• The Journal of Korean Physical Therapy
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• v.27 no.4
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• pp.264-269
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• 2015

Purpose: The objective of this study was to determine the effects of game based weight-bearing training (GBWBT) on lower extremity muscle activation and balance in stroke patients. Methods: Thirty subjects were randomly divided into two groups: experimental group I (n=15) and control group II (n=15). Each group was provided intervention under two conditions, as follows: in the Game based weight-bearing training (group I), 30 minutes per day, five times per week, with physical therapy for 30 minutes, and in the functional weight-bearing training (group II), 30 minutes per day, five times per week, with physical therapy for 30 minutes The training program was conducted for a period of eight weeks. Subjects were measured on lower extremity muscle (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) by electromyography and balance by Biorescue. ANCOVA was performed for comparison of lower extremity muscle activation and balance between different intervention methods. All patients were evaluated at baseline and at the end of the treatment protocol. Statistical significance was tested between the patients before and after treatment by t-test. Results: Significant difference in lower extremity muscle activation was observed in experimental group I compared with control group II (p<0.05). Significant difference in balance was observed in experimental group I compared with control group II (p<0.001). Conclusion: Findings of this study suggest that game based weight-bearing training may have a beneficial effect on improvement of lower extremity muscle activation and balance in stroke patients.

• PNF and Movement
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• v.4 no.1
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• pp.9-18
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• 2006

Purpose: The purpose of this study was to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) applied to the unilateral upper extremity on the muscle activation of contralateral lower extremity. Twenty-two healthy subjects (mean age of 23.7 years) participated in this study. Method : PNF patterns applied on the unilateral upper extremity in all subjects were the flexion/abduction/external rotation and lifting pattern. The hold and appoximation techniques for the irradiation were applied to end range of both patterns. Muscle activations in four patterns were measured in vastus medialis, tibialis anterior, rectus femoris, and gastrocnemius medial muscles of contralateral lower extremity using surface EMG system. Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed by one factor analysis of variance with repeated measure test. Result : There were significant differences in the between-subject effect (muscles) and within-subject effect (patterns) in comparison of muscle activation by application of PNF patterns (p<.05). The irradiation led to higher activation in the flexion/abduction/external rotation pattern than that of lifting pattern in all muscles (p<.05). The approximation techniques revealed more activations than these of hold technique in all muscles (p<.05). Conclusion : These results suggest that the application of PNF patterns to the unilateral upper extremity affect on the muscle activation of contralateral lower extremity and increase according to the intensity of resistance. This mechanism of contralateral effect might provide a help to the development of treatment method for the affected side and functional improvement for the patients who have damages of central nervous system or musculoskeletal problems by orthopedic injury.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.4
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• pp.67-75
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• 2016

Purpose: The purpose of this study was to compare Hip-Knee-Ankle(HKA) angle and muscle activation ratio between vastus medialis(VM), rectus femoris(RF), and vastus lateralis (VL), and by this, to examine their relationship. It is aimed to explore how the activation ratio among the muscles involved in patellofemoral kinetics would vary in relation with the frontal alignment of the lower extremity. Subjects and Methods: 26 healthy subjects were recruited for the study. The HKA angles were measured with radiograph. The VM, RF, VL muscle activation level were measured by surface electromyography while each participant performed 4 different types of movement (isometric knee extension, squat, ambulation, step-up) and VM/RF, VM/VL, RF/VL ratios were calculated. Pearson correlation was used to estimate the relationship between the HKA angle and the muscle ratio. Results: There was significant moderate correlation between HKA angle and VM: RF on the left side during ambulation (p<0.05). Moderate correlations were also observed during step-up and squat with less significance (p<0.1). Conclusion: The frontal alignment of the knee measured by the HKA angle was conditionally associated with muscle activation ratio between VM and RF (VM:RF); On the left, during ambulation, step-up, and squat, the more valgus knee tended to correlate with the more VM muscle activation ratio, which is expected to induce more stabilizing effect to the patella and its tracking. It suggests that the frontal alignement measured by the HKA-angle can affect PF kinetics. It also indicates a possibility that increase in valgus alignment of the knee, by the HKA measurement, may not act unfavorably to generate PFP.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.2
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• pp.215-223
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• 2011

Purpose: The purpose of this study was to determine the effect of leg muscle activation by applying proprioceptive neuromuscular facilitation (PNF) arm patterns to unilateral upper extremities under the condition of both open and closed kinetic chains in a seated position. Methods: Twenty-two healthy subjects participated in this study. Four PNF patterns were applied to each subject's unilateral upper extremity. EMG data were collected from the vastus medialis, biceps femoris, tibialis anterior and gastrocnemius. The measured EMG data were digitized and processed to root mean square (RMS) and expressed as percentage maximal voluntary isometric contraction (%MVIC). The data were analyzed using two-way analysis of variance (ANOVA) with repeated measures to determine the statistical significance. Results: The results of this study were summarized as follows: Firstly, in comparison to muscle activation of the biceps femoris, there was a significant increase in the D2 flexion pattern when it was compared with D2 extension pattern and when it was compared with D1 flexion pattern (p<.05). Secondly, there was a significant increase in the muscle activation of the vastus medialis and tibialis anterior with a closed kinetic chain rather than an open kinetic chain (p<.05). Conclusion: In conclusion, in order to increase muscle activation of the biceps femoris, the D2 flexion pattern can be applied, regardless of kinetic chain. In addition, in order to increase muscle activation of the vastus medialis and tibialis anterior, four arm patterns can be applied with a closed kinetic chain.

• Korean Journal of Applied Biomechanics
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• v.30 no.4
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• pp.311-319
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• 2020

Objective: The purpose of this study was to examine of this study is to study the effect of squat exercise on muscle activation in a sling device using various types of ropes and to propose an effective sling exercise method for strengthening the lower extremity strength. Method: 20 adult male subjects (age: 25.2±2.4 yrs, height: 176.5±3.2 cm, weight: 77.2±4.5 kg) participated in this study. In the experiment, a total of four squats were conducted: squat [SE], sling squat using inelastic rope [IR], sling squat using elastic rope [ER], and sling squat using two elastic ropes [TER]. Squats were performed 5 times for each condition, and a 60-second break was given for each condition to minimize muscle fatigue. The activation of biceps brachii, rectus femoris, gastrocnemius, and tibialis anterior muscles was measured. Results: It was found that the activation of all muscles was the lowest during the squat exercise [SE]. During the sling squat using inelastic rope [IR], the muscle activation of the biceps brachii was the highest. During the sling squat using elastic rope [ER], the activation of the rectus femoris, gastrocnemius, and tibialis anterior muscles was found to be the highest. In the sling squat using two elastic ropes [TER], most of the muscle activation was similar to that of the sling squat using inelastic rope [IR]. Conclusion: Our results of the experiment, it was found that sling squat exercise using elastic rope had a positive effect on the activation of all muscles. It is thought that performing a squat exercise under moderate weight load and unstable conditions, such as sling squat exercise using elastic rope, can increase the muscle activity of the lower limbs and perform more effective exercise effect than performing a conventional squat exercise under stable conditions. In the future, if research is conducted not only on adult men, but also on various ages and patients, it will be able to provide positive help in improving balance, stability and stamina through squat exercise.

• Physical Therapy Korea
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• v.31 no.2
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• pp.114-122
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• 2024

Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]). Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength. Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position. Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.411-416
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• 2013

Purpose: The purpose of the present study was to determine the effects of activation of gluteus maximus (Gmax) and abdominal muscle using EMG biofeedback on lumbosacral and tibiocalcaneal angles in standing position. Methods: Fourteen healthy subjects with normal feet participated in the present study. Electromyographic (EMG) biofeedback using visual cue was used to activate the external oblique (EO) and Gmax. The lumbosacral and tibiocalcalcaneal angles were measured by electronic goniometers. All the subjects were instructed to activate the Gmax and EO monitoring increasing amounts of the muscle activities in each muscle. The lumbosacral and tibiocalcaneal angles were collected in three trials during resting and activation of each muscle using EMG biofeedback in standing position. The mean value of three trials was used in the data analysis. A paired-t test was used to compare the lumbosacral and tibiocalcaneal angles between resting and activation of the Gmax and EO using EMG biofeedback. Results: The lumbosacral and tibiocalcaneal angles were significantly less in the resting compared to activation using EMG biofeedback (p<0.05). Conclusion: The activaition of Gmax and abdominal muscles using EMG biofeedback play role to control the pronation of subtalar joint during the weight-bearing.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.40-46
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• 2016

Objective: The purpose of this study was to examine the effect on multifidus and external oblique abdominis muscle activation during hip contraction of three types (concentric, isometric, eccentric) in standing position. Design: Cross-sectional study. Methods: Twenty healthy adult men volunteered to participate in this study. Muscle activation was recorded from gluteus maximus, both multifidus, and both external oblique abdominis by surface electromyography (EMG) while holding position in the type of gluteus maximus contraction. EMG values were normalized by maximum muscle contractions (% maximum voluntary isometric contraction). All subjects performed hip extension with three contraction methods. The type of gluteus maximus contraction using Thera-band was composed of concentric contraction (type 1), isometric contraction (type 2), and eccentric contraction (type 3). To measure muscle activation on the gluteus maximus contraction type, each position were maintained for 5 seconds with data collection taken place during middle three seconds. Muscle activation was measured in each position three times. Results: For the results of this study, there was no significant difference within three contraction patterns of the gluteus maximus (concentric, isometric, and eccentric) each both multifidus, both external oblique abdominis, and gluteus maximus. And there was no significant difference among both multifidus, both external oblique abdominis, and gluteus maximus each hip extension contraction type. Conclusions: These findings suggest that specific contraction types of the gluteus maximus does not lead to a more effective activation of the multifidus, external oblique abdominis, and gluteus maximus.

• Journal of Biomedical Engineering Research
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• v.29 no.4
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• pp.316-322
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• 2008

The purpose of this study was to investigate muscle activation of lower extremity such as rectus femoris, tibialis anterior and soleus according to 0cm(bare foot), 4cm and 7cm heel height of shoe on the rocking surface in older women. 20 older women who did not have any lower musculoskeletal and neurological disorders in the past were participated in this study. Each subject was standing for 15 seconds on the level 8 of Biodex Stability System (BSS) while wearing 4cm and 7cm heel height shoes including bare foot. Electromyography was used to measure muscle activation of lower extremity, and the muscle activation was expressed as a percentage of maximal voluntary isometric contraction (% MVIC). We measured % MVIC of three muscles during 5 seconds except for the first 5 seconds and last 5 seconds. SPSS 12.0 program was used for this study. Repeated one-way analysis of variance(ANOVA) was performed to compare the significant difference among the muscles of lower extremities according to heel heights of shoe on the rocking plate. % MVIC of each muscle such as rectus femoris, tibialis anterior and soleus regarding heel heights of shoe had statistically significant differences (p<0.05). The results of contrast test were as follows; 1) % MVIC of rectus femoris had significant differences between barefoot and 4cm, and barefoot and 7cm. 2) % MVIC of tibialis anterior had significant differences between barefoot and 4cm, barefoot and 7cm, and 4cm and 7cm. 3) % MVIC of soleus had significant differences between barefoot and 7cm, 4cm and 7cm. The results indicate that all commonly responsive muscle on the conditions of barefoot, 4cm, and 7cm shoe height on the rcoking surface is tibialis anterior muscle. We found out that the more heels of shoe high, the more muscle activation increases. High-heeled shoes above 7cm remarkably increase the muscle activation of lower extremity and may result in muscle fatigue. Thus, these shoes may summate risk factors of falls in older women. We can acknowledge that the heels above 4 cm affect each muscle activation in lower extremity on the rocking surface.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.147-157
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• 2020

Purpose : The purpose of this study was to investigate the effects of active release technique and lumbar stabilization exercise on pelvic asymmetry, muscle activation and pain in chronic low back pain patients. Methods : The subjects were 37 outpatients diagnosed with chronic low back pain. The patients were randomly divided into an active release technique therapy group (ART; n=18), and lumbar stabilization exercise group (LSE; n=19). These groups performed their respective therapy for a 30-minute session occurring two times a week over six-weeks period. To assess the patients' pelvic asymmetry, their pelvic tilt, and pelvic rotation was measured using X-ray imaging. EMG was used to evaluate the muscle activity of the lumbar muscle. The visual analogue scale (VAS) were used to measure the subjects' pain. Results : Both ART group, and LSE group exhibited statistically significant differences in their subjects' VAS and muscle activation of lumbar muscle after the therapy (p<.05). In ART group exhibited statistically significant decreases in their subjects' pelvic tilt and pelvic rotation after therapy (p<.05). There was a significant difference between the ART group, and LSE group (p<.05). Conclusion : The results of this study suggest that active release technique and lumbar stabilization exercise are effective in decrease pain and increase muscle activation in chronic low back pain patient. In addition active release technique is considered to be more effective in improving pelvic tilt and pelvic rotation than lumbar stabilization exercise.