• Physical Therapy Korea
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• v.16 no.3
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• pp.42-49
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• 2009

This study examined the vastus medialis oblique (VMO) and the vastus lateralis (VL) onset time differences (OTD) during quadriceps contraction in different hip positions. Twelve healthy subjects were recruited (four men, eight women). Surface EMG activities of the VMO and VL were measured during a quadriceps strengthening exercise in a long sitting condition and in a sitting at a chair with feet hanging condition. For each condition, subjects were tested in two hip positions (neutral and adduction). The OTD between the two muscles was calculated for each condition, by subtracting the onset time of the VL from the VMO. Therefore, the negative value of OTD represent earlier EMG onset of the VMO compared to the VL. The OTD was not significantly different between the hip neutral and the hip adduction position in the long sitting condition (p=.064). However, the OTD was significantly different between the hip neutral position ($15.83{\pm}109.51$ ms) and hip adduction position ($-5.58{\pm}121.08$ ms) during the sitting at a chair with feet hanging condition (p=.047). The negative OTD value in the hip adduction condition during quadriceps strengthening exercises is the result of earlier onset of the VMO than VL. Therefore, quadriceps contraction in the hip adduction position can prevent the risk of patella lateral tracking. We expect that quadriceps strengthening exercise in the hip adduction position will be a safe way to prevent patellofemoral pain syndrome resulting from abnormal patella lateral tracking.

• Physical Therapy Korea
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• v.4 no.1
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• pp.1-10
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• 1997

The purposes of this study were to compare the electromyographic activities from the rectus femoris, vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis during straight leg raising (SLR) and quadriceps setting (QS) exercise and to determine which exercise is more effective to selectively strengthen the vastus medialis. Thirty two healthy subjects <19 men, 13 women) participated in the study. All participants performed SLR and QS exercises while electromyographic activity was recorded from EMG surface electrodes. Statistical analysis demonstrated significantly greater values for the vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis activities during QS exercise than for those during SLR exercise. However, the rectus femoris muscle activity between SLR and QS exercises was not significantly different. The ratios of vastus lateralis to vastus medialis during SLR and QS exercise were not significantly different. These results show that QS exercise is more effective for strengthening the quadriceps muscle on the whole than the SLR exercise. As for selective methods of strengthening vastus medialis specifically, both SLR and QS exercises are useful.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.2
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• pp.165-175
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• 2011

Purpose: This study examined the effect of the strengthening exercise and stretching exercise to decrease symptom patellofemoral pain syndrome (PFPS). Methods: The Anterior Knee Pain Scale (AKPS) and Clark's test performed for diagnosis of intrinsic PFPS among young adults. Selected thirty young adults subjects who aged 20~26 years participated in the study. Participants were randomly assigned to strengthening, stretching, or control groups. Strengthening group consisted of quadriceps, hamstring and iliotibia band training used elastic band. Stretching group consisted of quadriceps, hamstring and iliotibia band trainings used stretching exercises program. Participants received 50-minute individualized exercise sessions, 3 times a week for 6 weeks. Results: The results were as follow: there were significantly difference stretching exercise group by all muscles on muscular strength test (p<.05). there were significantly difference both strengthening and stretching exercise group by all muscles on flexibility test (p<.05). There were significantly difference stretching exercise group by all muscles on step-down test (p<.05). There were significantly difference both strengthening and stretching exercise group by all muscles on visual analog scale (p<.05). Conclusion: Results suggest important implications for exercise programs of PFPS that stretching exercise is more improved knee pain, functional performance, patella mobility than strengthening exercise.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.296-301
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• 2014

Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.23-31
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• 2021

PURPOSE: This study was conducted to identify the effects of altering foot position on quadriceps femoris including vastus medialis obliques (VMO), vastus lateralis (VL) and rectus femoris (RF) activation during wall squat exercises. METHODS: All subjects (n = 15) were selected and randomly performed three kinds of wall squats: 1) GWS (General Wall Squat), 2) WSS1/4 (Wall Squat Short 1/4), and 3) WSS1/2 (Wall Squat Short 1/2). Each subject completed all three kinds of wall squatting exercises at three different times and recorded the muscle activity data of vastus medialis obliques, vastus lateralis and rectus femoris. RESULTS: Compared with GWS exercise, VMO and RF muscle activity significantly increased under WSS1/2 exercise (p < .05), while only RF muscle activity significantly increased under WSS1/4 exercise (p < .05). CONCLUSION: The results of the present study indicate that moving the foot toward the wall during wall squats has a positive effect on quadriceps activation. The exercise of wall squat short can not only be used as the lower limb muscle strengthening training for normal people, but also as the recovery training for patellofemoral pain syndrome patients in the rehabilitation stage. Besides, Anterior cruciate ligament patients can also try this exercise according to the advice of doctors and therapists.

• Physical Therapy Korea
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• v.8 no.2
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• pp.1-16
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• 2001

This study was designed to identify the effects of foot position on electromyographic (EMG) activity of the quadriceps femoris during maximum voluntary contraction (MVC) in standing. Twenty young adults who had not experienced any knee injuries were recruited. Their Q-angles were within a normal range. They were asked to stand in five different foot positions ($40^{\circ}$ externally rotated, $30^{\circ}$ internally rotated, neutral, $20^{\circ}$ plantarflexed, and $10^{\circ}$ dorsiflexed foot position). The EMG activities of the vastus lateralis (VL), rectus femoris (RF), and vastus medialis oblique (VMO) were recorded in standing by surface electrodes and normalized by MVC EMG values derived from manual muscle test. The normalized EMG activity levels (%MVC EMG) of muscles in the five foot positions were compared using repeated measures ANOVA. The EMG activity levels of the VL, RF, and VMO were the highest when foot was externally rotated. The EMG activity levels of the VL and RF were significantly different among the foot positions (p<.05). However, EMG activity levels of the VL, RF, VMO, and VMO/VL ratio did not show significant differences in each foot position (p> .05). The results suggest that the quadriceps femoris may be effectively activated by performing MVC at an externally rotated foot position. Therefore, the externally rotated foot position can be considered as an effective foot position for quadriceps femoris strengthening exercise. Further studies are needed to identify whether there are differences in the effects of foot position on muscle strength after MVC exercise of quadriceps femoris in standing.

• PNF and Movement
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• v.17 no.3
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• pp.441-450
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• 2019

Purpose: This study identified the co-activation of quadriceps and hamstring muscles during hamstring strengthening exercises in healthy adults. Methods: Twenty-one participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. Thus, this study recruited 21 healthy adults. All participants performed Nordic exercises, bridge exercises, and one-leg deadlifts randomly. The activity of the rectus femoris, vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (SM) were measured. In addition, the ratios of VM/VL and hamstring/quadriceps (HQ) were measured during the three hamstring strengthening exercises using electromyography. One-way ANOVA was used to compare the co-activation of quadriceps and hamstring muscles in the three exercises. Results: The activity of VM and VL during the performance of one-leg deadlifts was significantly higher than the other two exercises. The BF had significantly higher activity during the Nordic exercises compared to the other two exercises. In addition, the SM activation was significantly greater during Nordic exercises than one-leg deadlifts. Additionally, there was significant difference in HQ ratio among hamstring strengthening exercises. In specific, the one-leg deadlifts yielded a significantly lower HQ ratio. Conclusion: This study revealed that one-leg deadlifts are effective in rehabilitation for anterior cruciate ligament injury. In addition, Nordic exercises can be recommended to facilitate hamstring muscle activation.

• Physical Therapy Korea
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• v.12 no.2
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• pp.11-19
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• 2005

Patellofemoral pain syndrome (PFPS) is often attributed to malalignment and maltracking of patella within the patellofemoral joint. Most exercise for PFPS has focused on selectively strengthening the vastus medialis oblique muscle (VMO). This study was designed to identify the effect of medial, lateral wedge and difference of Quadriceps angle (Q-angle) on vastus medialis oblique/vastus lateralis muscle (VL) activity ratios. The subjects were twenty young adult males who had not experienced any knee injury. They were asked to perform isometric contraction exercises in three postures using medial and lateral wedge. The EMG activity of the VL and VMO were recorded in three postures by surface electrodes and normalized by %MVC values derived from seated, isometric knee extensions. The normalized EMG activity levels (%MVC) of the VL and VMO for the three postures of the lower extremities were compared using 2-way repeated measures ANOVA with 1 between-subject factor (group), and 1 within-subject factor (wedge). Results of repeated measures of ANOVA's revealed that the medial wedge isometric contraction exercise produced significantly greater EMG activity of VMO/VL ratios in Group I (Q-angle $18^{\circ}$ or less) (p<.05). But, the medial wedge isometric contraction exercise was no significant difference of VMO/VL ratios in Group II (Q-angle $19^{\circ}$ or more) (p>.05). These results have important implications for selective VMO muscle strengthening exercises in PFPS patients.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.361-368
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• 2011

The purpose of this study was to investigate the effect of isometric hip adduction and abduction on the muscle activities of vastus medialis oblique(VMO) and vastus lateralis(VL) during leg squat exercises. This study consisted of 21 healthy subjects who had no medical history of anterior knee pain or lower extremity disorders. The ball and belt were used to isometrically adduct and abduct the hip joint during the leg squat exercise, respectively. The surface electromyograms of VMO and VL were analyzed, and the findings were used to calculate the VMO:VL ratio during 3 different quadriceps-strengthening exercises(leg squat, LS leg squat with isometric hip adduction, LSHD leg squat with isometric hip abduction, LSHB). The muscle activities of VMO and VL and the VMO:VL ratios were compared using the paired t-test with Bonferroni adjustment. The results showed that the muscle activities of VMO and VL during LSHD were greater than those during LSHB. The VMO:VL ratio was the highest during LSHD. This finding suggests that LSHD using a ball is more effective than LS and LSHB in selectively increasing the muscle activities of VMO. Therefore, we suggest that leg squat exercise with isometric hip adduction using a ball would be useful for maintaining correct patella tracking and for selectively strengthening VMO.

• Journal of the Korea Convergence Society
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• v.7 no.2
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• pp.43-52
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• 2016

The purpose of this study was to suggest the effective squat exercise position to strengthening vastus medialis oblique, and vastus lateralis in quadriceps. Subjects were twenty patients with patellofemoral pain syndrome (PFPS) volunteered to participate in this study. All subjects were applied to static squat convergence exercise with knee flexed $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ for 30 seconds total 5 times. Measurement variables were maximal voluntary isometric contraction (MVIC) of the quadriceps, Q angle and length of thigh. Those were measured before and after the squat exercise on knee joint angle, change rate of which were used for statistical analysis. As a result, squat exercise with knee flexed $90^{\circ}$ increase significantly among knee joint angle in the MVIC change rates of quadriceps (p<.05), however the rates of Q-angle and length change of thigh showed no significant difference. Therefore, this findings suggest that squat exercise with knee flexed $90^{\circ}$ strengthen quadriceps effectively in patients with PFPS.