• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.81-87
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• 2013

Purpose: The purpose of the current study was to examine the effects of electromyography (EMG)-biofeedback training on lower extremity muscle activity and balance of patients with total knee replacement (TKR). Methods: Subjects were randomly allocated to two groups: experimental and control group. Subjects in the experimental group (n=10) were provided with quadriceps setting exercise by EMG-biofeedback (QSE+BF) and those in the control group were provided with QSE. Subjects in both groups were provided with the respective training programs for 20 minutes per session, five times per week, for a period of six weeks. To test significance, data analysis was performed using repeated-ANOVAs. Results: Statistically significant differences in muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability were observed in the experimental group, compared with the control group. In comparison of the muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability between different training periods within the groups, both groups showed statistically significant differences. Conclusion: EMG-biofeedback training is effective in improving lower extremity muscle activity and balance ability of patients with TKR, and should be effective in patients with other diseases.

• PNF and Movement
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• v.19 no.1
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• pp.9-17
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• 2021

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.

• Physical Therapy Korea
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• v.23 no.1
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• pp.11-19
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• 2016

Background: Investigation in gender differences of kinetics and kinematics for individuals with patellar femoral pain syndrome (PFPS) was not sufficiently performed. Objects: The purpose of this study is that whether there is a difference depending on gender from muscle activity and strength and knee valgus angle during controlled single-leg squat which is widely used as clinical movement test for the patient with PFPS. Methods: 20 young adults (10 men, $20.0\pm}2.1$years; 10 women, $20.4{\pm}2.1$years) with PFPS were voluntarily recruited in this study. Muscle activity and strength and knee valgus angle were collected during single-leg squat. Independent t-test and Mann-Whitney test were used to compare the differences between groups of male and female. Results: Rectus femoris (t=-2.204, p=.041) and vastus medialis oblique (t=-2.151, p=.045) muscle activity of women were significantly higher than male group. Normalized muscle strength of hip and knee muscles showed a significant difference between men and women (p<.05). Valgus angle of the knee in women (t=-2.450, p=.025) were increased significantly than men. Conclusion: The therapist would consider the characteristics of these gender differences during performing movement test, exercise, and education for the individuals with PFPS.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.347-354
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• 2014

PURPOSE: This study was to examine changes in muscle activity of lower extremity shoes sole form (high heels, shoes with curved out sole, house shoes). METHODS: The subjects of this study were 12 women in their twenties. They put three kinds of shoes (high heels, shoes with curved out sole, house shoes) and walked 5m. The muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) were measured using a wireless electromyogram (EMG). Rectus femoris was attached to 1/2 position at the distance between ASIS and knee bone and vastus medials was attached to 2cm from upper inside of knee bone. Tibialis anterior was attached to 75% position above line connecting knee joint and ankle joint and gastrocnemius medial part was attached to 3 5% position above knee joint and ankle. RESULTS: It was found that there were significant differences in changes of muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) on shoes sole forms (p<.05). All lower extremity muscles were showed high muscles activities, when high heels wear (p<.05). Wearing shoes with curved out sole was showed high muscle activity of tibialis anterior and lower muscle activity of gastrocnemius medial part compared with wearing house shoes (p<.05). CONCLUSION: Shoes sole form should be considered when patients with knee and ankle joint problems choose shoes because muscles were showed different activities according to shoes sole forms.

• Physical Therapy Korea
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• v.8 no.2
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• pp.65-72
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• 2001

The purpose of this study was to investigate the effect of knee exercises on the onset times of vastus medialis oblique muscle (VMO) and vastus lateralis muscle (VL) and in healthy subjects. Fifteen subjects (7 men, 8 women) in a mean age of 26.4 years participated in the study. Electromyographic (EMG) signals were recorded from the VMO and VL under four exercises. Knee exercises consisted of open kinematic terminal knee extension, straight leg raising, isometric hip adduction exercise, and closed kinematic terminal knee extension. No significant differences were found in the onset times of EMG activities of VMO and VL in the four exercises. There were also no significant differences among the exercises. These results coincided with previous studies that found no difference between onset of VMO and VL. However, it is difficult to say that there is no difference between onset of VMO and VL in healthy subjects. To confirm this results, further researches that follow same on set determination metod and exercises are needed. Not only is the study of onset time of muscle needed, but also the studies of the amount of activation and the rate of increase of muscle activation are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.97-104
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• 2016

PURPOSE: Bridge exercise is widely used in rehabilitation exercise for trunk stabilization through various applications in clinical practice. However, there is a lack of studies changing the base of support for the shoulders. The purpose of this study is to investigate the changes in the base of support for the shoulders of trunk muscle activation during bridge exercise. METHODS: 20 healthy subjects (10 men, 10 women) in their twenties were participated in this study. They performed 5 bridge exercises (bridge exercise with their shoulders on a stable table (1/2 knee height, knee height), and on a sling (1/2 knee height, knee height), conventional bridge exercise. The surface electromyography were used for rectus abdominis (RA), internal oblique (IO), external oblique (EO), and erector spinae (ES). RESULTS: During bridge exercise that their shoulders on the sling of 1/2 knee height, the RA, EO, IO muscle activities were significant increased. And during bridge exercise that their shoulders on the stable surface of knee height, the IO/RA ratio were higher than other positions but there were no significant difference between positions for EO/RA, IO/RA ratio. CONCLUSION: Based on this result, using various bases of support and changing the height of bridging exercise may be used to provide effective trunk stabilization exercises.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.7 s.196
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• pp.133-138
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• 2007

It is important to understand the characteristics of amputee gait to develop more advanced prostheses. The aim of this study was quantitatively to analyze the stair climbing task for the above-knee amputee with a prosthesis and to predict muscle forces and joint moments at musculoskeletal joints by dynamic analysis. The three-dimensional musculoskeletal model of lower extremities was constructed by gait analysis and transformation software for one above-knee amputee and ten healthy people. The measured ground reaction forces and kinematical data of each joint by gait analysis were used as input data during inverse dynamic analysis. Lastly, dynamic analysis of above-knee amputee during stair climbing were performed using musculoskeletal models. The results showed that summed muscle farces of hip extensor of amputated leg were greater than those of sound leg but the opposite results were revealed at hip abductor and knee flexor of amputated leg. We could also find that the higher moments at hip and knee joint of sound leg were needed to overcome the flexion moment caused by body weight and amputated leg. In conclusion, dynamic analysis using musculoskeletal models may be a useful mean to predict muscle forces and joint moments for specific motion tasks related to rehacilitation therapy..

• Physical Therapy Korea
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• v.21 no.4
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• pp.15-22
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• 2014

The purpose of this study was to determine the muscle activities of the erector spinae (ES), gluteus maximus (Gmax), gluteus medius (Gmed), and the hamstring (HAM) and the ratios of Gmax/ES, Gmax/HAM, and Gmed/HAM during the prone heel squeeze (PHS) with different knee flexion angles ($45^{\circ}$, $90^{\circ}$, and $135^{\circ}$). Fifteen young and healthy subjects (8 men, 7 women) were recruited for the study. Surface electromyography signals were collected on ES, Gmax, Gmed, and HAM during PHS. A separate one-way analysis of variance with repeated measures was used to determine the significance of the muscle activities of ES, Gmax, Gmed, and HAM and the ratios of Gmax/ES, Gmax/HAM, and Gmed/HAM with different knee flexion angles during PHS. There was a significant increase in the Gmax activity at the knee flexion of $90^{\circ}$ in comparison with that of the $45^{\circ}$ (p=.016). There were significant increases in the Gmed activity at the knee flexion of $90^{\circ}$ (p=.008) and $135^{\circ}$ (p=.006) in comparison with that of the $45^{\circ}$. There were significant decreases in the HAM activity at the knee flexion of $90^{\circ}$ (p=.009) and $135^{\circ}$ (p=.004) in comparison with that of the $45^{\circ}$. There were significant increases in the Gmax/HAM muscle activity ratio at the knee flexion of $90^{\circ}$ (p=.007) and $135^{\circ}$ (p=.012) in comparison with that of the $45^{\circ}$. There were significant increase in the Gmed/HAM muscle activity ratio at the knee flexion of $135^{\circ}$ in comparison with that of the $45^{\circ}$ (p=.008). The knee flexion of $90^{\circ}$ during PHS can induce decreasing activity of HAM and increasing activity of Gmax, and the knee flexion of $135^{\circ}$ during PHS can induce decreasing activity of HAM and increasing activity of Gmed. Hence, PHS with different knee flexion positions could be considered for the different target muscle.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.556-575
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• 1996

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test & post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60° and 180° with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows : 1) Flexion and extension muscle strength at angular velocity of 60° and 180° were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180°(F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference (F=4.28, P=0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise(F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of be-fore exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after 6weeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ once (F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a pre-experiment with small size subjects. So, con-trolled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.