal gait (p<0.05). Conclusion: The following conclusions were drawn from our data. Contralateral cane gait is more efficacious for persons with weakness of knee extensors, however, for a patient with varus deformity, the cane should be used in the ipsilateral hand.

• Korean Journal of Applied Biomechanics
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• v.32 no.4
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• pp.141-146
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• 2022

Objective: The purpose of this study was to investigate the effects of different frequency on muscle function of the thigh in patients with degenerative knee arthritis during the functional electrical stimulation (FES). Method: For this study, 16 male participants over 65 who patients with degenerative knee arthritis were recruited as research participants. In this research, isokinetic muscular function, EMG, and joint position sensation were performed after FES treatment was applied for three conditions (FES 20, FES 50, and Without FES). For each dependent variable, one-way ANOVA with repeated measures was to determine whether there were significant differences among three different conditions (p<.05). When a significant difference was found, post hoc analyses were performed by using the contrast procedure. Results: When compared to FES 50 and without FES, FES 20 causes significant increase in isometric knee extension strength. No significant differences were found in EMG values across different EMS conditions. Conclusion: The present study examined isokinetic muscular function, EMG, and joint position sensation in order to investigate the effects of different frequency muscle function of knee extensors during the functional electrical stimulation. The results of this study showed that FES with 20 Hz frequency had positive effect on knee extensor. Based on the findings of the present study, FES with lower frequency may help the performer to focus on developing strength in knee extensor muscles.

• Physical Therapy Korea
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• v.26 no.2
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• pp.69-75
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• 2019

Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman's rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.103-109
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• 2021

PURPOSE: This study examined the effects of the Visual Analog Scale (VAS) and knee function index on the knee strength and endurance in the national male field-hockey athletes. METHODS: Twenty-four male field-hockey athletes with a painful knee who trained at the national training center in 2019 were enrolled. The VAS and knee function index questionnaire were used to evaluate the degree of pain and functional state of the knee. The muscle strength and endurance of the knee were measured by Biodex (System 4, USA). The Pearson product moment correlation was performed to examine the effects of the VAS and knee function index the of knee on the strength and endurance. In addition, the VAS and knee function index and muscle strength and muscle endurance were examined to determine the relationship using Simple Linear Regression. The statistical significance level was α=.05. RESULTS: An analysis of the correlation between VAS and knee function index and muscle strength and muscle endurance revealed the VAS and knee function index to be statistically significant (r = .700). In addition, the extensor muscle strength, knee VAS (r = -.457), and knee function index (r = -.414) were also statistically significant. A 1-point increase in the VAS and knee function index was associated with an approximately 9.881 and 1.006 extensor muscle strength. CONCLUSION: The VAS and knee function index of field-hockey athletes are related to the strength of the knee extensors. Therefore, field-hockey athletes should develop a program to strengthen the extensor muscle strength of the knee.

• The Journal of Korean Physical Therapy
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• v.29 no.1
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• pp.39-43
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• 2017

Purpose: This study was to investigate the effects of unilateral muscle fatigue in knee and ankle joints on balance and gait in healthy adults. Methods: Exercise inducing muscle fatigue in the knee joint consisted of concentric and eccentric contraction of dominant knee extensors in healthy adults by using the Leg Extension Rehap exercise machine (HUR, Finland). Exercise inducing muscle fatigue in the ankle joint was composed of voluntary contractions and forced contractions of the dominant plantar flexors in healthy adults. Exercises to induce muscle fatigue in the knee and ankle joints were performed until the subject complained of fatigue or pain, the occurrence of muscle fatigue was confirmed by electromyography. We measured static and dynamic balance using the Good Balance system and gait performance by RS-scan. Results: Static and dynamic balance ability and spatial-temporal gait decreased significantly after muscle fatigue in knee and ankle joint. Conclusion: These results show that unilateral muscle fatigue of the lower extremities affected postural control and gait. Therefore, therapists and sport trainers should minimize the risks of fall and injuries related to unilateral muscle fatigue.

• Physical Therapy Korea
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• v.12 no.1
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• pp.45-54
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• 2005

The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

• Physical Therapy Korea
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• v.22 no.2
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.