Earticle

본 연구의 목적은 여자 배구선수와 탁구 선수 사이에 무릎 관절의 등속성 근력 수준을 비교하는 것이다. 총 27명의 엘리트 배구 선수와 27명의 탁구 선수가 이 연구에 참여하였다. 본 연구는 등속성 근력 측정을 통해 여자 배구선수 및 탁구 선수 무릎 굽힘근 근력과 폄근 근력의 양을 측정하였다. 최대 토크는 60°/s에서 3회 최대 수의적 굽힘과 폄 수축을 수행하여 측정하였다. 여자 배구 선수는 여자 탁구선수 보다 무릎 폄과 굽힘근 근력이 높았다. 탁구 선수들은 왼쪽과 오른 쪽 무릎 근력에 유의한 차이가 없었다. 하지만 배구 선수들은 양쪽 무릎 근력에 차이를 보였다. 또한, 신장과 체중은 무릎 근력과 양의 상관관계를 보였다. 본 연구를 통해 여자 배구 선수는 탁구 선수보다 무릎 근력이 더욱 높은 수준에 있음을 알 수 있었다. 또한 배구 선수가 비대칭적 무릎 근력이 있음을 발견하였다. 향후 연구에서는 등속성 근력강도에 대한 연구 가 다른 스포츠 선수와 비교하여 확인될 것을 기대한다.

The purpose of this study was to compare the isokinetic muscular strength of the knee joint between female volleyball and table tennis players. A total of 27 elite volleyball players and 27 table tennis players participated in the study. This study measured both knee extensor and flexor strengths of volleyball and table tennis players using the isokinetic dynamic test. Peak torque was measured by performing maximal voluntary flexion and extension three times at 60°/s. Volleyball players had higher knee extensor and flexor strengths than table tennis players. No significant difference in both knee strengths was noted in table tennis players. However, volleyball players showed significant differences in both knee strengths. Height and weight showed a positive correlation with knee strength. This study found that volleyball players had greater knee strength than that of table tennis players. We also found that volleyball players have asymmetrical knee strength. Comparison with other sport players is warranted to better understand isokinetic muscular strength of the knee joint.

Objective To investigate the reliability of knee extensor strength measurements using a supine hand-held dynamometer (HHD) anchoring frame in patients with limited physical activity. Although an HHD is suitable for bedside use, its inter-rater reliability is low because measurements can be influenced by tester strength. Methods Maximal knee extensor isometric strength was measured using an HHD anchored to the supine frame. Three trials of three maximal contractions were assessed by two raters. Results A total of 33 inpatients who were non-ambulatory due to acute illness participated in the study. The intraclass correlation coefficients were 0.974 (inter-rater) and 0.959 (intra-rater). The minimal detectable changes in intra- and inter-observer measurements were 29.46 N (24.10%) and 36.73 N (29.26%), respectively. The limits of agreement ranged from -19.79% to 24.81% for intra-rater agreement and from -21.45% to 37.07% for inter-rater agreement. Conclusion The portable dynamometer anchoring system can measure the isometric strength of the knee extensor reliably in the supine position, and could be used for measurements in patients who have difficulty visiting the laboratory and maintaining a seated posture.

Objective To identify the potential predictors of ambulatory function in subacute stroke patients, and to determine the contributing factors according to gait severity. Methods Fifty-three subacute stroke patents were enrolled. Ambulatory function was assessed by gait speed and endurance. Balance function was evaluated by the Berg Balance Scale score (BBS) and the Timed Up and Go test (TUG). The isometric muscular strengths of bilateral knee extensors and flexors were measured using an isokinetic dynamometer. Cardiovascular fitness was evaluated using an expired gas analyzer. Participants were assigned into the household ambulator group (<0.4 m/s) or the community ambulator group (≥0.4 m/s) based on gait severity.Results In the linear regression analyses of all patients, paretic knee isometric extensor strength (p=0.007) and BBS (p<0.001) were independent predictors of gait endurance (R2=0.668). TUG (p<0.001) and BBS (p=0.037) were independent predictors of gait speed (R2=0.671). Paretic isometric extensor strength was a predictor of gait endurance (R2=0.340, p=0.008). TUG was a predictor of gait speed (R2=0.404, p<0.001) in the household ambulator group, whereas BBS was a predictive factor of gait endurance (R2=0.598, p= 0.008) and speed (R2=0.713, p=0.006). TUG was a predictor of gait speed (R2=0.713, p=0.004) in the community ambulator group.Conclusion Our results reveal that balance function and knee extensor isometric strength were strong predictors of ambulatory function in subacute stroke patients. However, they work differently according to gait severity. Therefore, a comprehensive functional assessment and a different therapeutic approach should be provided depending on gait severity in subacute stroke patients.

Objective To determine the reliability and validity of hand-held dynamometer (HHD) depending on its fixation in measuring isometric knee extensor strength by comparing the results with an isokinetic dynamometer.Methods Twenty-seven healthy female volunteers participated in this study. The subjects were tested in seated and supine position using three measurement methods: isometric knee extension by isokinetic dynamometer, non-fixed HHD, and fixed HHD. During the measurement, the knee joints of subjects were fixed at a 35o angle from the extended position. The fixed HHD measurement was conducted with the HHD fixed to distal tibia with a Velcro strap; non-fixed HHD was performed with a hand-held method without Velcro fixation. All the measurements were repeated three times and among them, the maximum values of peak torque were used for the analysis. Results The data from the fixed HHD method showed higher validity than the non-fixed method compared with the results of the isokinetic dynamometer. Pearson correlation coefficients (r) between fixed HHD and isokinetic dynamometer method were statistically significant (supine-right: r=0.806, p<0.05; seating-right: r=0.473, p<0.05; supine-left: r=0.524, p<0.05), whereas Pearson correlation coefficients between non-fixed dynamometer and isokinetic dynamometer methods were not statistically significant, except for the result of the supine position of the left leg (r=0.384, p<0.05). Both fixed and non-fixed HHD methods showed excellent inter-rater reliability. However, the fixed HHD method showed a higher reliability than the non-fixed HHD method by considering the intraclass correlation coefficient (fixed HHD, 0.952-0.984; non-fixed HHD, 0.940-0.963). Conclusion Fixation of HHD during measurement in the supine position increases the reliability and validity in measuring the quadriceps strength.

Objective To investigate the reliability and validity of a new method for isometric back extensor strength measurement using a portable dynamometer.Methods A chair equipped with a small portable dynamometer was designed (Power Track II Commander Muscle Tester). A total of 15 men (mean age, 34.8±7.5 years) and 15 women (mean age, 33.1±5.5 years) with no current back problems or previous history of back surgery were recruited. Subjects were asked to push the back of the chair while seated, and their isometric back extensor strength was measured by the portable dynamometer. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). For the validity assessment, isometric back extensor strength of all subjects was measured by a widely used physical performance evaluation instrument, BTE PrimusRS system. The limit of agreement (LoA) from the Bland-Altman plot was evaluated between two methods.Results The test-retest reliability was excellent (ICC=0.82; 95% confidence interval, 0.65?0.91). The Bland-Altman plots demonstrated acceptable agreement between the two methods: the lower 95% LoA was ?63.1 N and the upper 95% LoA was 61.1 N.Conclusion This study shows that isometric back extensor strength measurement using a portable dynamometer has good reliability and validity.

ABSTRACT Background There is little research on the strength and electromyograph (EMG) activity of elbow extensors according to the measuring posture. Purpose We investigated which posture influenced strength and EMG activity of elbow extensors in evaluating postures (supine and prone). Study design Comparative, repeated measures design. Methods Twenty-one healthy subjects performed maximal elbow extension in two postures (supine and prone). EMG activity was measured in the anconeus, long head of triceps (LoT), and lateral of triceps (LT). When measuring EMG activity of elbow extensors, the strength of elbow extensors was also measured by Smart KEMA strength measurement system. Results In supine, EMG activity of anconeus and LT was significant increased. The other way, EMG activity of LoT and strength of elbow extensors were significant increase in the prone position. Conclusions We recommend the prone position to increase EMG activity of LoT and to improve strength of elbow extensors. In addition, supine position should be considered to increase muscle activity of anconeus and LT.

Background: Lateral epicondylitis, generally referred to as tennis elbow, is a common condition of the forearm. Treatment typically includes specialized manual therapy, including deep friction massage (DFM), taping, and Mill’s manipulation. Purpose: The aim of this study was to evaluate changes in pain, function, strength, and muscle activity following taping with DFM. Study design: Randomized controlled trial Methods: We recruited 30 patients with tennis elbow and equally divided into two groups using randomization (Taping group versus taping and DFM group). Pre- and post-intervention measures included a visual analog scale (VAS) pain scores, the Patient-rated Tennis Elbow Evaluation (PRTEE) questionnaire, pain-free grip strength (PFGS), wrist extensor strength (WES), and wrist extensor electromyography (EMG). DFM and diamond taping were applied as the study intervention. The differences between pre- and post-intervention outcome measures were analyzed using two-way repeated-measures analysis of variance. Results: A significant time-by-group interaction was observed for the VAS, PRTEE scores, PFGS, WES, and EMG. A post hoc paired t-test showed that pain, function, and strength improved significantly post-intervention in the group treated with taping and DFM. The VAS and PRTEE scores significantly decreased, and PFGS, WES, and EMG significantly increased in both groups post-intervention. Conclusions: Our findings demonstrated that taping with DFM can be an effective strategy for decreasing pain, improving function, and increasing strength and muscle activation in patients with lateral epicondylitis.

본 연구는 8주간 만성 요통을 가진 여성에게 필라테스와 요추 안정화 운동의 효과를 비교 분석했다. 연구 대상은 비-특이적 만성 요통을 가진 20~45세 여성 24명을 모집해, 필라테스를 적용한 집단(PG, n=11), 그리고 척추 안정화 운동 을 적용한 집단(SG, n=13)으로 나누어, 한 세션 당 50분으로 구성된 중재 프로그램을 8주 동안 주 2회 시행하였다. 중재 방법의 효과 검증을 위해 요추 전만 각도, 요추 신전 근력, ODI 및 VAS를 평가하였으며, 두 집단 모두 중재 후 요추 전만 각도와 요추 신전 근력이 개선되었으나, 집단-간 차이는 나타나지 않았다. 하지만 ODI 및 VAS를 통한 요통 증상 개선에 있어서는 필라테스 그룹이 더 효과적이었다. 따라서 만성 요통을 가진 여성 환자들에게 필라테스의 적용은 요추 전만 각도 와 신전 근력을 개선하며, 요통의 증상 완화에 있어 척추 안정화 운동에 비해 더 효과적이기 때문에 만성 요통의 개선을 위한 재활 운동 프로그램에 포함하는 것을 권장할 수 있다. 향후 연구에서는 대규모 집단과 장기적 효과 검증이 필요하며, 요추 전만 각도 변화가 요통에 미치는 정확한 인과 관계를 파악할 필요가 있다.

This study compared the effects of Pilates and spine stabilization exercise on women with chronic low back pain for 8 weeks. Twenty-four women aged 20-45 years with non-specific chronic low back pain were recruited and divided into two groups: Pilates (PG, n=11) and spinal stabilization exercises (SG, n=13) who received an intervention program consisting of 50 minutes per session, twice a week for 8 weeks. Lumbar lordosis angle, lumbar extensor strength, ODI, and VAS were evaluated to determine the effectiveness of the intervention. Both groups showed improvement in lumbar lordosis angle and lumbar extensor strength after the intervention, with no differences between the groups. However, the Pilates group was more effective in improving low back pain symptoms as measured by the ODI and VAS. Therefore, the use of Pilates in female patients with chronic low back pain can be recommended for inclusion in rehabilitation exercise programs for the improvement of chronic low back pain because it improves lumbar lordosis angle and extensor strength and is more effective than spinal stabilization exercises in reducing low back pain symptoms. Future studies should include larger cohorts and long-term validation of efficacy and determine the exact causal relationship between changes in lumbar lordosis angle and low back pain.

본 연구는 요통과 요부신전근력의 관계를 규명함과 동시에 환자 자신의 요부 근력 상태에 대한 지표를 제공하며 운동 처방의 기초 자료로 활용하는 것이 목적이다. 본 연구는 사례연구로 척추전문 병원에 내원하여 요통 치료를 받았던 환자들로 2003년 11월부터 2007년 3월까지 30대에서 50대 남녀 환자 총 1788명(남: 944, 여: 844)를 대상으로 요부 신전근력을 측정한 결과를 토대로 작성되었다. 요부신전 근력 검사는 등척성 원리를 이용하여 제작된 Medx장비를 이용하여 0°~72° 사이에 12°간격으로 7단계로 측정되었다. 측정결과 남성은 연령대가 증가함에 따라 요부 신전 근력의 감소가 뚜렷이 나타난(P<.05) 반면 여성은 연령대가 증가함에 따라 요부 신전 근력의 감소가 일관되지 못하였고 통계적 차이도 없는 것으로 나타났다(P>.05). 남성은 30대에서 40대의 감소가 뚜렷하였고, 여성은 40대에서 50대의 감소가 뚜렷하여 남녀의 요부 신전 근력 감소에 대한 차이가 있는 것으로 나타났다. 결론적으로 연령대별로 남녀 성별에 대한 요부근력 감소 차이가 다르게 나타나 서로 다른 운동 치료적 접근이 필요할 것이다.

The aim of this study is to examine the relationship between the lower back pain and lower back extensor strength as well as to provide patients for their indices of the lower back ex-tensor strength status and even more, to apply them as basic data for exercise prescription. This is a case study based on the collected lower back extensor strength measurement data from Nov. 2003 to Mar. 2007 and from total 1788 patients aged 30s to 50s (male: 944, female: 844) at the spine clinic. The extensor strength test of lower back was measured by 7 stages having 12 degree interval within 0°~72° with Medx manufactured by isometric principle. As a result, there was a significant lower back extensor strength reduction in male (P<.05) according to an increase in age. However, there was inconsistent lower back extensor strength reduction in female and the data was not significantly different (P>.05). There was a difference in lower back extensor strength reduction between male and female in this study because the reduction was very clear in male aged 30s to 40s and in female aged 40s to 50s. These study results showed that there was a dif-ference in lower back extensor strength reduction between male and female based age. Therefore, there is a great need for having different therapeutic exercise approach based on gender and age for the lower back pain.

Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.

Background: This study examined the effects of thermal kinesio taping on back pain, extensor muscle strength, and flexibility in sedentary workers who generally sit on chairs for more than six hours a day. Methods: In this study, single-subject cases with chronic pain of 6 or higher on the visual analog scale (VAS) for more than three months and leading a sedentary lifestyle (n=16) were administered general Kinesio taping and thermal Kinesio taping to the lumbar region. Changes in lower back pain, trunk extensor muscle strength, and lumbar flexibility were observed at baseline, 30 minutes, and two hours post-application. Lower back pain was assessed using the VAS, trunk extensor muscle strength was measured with a handheld dynamometer, and trunk flexibility was evaluated using the standing forward bend test. Results: In this study, a 2-week application of thermal taping resulted in significant reductions in back pain (p<.001), improvements in back extensor muscle strength (p<.001), and increased back flexibility (p<.001) compared to the application. Conclusion: The findings of this study indicate that thermal Kinesio tape is more effective in reducing lower back pain compared to general Kinesio tape. Additionally, it has been found to have a significant impact on enhancing trunk extensor muscle strength and flexibility.

Background: The purpose of this study is to compare and analysis the changes in strength and endurance of the knee extensor muscles after Anterior cruciate ligament reconstruction. Methods: Twelve male subjects with ligament injury were seated on Biodex and the hip joint was flexed at 110°, and torso, lower extremities, and legs were fixed using Velcro. The resistance device was placed at a point 3cm above the ankle, and measurements were taken before and a surgery at 60°/sec and 180°/sec when the knee was maximally extended. The postures ingeniously combine forward-bending poses countered with backward-bending ones. Results: There was no significant difference in the comparison of muscle strength of 60°/sec and 180°/sec before surgery. But there was a significant difference after surgery. There was significant difference in muscle endurance both before and after surgery. There was a significant difference in the pre- and post- operative comparison values of muscle strength and endurance in isokinetic movements at 60°/sec and 180°/sec during knee extension on the injured side. Conclusion: For cruciate ligament tears, Orthopedic reconstruction is recommended. Correct alignment of the knee ligament after surgery can enhance the strength and endurance of the quadriceps femoris during knee extension rejuvenated.

Purpose：This study aimed to examine the Influence of muscle strengthening exercise and stretching exercise of trunk extensor muscles on muscular strength and flexibility in adolescent of the twenties. Methods：Muscle strengthening exercise group(n=10), stretching exercise group(n=10) and strengthening and stretching exercise group(n=10) were measured muscular strength by digital back and leg dynamometer and flexibility by sit and reach test and trunk extension test at pre-intervention and post-intervention in 4weeks. Results：The flexibility 1, flexibility 2 and muscular strength of muscle strengthening exercise group were significantly increased within the intervention period(p＜.05). The flexibility 2 and muscular strength of stretching exercise group were significantly increased within the intervention period(p＜.05). but flexibility 1 was not significantly different at in 4 weeks(p>.05). The flexibility 1, flexibility 2 and muscular strength of muscle strengthening and stretching exercise group were significantly increased within the intervention period(p＜.05). Conclusion：We were found that muscle strengthening exercise and stretching exercise of trunk extensor muscles could improve muscular strength and flexibility for adolescent of the twenties.

Background: The wall squat is considered an effective exercise because it can reduce the knee load and prevent excessive lumbar movement. However, the relationship between wall squat performance and strength of knee extensors and hip extensors remained unclear. Objects: The purpose of this study was to compare the strengths of the knee extensors and hip extensors between groups with low and high wall squat performance. Method: Nineteen males (low performance group: 9 subjects, high performance group: 10 subjects) participated in this study and performed wall squats. The subjects who were performing less than 30% of the average wall squat count were classified into the low wall squat performance group (less than or equal to 4 times) and the subjects who performed more than 30% of the average wall squat count were classified into the high wall squat performance group (greater than or equal to 8 times). Knee extensor and hip extensor strength were measured with a strength measurement system. An independent t-test was used to compare the strengths of the knee extensors and hip extensors between the groups with low and high wall squat performance. Results: The ratios of knee extensor and hip extensor strength to bodyweight were greater in the high wall squat performance group than in the low wall squat performance group (knee extensors: p<.001; hip extensors: p=.03). In the high- and low-performance groups, the ratios of knee extensor strength to bodyweight were $42.74{\pm}5.72$ and $30.76{\pm}8.54$, respectively, and the ratios of hip extensor strength to bodyweight were $31.95{\pm}10.61$ and $20.66{\pm}11.25$, respectively. Conclusion: Our findings suggest that knee extensor and hip extensor strength are needed for high wall squat performance. Thus, exercise to increase the knee and hip extensors strength can be recommended to improve squat performance.

Background: The wall squat exercise has been recommended for strengthening of the lower extremity muscles with maintaining lumbar lordosis. Although squat has been studied to be related to lower extremity extensor strength, the relationship between wall squat and lower extremity extensor strength unclear. Because squat and wall squat are biomechanically different, study on the relationship is needed. Objects: The purpose of this study was to determine the lower extremity extensor strength associated with wall squat performance. Methods: 74 healthy volunteers were recruited to participate in this study. The volunteers were measured hip and knee extensors strength and then performed wall squat exercise for maximum count. Results: We found significant relationships between wall squat performance and hip extensor strength normalized by body weight, knee extensor strength normalized by body weight and the composite value. In a regression analysis, hip extensor strength normalized by body weight explained 29% of the variation in wall squat performance in males and 35% in females. Conclusion: These results demonstrate that hip extensor strength normalized by body weight is critical to wall squat performance in both sexes.