• 대한물리치료과학회지
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• 제31권3호
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• pp.23-30
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• 2024

Background: Following lower limb strength training exercises, patients with stroke often experience muscle fatigue, which can frequently lead to falls. Therefore, this study aims to explore how lower limb muscle fatigue caused by squats affects the strength and balance of healthy individuals before extrapolating it to patients with stroke. Design: Cross-sectional study Methods: The study followed a cross-sectional design. The study was conducted on 30 healthy adults. Strength and balance were measured before and after performing wall squat exercises. Muscle strength was measured using a dynamometer, while balance was assessed with the S3 check system. A paired t-test was used for the analysis. Results: The knee extensor and hip extensor showed a significant decrease after wall squat (p < 0.05). However, there was no significant difference observed in knee flexor and hip abductor between before and after wall squat. Balance did not show a significant difference between before and after wall squat. Conclusion: Muscle fatigue caused by wall squats was found to reduce the strength of the knee and hip extensors, while having no impact on balance. The results of this study may serve as foundational data for future research targeting patients with stroke.

• 대한인간공학회지
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• 제35권5호
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• pp.307-317
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• 2016

Objective: This study looks into biomechanical variables occurring when one moves in a sitting posture, and presents objective references to make improvements in work environments of farm workers. Background: The farmers have more common musculoskeletal disorders compared to other professions, because they are much more exposed to biomechanical risk factors. The sitting posture that is the representative form of the squatted, can cause typical knee joint diseases, such as osteoarthritis or patellofemoral pain syndrome of the knee joint. Therefore, a quantitative study of knee load upon the movement in a squatting posture is required. Method: In order to proceed with its investigation, the study examined movements in a sitting posture with and without a lower body supporter through a threedimensional image analysis and by using Surface EMG. The study compared and analyzed the average muscle activity and the maximum muscle activity as well. Results: Every movement in a sitting posture is related to loads onto the knee joints and, when the farm workers move to sides, the study observed a high level of bowlegged moment. The study also noticed differences in muscle activity of medial gastrocnemius with and without the lower body supporter. Conclusion and Application: The study argues that what has been discussed so far is evidence to prove how the farm working environments should be improved in consideration of these movements observed when the farm workers move in a sitting posture.

• 근관절건강학회지
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• 제17권2호
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• pp.142-150
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• 2010

Purpose: The purpose of this study was to examine EMG activities and VMO/VL ratio of the vastus medialis oblique, vastus lateralis, and rectus femoris during squat exercise (knee angle: 15, 45, and 60 degrees; tibial rotation: internal rotation, neutral, and external rotation). Methods: Twelve subjects performed squat exercise at each knee angle and tibial rotation while electromyographic (EMG) activity was collected. Statistical analysis consisted of two-way repeated measures analysis of variance with post hoc analysis. Results: There were significant main effects of knee angles and foot positions and interaction effect on EMG activities of vastus medialis oblique and vastus lateralis. VMO/VL ratios were significantly different by tibial rotations and there was an interaction effect. A neutral position produced significantly more VMO/VL activity ratio than that from internally rotated position and externally rotated position at 60 degrees. Conclusion: Considering the interaction effects for EMG activity across quadriceps muscles tested, the 60 degrees knee angle with a neutral foot position may provide the most effective condition for patients with acute patellofemoral syndrome.

• 국제물리치료학회지
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• 제12권2호
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• pp.2331-2337
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• 2021

Background: More women than men experience genu recurvatum, which can lead to knee pain and arthritis if left unattended. Pilates combined with taping is a suitable rehabilitation method for women with genu recurvatum. Objectives: To aimed the effect of taping and Pilates stabilization exercise on physical alignment and improvement of genu recurvatum in women with genu recurvatum. Design: A Randomized controlled trial. Methods: Twenty-one women were divided into three groups: taping group (back of knee taping and quadriceps femoris taping, n=7), Pilates exercise group (hip, knee and abdominal muscles exercise, n=7), and combined group (taping with pilates exercise, n=7). The measured variables were sagittal plane alignment and back and abdominal muscle, knee flexor and extensor strength. Results: After the intervention, all sagittal plane alignments were significantly improved in both the Pilates and combined groups. Sagittal plane alignment was significantly improved in the combined group compared with the taping group. Back and abdominal muscle strength were significantly improved in the Pilates and combined groups compared with the taping group. Knee flexor and extensor were significantly improved in the combined group compared with the Pilates group and in the Pilates group compared with the taping group. Conclusion: Pilates exercise with taping or Pilates exercise alone was effective intervention methods to improve physical alignment and strength in women with genu recurvatum.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.46-52
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• 2018

Background: The hamstring muscles in the lower extremity are highly important for knee joint stability and can be classified into medial and lateral hamstrings according to the anatomical position, which have some different functions. To measure the strength of the individual hamstring muscles, manual muscle testing is clinically performed by dividing rotation postures into internal and external postures. However, this has no sufficient scientific background. Objects: This study aimed to test the difference that the tibial rotation would cause in the muscle activity of the medial and lateral hamstrings. Methods: The muscle activities of the biceps femoris, semitendinosus, and semimembranosus were measured in a total of three different postures (neutral position and internal and external rotations) with 3 replications. During the maximal isometric contraction, resistance was constantly provided by the string attached to the strap, not by manual resistance of the examiner. Before and after electromyography measurements, the participants underwent hamstring flexibility measurement using the active knee extension test in the supine position on the treatment table. Results: The semitendinosus had a 12.56% reduction in muscle activity in external rotation as compared with that in neutral position. The biceps femoris and semimembranosus showed reduced muscle activities in both external and internal rotations as compared with those in neutral position. Only the women showed significant decreases in the comparison between pre and post-active knee extension. Conclusion: Only the semitendinosus muscle was consistent with the anatomical speculation. However, the reduction in the muscle activity of the semitendinosus as compared with that in neutral position was only 12.56%, the clinical value of which may be difficult to justify.

• The Journal of Korean Physical Therapy
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• 제31권6호
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• pp.339-345
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• 2019

Purpose: The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.256-265
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• 2021

Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

• The Journal of Korean Physical Therapy
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• 제34권2호
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• pp.63-67
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• 2022

Purpose: The purpose of this study was to investigate the effect of assistance tools such as gym balls, wedges, and straps on lower extremity muscle activity and the increase in the range of motion made possible by the use of these tools. The subjects were divided into two groups: a group capable of deep-squatting (PS) and the second finding it impossible or having difficulty in performing such squats (IS). Methods: Twenty-three subjects participated in this study. Surface electromyography was used to measure the muscle activation of the rectus femoris (RF), vastus medialis (VM), and tibialis anterior (TA) muscles during deep squats, normal squats (NS), gym ball squats (GS), wedge squats (WS), and strap squats (SS). A motion analysis system was used to measure the range of motion of the knee joint during each of these exercises. Results: There was a significant difference in the RF muscle activity between the possible squat (PS) and the impossible squat (IS) groups in the GS, and there were significant differences in the RF and TA muscle activity between the groups in the WS. Both the PS group and the IS group showed a significant difference in the TA muscle activity depending on the tool used. There were also significant differences in the range of motion of the knee joints between the intervention methods using NS and those using the tools. Conclusion: In both groups, the muscle activity of the TA muscles was lower when GS, WS, and SS were performed compared to NS. In addition, compared to NS, the range of motion of the knee joint increased when the three tools were used. This study shows that the activity of the RF, VM, and TA muscles decreased and the range of motion of the knee joint increased during deep squats for both the PS and IS groups when tools were used.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.262-268
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• 2022

Background: Virtual reality (VR) programs based on motion capture camera are the most convenient and cost-effective approaches for remote rehabilitation. Assessment of physical function is critical for providing optimal VR rehabilitation training; however, direct muscle strength measurement using camera-based kinematic data is impracticable. Therefore, it is necessary to develop a method to indirectly estimate the muscle strength of users from the value obtained using a motion capture camera. Objects: The purpose of this study was to determine whether the pedaling speed converted using the VR engine from the captured foot position data in the VR environment can be used as an indirect way to evaluate knee muscle strength, and to investigate the validity and reliability of a camera-based VR program. Methods: Thirty healthy adults were included in this study. Each subject performed a 15-second maximum pedaling test in the VR and built-in speedometer modes. In the VR speedometer mode, a motion capture camera was used to detect the position of the ankle joints and automatically calculate the pedaling speed. An isokinetic dynamometer was used to assess the isometric and isokinetic peak torques of knee flexion and extension. Results: The pedaling speeds in VR and built-in speedometer modes revealed a significantly high positive correlation (r = 0.922). In addition, the intra-rater reliability of the pedaling speed in the VR speedometer mode was good (ICC [intraclass correlation coefficient] = 0.685). The results of the Pearson correlation analysis revealed a significant moderate positive correlation between the pedaling speed of the VR speedometer and the peak torque of knee isokinetic flexion (r = 0.639) and extension (r = 0.598). Conclusion: This study suggests the potential benefits of measuring the maximum pedaling speed using 3D depth camera in a VR environment as an indirect assessment of muscle strength. However, technological improvements must be followed to obtain more accurate estimation of muscle strength from the VR cycling test.

• PNF and Movement
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• 제18권3호
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• pp.323-331
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• 2020

Purpose: This study was conducted to determine the effects of motion taping on muscle activity and the WOMAC in a rehabilitation exercise program for elderly women with knee joint osteoarthritis. Methods: The subjects were 28 elderly women aged over 65 years with knee joint osteoarthritis. The subjects were divided into two groups: one experimental and one control group. During the study period, a total of 26 patients completed the experiment, with one drop each from the experimental group and control group. The experimental group applied motion taping and conducted a rehabilitation exercise program. The control group experienced a rehabilitation exercise program without motion taping. The rehabilitation exercise program consisted of warm-up exercises, maximum isometric exercises, the range of motion of the joints, and leg stretching exercises. The intervention was conducted three times a week for six weeks. To investigate the effects of the intervention, muscle activity and the WOMAC were measured. The WOMAC is a tool that can be used to evaluate the pain, stiffness, and physical function of osteoarthritis patients; it has 29 items in three areas. Results: The change in muscle activity according to the intervention showed a statistically significant increase in both the experimental group and control group. The WOMAC also showed statistically significant changes in terms of pain, stiffness, and physical function in both the experimental and control groups. The experimental group showed a greater functional improvement than the control group. Conclusion: For older women with osteoarthritis of the knee, a rehabilitation exercise program is a good intervention. When motion-taping is applied, it is considered to be an intervention program that can be expected to have a better effect on knee joint osteoarthritis.