• PNF and Movement
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• v.7 no.3
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• pp.17-27
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• 2009

The purpose of this study was to investigate the effect of close kinetic chain(CKC) and open kinetic chain(OKC) posion on proprioceptive neuromuscular facilitation applied to the unilateral upper extremity on the muscle activation of lower extremity. All subjects were randomly assigned to two groups: open kinetic chain group(n=5),closed kinetic chain group(n=5). All participants were PNF patterns applied on the unilateral upper extremity in all subjects were the kinetic chain(CKC) and open kinetic chain(OKC) posion on flexion/abduction/external rotation. The hold and approximation techniques for the irradiation were applied to end range. All measurements for each subject took the following tests: pre-test, post - test in 4weeks, post-testin 8weeks. EMG data was collected from the vastus medialis, tibialis anterior, biceps femoris, and gastrocnemius muscle of both lower extreamity using surface EMG system, Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed using Two-way analysis of variance(ANOVA) with repeated measures to determine the statistical significances. The results of this study are summarized as follows. First, during for close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application, all of the %MVIC values of close kinetic chain and open kinetic chain posion increased sign ificantly compared(p<0.05). Second, The close kinetic chain(CKC) and open kinetic chain(OKC) posion on PNF pattern application was significantly increased with in the intervention period(p<.05). Third, there was a no significant open kinetic chain posion on PNF pattern application of sing muscle group with in the intervention period.(p<0.05) there was a significant close kinetic chain posion on PNF pattern application of sing muscle group with with in the intervention period(p<0.05). Forth, interaction of the exercise position and muscle was also significant. Post-hoc tests revealed that the activation levels of vastus medialis muscle and tibialis anterior muscle was higher in the closed kinetic chain position(p<.05). that the activation levels of vastus medialis and gastrocnemius muscle was higher in the open kinetic chain position(p<.05). In conclusion, it was found that the application of PNF patterns to the unilateral upper extremity effect on the muscle activation of lower extremity and both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.223-231
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• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.22-31
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• 2009

Purpose The purpose of this study was to compare the effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Methods Ten patients with stroke were randomly allocated to either a closed kinetic chain exercise (CKC) group(n=5) or an open kinetic chain exercise(OKC) group(n=5). The subjects of each group followed the exercise regimen of their respective groups, and each exercise was performed for 50 mins per day, 3 days per week, for 4 weeks. Assessment was made using Berg Balance Scale (BBS), One Leg Standing(OLS) test, and Timed up and go(TUG) test. The 2 groups were assessed twice: before and after the intervention. Results The TUG test score was significantly different in the CKC group between before and after intervention (p<.05); however, there was no such deference in the OKC group (p>.05). Further, the scores of the BBS and OLS tests were not significantly different for the 2 groups between before and after intervention (p>.05). The hanges in these BBS and OLS score were not significantly different(p>.05); however, there was a significant difference in the change in the TUG scores (p<.05). Conclusion On the basis of the results of this study, we found that the closed kinetic chain exercise is more effective in improving the walking ability and dynamic balance in patients with stroke. Future studies are warranted in this regard.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.182-190
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• 2014

Purpose: This study aimed to determine the effects of open kinetic chain exercise (OKCE) and closed kinetic chain exercise (CKCE) using knee reposition sensing on balance, strength, and knee joint reposition sense (JPS) in chronic stroke patients. Methods: Twenty-nine hemiplegic patients participated in this study. Participants were randomly divided into 3 groups, CKCE, OKCE, and controls, with 9, 10, and 10 participants, respectively. The CKCE group completed CKCE using knee reposition sensing, whereas the OKCE group completed OKCE using knee reposition sensing. The control group completed conventional physical therapy. Results: Significant differences between the CKCE and OKCE groups were apparent for all outcomes except the functional reaching test. The CKCE group displayed significant improvements in knee JPS versus the OKCE and control groups (p<0.01). The OKCE group displayed significant improvements in knee extensor muscle strength versus the CKCE and control groups (p<0.05). The CKCE and OKCE groups displayed significantly improvements in static balance versus the control group (p<0.05). Conclusion: CKCE and OKCE improved balance, strength, and knee JPS. Additionally, CKCE might provide a more useful intervention benefit than OKCE for increasing knee JPS, a weight-bearing task. OKCE was sufficient to improve the knee extensor muscle strength.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.131-138
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• 2019

PURPOSE: This study examined the effects on muscle activation and ankle instability following sudden ankle inversion of the closed kinetic chain exercise using visual feedback to evaluate chronic ankle instability in adult males. METHODS: In this study, 28 subjects with chronic ankle instability were recruited and randomly divided into a closed kinetic chain exercise using a visual feedback group(n=13) and an open kinetic chain exercise group(n=15). Each group underwent 30 minutes of exercise three times a week for 8 weeks. The electromyographic(EMG) values of the rectus femoris, biceps femoris, tibialis anterior, peroneus longus, peroneus brevis, and lateral gastrocnemius muscles were measured to analyze muscle activity. The Cumberland ankle instability tool(CAIT) was used to measure ankle instability. RESULTS: Both groups showed improvements in tibialis anterior, peroneus longus and CAIT score(p<.05). In the experimental group, there were significant improvements in the rectus femoris, biceps femoris, and lateral gastrocnemius muscle activation(p<.05). CONCLUSION: The results suggest that closed kinetic chain exercise using visual feedback can be a useful treatment method for patients with chronic ankle instability.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.165-179
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• 2019

Purpose : The purpose of this study is to improve the stroke patient's gait ability by applying a closed or kinetic chain lower limb exercise Methods : The study subjects were 48 hospitalized hemiplegic patients who agreed to participate in the study. 48 subjects went through the intervention: 24 in the experimental group and 24 in the control group. One set consisted of 10 repeats of the exercise. The subjects performed three sets of the exercise once a day, 5 times a week, for 6 weeks. Results : TUG and FGA were significantly improved in the experimental group. The spatio-temporal gait variables in the experimental group all showed significant improvement. In the control group, velocity, cadence, and double limb support showed significant improvement, Trunk sway angle showed significant improvement in all three axes in both groups. Conclusion : The results of this study indicate that a more positive effect in terms of improvement of the stroke patient's gait ability will be seen for closed rather than open kinetic chain lower limb resistance exercise.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.1
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• pp.23-30
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• 2009

Purpose : This study was investigated the effect of static balance recovery during open kinetic chain exercise (OKC) and closed kinetic chain exercise(CKC). Methods : The paticipants were consisted of forty-one, was perform 3 sets, 3 times per week for 6 weeks, balance was measured by GOOD BALANCE. Statistical analysis was used repeated measure two-way ANOVA and independent t-test. Results : In CKC group, Center of presure(COP) medial-lateral(ML) velocity was significantly increased post 6 week test than pre-test, post 2 week test. COP anterior-posterior(AP) velocity was significantly increased post 6 week test than pre-test (p<.05). Conclusion : It was found that both OKC and CKC was significantly increased balance recovery in normal younng adults. In further study, it was suggested that was regard patient with muscle weakness.

• 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.

• Physical Therapy Korea
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• v.26 no.2
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.2
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• pp.67-80
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• 2013

Purpose : This study was to investigate effects of closed kinetic chain and open kinetic chain exercise on the lumbar stabilizarion. Methods : A total of 30 healthy over 20 years old college students(men = 14, women = 16) who were participated in this. We selected randomly people of CKC, OKC, and control group. For the past four weeks, CKC and OKC group worked out 3 times per week and then we compared within group and between groups on muscle width. Results : 1. The width of internal oblique, transverse abdominis, and multifidus were all significantly increased after four weeks exercise in the CKC group(P<.05). 2. The width of internal oblique, transverse abdominis, and multifidus were all increased after four weeks exercise in the OKC group but transverse abdominis musule only showed significant difference. 3. Difference values between pre-exercise and post-exercise of transverse abdominis and multifidus in the CKC group was significantly high and difference among the groups were significant. Conclusion : Accordingly, lumbar stabilizing exercise was more effective to increase a width of abdominal deep muscles through CKC exercise.