• PNF and Movement
• /
• 제21권2호
• /
• pp.231-241
• /
• 2023

Purpose: Weakness of the vastus medialis oblique muscle (VMO), or the imbalance between VMO and vastus lateralis muscle (VL) activity, is one of the most important factors in knee joint problems. Rigid taping techniques, such as patellar inhibition taping and VL inhibition taping, are frequently used in clinical practice to treat knee joint problems. The purpose of this study was to compare the acute effect of three different types of taping (patellar inhibition taping (PIT), distal VL inhibition taping (DVLIT), and proximal VL inhibition taping (PVLIT)) on electromyography (EMG) activity of VMO, VL, and VMO:VL ratio during walking. Methods: Thirty-eight normal healthy subjects (38 males; mean age = 31.00 years) voluntarily participated in this study. EMG was applied to investigate muscle activation during walking. Repeated measures of ANOVA and one-way ANOVA compared the three different conditions (PIT, DVLIT, and PVLIT) for each variable. Results: VMO and VL activation were significantly increased after PTIT application, and VMO and VL activation were significantly decreased after DVLIT and PVLIT application. The VMO:VL ratio increased after the three types of taping application, but there were no significant differences among the three types of taping. Conclusion: Based on the results of this study, PTIT is more effective than DVLIT and PVLIT in increasing the muscle activation of the VMO and VL during walking. Also, DVLIT is more effective for increasing the VMO:VL ratio and has beneficial effects on the imbalance between VMO and VL activity.

• The Journal of Korean Physical Therapy
• /
• 제20권3호
• /
• pp.35-43
• /
• 2008

Purpose: We investigated the effect of isometric resistance exercise on the vastus medialis oblique muscle with inelastic tape and EMG biofeedback training applied to the patello-femoral joints of patients with patella malalignment. Methods: The 39 elderly subjects that had patella malalignment but no neuromuscular disorders were divided into a control group, taping group, and EMG biofeedback training group. Evaluations of function improvement performed before and after the treatment, as well as 4 weeks after treatment. Results: Change in pain in the knee joint were significantly different among groups (p<0.05). Maximum voluntary isometric contractility in the quadriceps muscle was significantly in the EMG biofeedback group (p<0.001). The WOMAC (Western Ontairo & McMaster Questionnaire) index showed a significant change (p<0.05) in pain, function, and total score. Taping and EMG biofeedback training showed a lasting effect until measurement 4 weeks after treatment. SF-36 (Medical outcome short form-36), which assesses the quality of life, did not significantly change. Conclusion: In osteoarthritis patients with a loss of patello-femoral joint function, isometric resistance exercise of the vastus medialis oblique muscle with taping seems effective.

• 대한관절경학회지
• /
• 제5권1호
• /
• pp.41-44
• /
• 2001

정복되지 않는 슬관절 탈구 중 내측 광근에 의한 단추구멍 손상에 의한 경우는 매우 드문 경우로 이에 대한 신속한 정복이 지연된 슬관절 탈구로 발생할 수 있는 합병증을 줄일 수 있다. 저자들은 슬부의 후외방 전위와 대퇴골 내과의 돌출을 보이는 환자를 자기 공명 영상으로 진단하고 이에 대해 관절 절개술을 이용하여 정복술 및 양측 십자인대 복원술로 치료한 환자를 경험하였다. 술후 10개월에 환자는 경도의 후방 불안정이 있었으나 관절의 운동 범위는 정상으로 회복되었다.

• 대한물리의학회지
• /
• 제6권2호
• /
• pp.215-223
• /
• 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.

• 대한의용생체공학회:의공학회지
• /
• 제40권6호
• /
• pp.223-229
• /
• 2019

The number of knee-related disease patients and knee joint surgeries is steadily increasing every year, and for knee rehabilitation training for these knee joint patients, it is necessary to strengthen the muscle of vastus medialis and quadriceps femoris. However, because of the cost and time-consuming difficulties of receiving regular hospital treatment in the course of knee rehabilitation, we developed knee exoskeleton using rapid prototype for knee rehabilitation with feedback from the electromyogram (EMG) and inertia motion unit (IMU) sensor. The modules was built on the basis of EMG and an IMU sensor applied complementary filter, measuring muscle activity in the vastus medialis and the range of joint operation of the knee, and then performing the game based on this measurement. The IMU sensor performed up to 97.2% accuracy in experiments with ten subjects. The functional game contents consisted of an exergaming platform based on EMG and IMU for the real-time monitoring and performance assessment of personalized isometric and isotonic exercises. This study combined EMG and IMU-based functional game with knee rehabilitation training to enable voluntary rehabilitation training by providing immediate feedback to patients through biometric information, thereby enhancing muscle strength efficiency of rehabilitation.

• 한국전문물리치료학회지
• /
• 제26권1호
• /
• pp.75-83
• /
• 2019

Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

• The Korean Journal of Pain
• /
• 제37권2호
• /
• pp.132-140
• /
• 2024

Background: This study aimed to identify exact anatomical landmarks and ideal injection volumes for safe adductor canal blocks (ACB). Methods: Fifty thighs from 25 embalmed adult Korean cadavers were used. The measurement baseline was the line connecting the anterior superior iliac spine (ASIS) to the midpoint of the patellar base. All target points were measured perpendicular to the baseline. The relevant cadaveric structures were observed using ultrasound (US) and confirmed in living individuals. US-guided dye injection was performed to determine the ideal volume. Results: The apex of the femoral triangle was 25.3 ± 2.2 cm distal to the ASIS on the baseline and 5.3 ± 1.0 cm perpendicular to that point. The midpoint of the superior border of the vasto-adductor membrane (VAM) was 27.4 ± 2.0 cm distal to the ASIS on the baseline and 5.0 ± 1.1 cm perpendicular to that point. The VAM had a trapezoidal shape and was connected as an aponeurosis between the medial edge of the vastus medialis muscle and lateral edge of the adductor magnus muscle. The nerve to the vastus medialis penetrated the muscle proximal to the superior border of the VAM in 70% of specimens. The VAM appeared on US as a hyperechoic area connecting the vastus medialis and adductor magnus muscles between the sartorius muscle and femoral artery. Conclusions: Confirming the crucial landmark, the VAM, is beneficial when performing ACB. It is advisable to insert the needle obliquely below the superior VAM border, and a 5 mL injection is considered sufficient.

• 대한임상전기생리학회지
• /
• 제5권2호
• /
• pp.61-72
• /
• 2007

INTRODUCTION: Local heat and cold application has been frequently used as means of muscle relaxation and blood circulation or reinforcing muscle strength, relaxing muscle tension in clinical situation. In particular, it has been known that long-term heat and cold application for relaxing muscle tension inhibits muscle spasticity or tension. But, it has been rarely reported that what influences of heat and cold application on activation of muscle action potential. Therefore, this study aims to analyze surface temperature and electromyography activities according to the heat and cold application. METHODE: Subjects of this research were 10 normal men and women (5 men, 5 women). Hot pack and cold pack was applied to vastus medialis muscle of thigh and rectus femoris muscle for 20 min. Surface temperature of vastus medialis muscle and rectus femoris muscle was measured, knee joint of subjects was in $45^{\circ}$ flexion, sitting on a chair, maximal isometric contraction was induced, surface electromyography (sEMG) signals were collected and root mean square (RMS) and median frequency (MOF) were analyzed. All measurements were conducted before and immediately after experiment, 10 min., 20 min. and 30 min. after experiment. Data were analyzed with SPSS 12.0 program, comparison of changes in superficial temperature and sEMG signals through repeated measurement was conducted with repeated measures ANOVA and significance level $\alpha$ was 0.05. RESULTS: Changes of surface temperature of vastus medialis muscle according to cold application were radically decreased immediately after application, but it was recovered after 30 min. of application and it showed significant difference (F4. 36=72.216, P<0.001). Surface temperature of rectus femoris also showed radical decrease immediately after application, but it was recovered after 30 min. of application and showed significant difference (F4. 36=88.930, P<0.001). Changes of surface temperature of vastus medialis muscle according to heat application were radically increased immediately after application, but it was recovered after 30 min. of application and it showed significant difference (F4. 36=27.267, P<0.001). Surface temperature of rectus femoris also showed radical decrease immediately after application, but it was recovered after 30 min. of application and showed significant difference (F4. 36=19.774, P<0.001). Changes of sEMG by heat and cold application were no statistical difference. Surface temperature of skeletal muscle after heat and cold application showed significant change for 30 min., but it was found that increase or decrease of surface temperature had not great influence on sEMG activities.

• 한국임상수의학회지
• /
• 제34권6호
• /
• pp.414-419
• /
• 2017

The present study aimed to document the biomechanical findings of soft tissue reconstruction surgeries for the treatment of medial patellar luxation in dogs. Stifle joints (n = 12) from dogs weighing 4.1-8.4 kg were used in this study. The following soft tissue reconstruction techniques used for the treatment of medial patellar luxation were selected for this study: vastus medialis release, medial retinacular release, and capsule release for medial realignment (n = 6), and retinacular imbrication and anti-rotational suture for lateral realignment (n = 6). A 5-kg traction using an electronic scale was applied at $45^{\circ}C$ laterally for medial realignment and medially for lateral realignment. Fluoroscopic imaging was used to measure the length of patellar displacement (LPD) in each technique. Among medial realignment techniques, capsule release had the highest horizontal LPD; vastus medialis release had significantly higher horizontal LPD than medial retinacular release. Vastus medialis release had the smallest increase statistically in vertical LPD, and vertical LPD did not differ significantly between medial retinacular and capsule release. Among lateral realignment techniques, the horizontal LPD was significantly higher in anti-rotational suture with retinacular imbrication than in retinacular imbrication alone, but the vertical LPD did not differ significantly between the two groups. Our findings indicated that vastus medialis release could decrease the medial tension on the patella without inducing patellar instability in dogs. Both medial retinacular and capsule release could increase patellar instability; moreover, medial retinacular release does not decrease the medial tension on the patella. Antirotational suture with retinacular imbrication provides more lateral tension than retinacular imbrication alone.

• 한국임상수의학회지
• /
• 제35권3호
• /
• pp.71-76
• /
• 2018

In 22 dogs with medial patellar luxation (MPL) of grade 3 or lower, resection of the vastus medialis oblique muscle, patellar anti-rotational suture, fascia lata overlap, and tibial tuberosity transposition (TTT) were undertaken to stabilize the patella without trochleoplasty. Data including signalment, clinical symptoms, details of the affected hindlimb, preoperative and postoperative patellar luxation grades, postoperative recovery time, and postoperative complications were obtained from medical records. The grade of lameness was evaluated preoperatively and postoperatively. Mean (${\pm}SEM$) grade of medial patellar luxation was $2.64{\pm}0.11$ preoperatively and $0.2{\pm}0.27$ postoperatively. Mean (${\pm}SEM$) grade of lameness was $1.73{\pm}0.27$ preoperatively and $0.18{\pm}0.15$ postoperatively. Patellar reluxation occurred in 1 of 22 (4.5%) cases requiring additional surgery. At final follow-up, 2 of the 22 (9.0%) dogs, including one with reluxation, had occasional lameness. Client-based questionnaire results demonstrated significant improvements in all parameters. Surgical treatment of MPL that included resection of the vastus medialis oblique without femoral trochlear groove deepening improved surgical outcomes in dogs with up to grade 3 MPL.