Scientific Rationale and Physiological Basis for the Use of Closed Kinetic Chain Exercise in the Lower Extremity

1996 ◽  
Vol 5 (1) ◽  
pp. 2-12 ◽  
Author(s):  
Lynn Snyder-Mackler
Keyword(s):  
Lower Extremity ◽  
Position Sense ◽  
Joint Position Sense ◽  
Kinetic Chain ◽  
Physiological Basis ◽  
Common Component ◽  
Anatomy And Physiology ◽  
Closed Chain ◽  
Closed Kinetic Chain

Closed kinetic chain exercise is a common component of lower extremity rehabilitation. It has virtually replaced open kinetic chain exercise in the treatment of some conditions. In this paper, anatomy and physiology as they relate to closed chain exercise are examined to elucidate its unique contributions to rehabilitation. Claims made about the specificity, functionality, and safety of closed kinetic chain exercise are discussed. Muscle action, the stretch–shortening cycle, joint position sense, and clinical cases are used to illustrate the distinct role of closed kinetic chain exercise in rehabilitation.

Effect of Closed Kinetic Chain Training on Neuromuscular Control in the Upper Extremity

1999 ◽  
Vol 8 (3) ◽  
pp. 184-194 ◽  
Author(s):  
Mary E. Ubinger ◽  
William E. Prentice ◽  
Kevin M. Guskiewicz
Keyword(s):  
Upper Extremity ◽  
Neuromuscular Control ◽  
Position Sense ◽  
Joint Position Sense ◽  
Kinetic Chain ◽  
Physically Active ◽  
Significant Difference ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Stimulation Of

When the upper extremity is injured, open kinetic chain (OKC) exercises are primarily used to increase strength and restore functional ability—the goals of rehabilitation. It is also imperative, however, that the receptors responsible for static and dynamic stabilization of the joint be trained. This can be done with closed kinetic chain (CKC) exercises. The purposes of this study were to investigate the effect of a 4-week CKC training program on the neuromuscular control of the upper extremity and to determine whether there was a significant difference between skill-dominant limb and nondominant limb stability indices. Thirty-two physically active participants (14 men, 18 women) were tested on the FASTEX 4 weeks apart. The training group's scores significantly improved, whereas the control group's scores remained the same. It was concluded that the CKC training significantly improved the training group's ability to remain stable. The results suggest that CKC training can increase the accuracy of joint position sense because of increased stimulation of the mechanoreceptors.

Effect of a Neoprene Sleeve on Knee Joint Position Sense During Sitting Open Kinetic Chain and Supine Closed Kinetic Chain Tests

1998 ◽  
Vol 26 (4) ◽  
pp. 562-566 ◽  
Author(s):  
Trevor B. Birmingham ◽  
John F. Kramer ◽  
J. Tim Inglis ◽  
Colleen A. Mooney ◽  
Lisa J. Murray ◽  
...  
Keyword(s):  
Knee Joint ◽  
Test Performance ◽  
Position Sense ◽  
Joint Position Sense ◽  
Primary Objective ◽  
Future Research ◽  
Joint Position ◽  
Kinetic Chain ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain

The primary objective of the present study was to compare the effect of a neoprene sleeve on knee joint position sense during a sitting open kinetic chain test and a supine closed kinetic chain test. Young (24 2 years old), healthy subjects (18 men and 18 women) performed knee joint angle replication tests during open kinetic chain knee extension (sitting) and closed kinetic chain leg press (supine with an axial load of 15% body weight) before and after application of a neoprene sleeve over the dominant knee. The improvement in ability to replicate joint angles after application of the sleeve (sleeve effect) was significantly less during the supine closed kinetic chain test (0.3° 1.4°) than during the sitting open kinetic chain test (1.2° 1.1°). The sleeve effect was inversely related to subjects' performance without the sleeve during both the sitting open kinetic chain and supine closed kinetic chain tests, suggesting that some people may derive greater benefit from the sleeve than others. Although the sleeve effects were small, particularly during the supine closed kinetic chain test, 72% of subjects felt that the sleeve improved their overall test performance. Future research is needed to establish the functional relevance of the small sleeve effects observed and to identify the characteristics of people who might derive greatest benefit from sleeve use.

Open versus Closed Kinetic Chain Rehabilitation of the Lower Extremity: A Functional and Biomechanical Analysis

1994 ◽  
Vol 3 (2) ◽  
pp. 154-167 ◽  
Author(s):  
Jose E. Rivera
Keyword(s):  
Lower Extremity ◽  
Muscular Activity ◽  
Biomechanical Analysis ◽  
Kinetic Chain ◽  
Functional Rehabilitation ◽  
Functional Activities ◽  
Closed Chain ◽  
Closed Kinetic Chain ◽  
Open Versus ◽  
Rehabilitation Exercises

Closed kinetic chain and functional rehabilitation have lately received increased attention in the rehabilitation community. The purpose of this paper is to review biomechanical considerations applicable to the lower extremity, in a way that clearly justifies the use of functionally sound rehabilitation exercises. The origin of the kinetic chain concept is reviewed, and the differences in biomechanical events in the foot, ankle, and knee under open versus closed chain conditions are described. An analysis of these biomechanical events supports the notion that function results from the integration of muscles and joints to achieve desired outcomes. This leads to the conclusion that rehabilitation exercises, in order to be functional, must demand integration of muscular activity, must be of a closed kinetic chain nature, and must challenge the utilization of normal proprioceptive mechanisms. Guidelines for the practical application of these principles are clearly outlined, and examples of functional activities are described. Readers are encouraged to explore creative and challenging approaches to help clients achieve their highest level of function.

Knee-Joint Position Sense: The Relationship between Open and Closed Kinetic Chain Tests

2005 ◽  
Vol 14 (4) ◽  
pp. 356-362 ◽  
Author(s):  
Lee Herrington
Keyword(s):  
Error Score ◽  
Outcome Measure ◽  
Weight Bearing ◽  
Absolute Error ◽  
Position Sense ◽  
Joint Position Sense ◽  
Kinetic Chain ◽  
Main Outcome Measure ◽  
Closed Kinetic Chain ◽  
The Relationship

Context:Authors have investigated knee joint-position sense (JPS) in non-weight-bearing open kinetic chain (OKC) manner, but few have investigated JPS during closed kinetic chain (CKC) weight-bearing activities or the relationship between these two.Objective:To investigate the relationship between knee JPS during OKC and CKC maneuvers.Design:2-group (men and women) repeated-measures.Setting:Biomechanics laboratory.Participants:80 asymptomatic subjects.Interventions:None.Main Outcome Measure:Absolute error score of knee JPS during 2 conditions, a CKC squat or OKC knee-flexion maneuver.Results:Statistical analysis by 2-way ANOVA showed sex not to have a significant effect on error score (P= .475), but statistically significant differences between error scores occurred during the 2 tests (P= .0001), the CKC test producing lower error scores (group mean absolute error score OKC [5.6° ± 4.3°] and CKC [2.8° ± 2.4°]), with the absence of a correlation between scores of each test (r= .1).Conclusion:Testing JPS in a CKC scenario would seem appropriate—the ability is greatest (least errors), and conversely any deficits might be most obvious.

Validity and Reliability of a Digital Inclinometer to Assess Knee Joint-Position Sense in a Closed Kinetic Chain

2017 ◽  
Vol 26 (1) ◽  
Author(s):  
Natalia Romero-Franco ◽  
Juan Antonio Montaño-Munuera ◽  
Pedro Jiménez-Reyes
Keyword(s):  
Knee Joint ◽  
Intraclass Correlation ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Kinetic Chain ◽  
Validity And Reliability ◽  
Digital Inclinometer ◽  
Closed Kinetic Chain ◽  
Very High

Context: Knee joint-position sense (JPS) is a key parameter for optimum performance in many sports but is frequently negatively affected by injuries and/or fatigue during training sessions. Although evaluation of JPS may provide key information to reduce the risk of injury, it often requires expensive and/or complex tools that make monitoring proprioceptive deterioration difficult. Objective: To analyze the validity and reliability of a digital inclinometer to measure knee JPS in a closed kinetic chain (CKC). Design: The validity and intertester and intratester reliability of a digital inclinometer for measuring knee JPS were assessed. Setting: Biomechanics laboratory. Participants: 10 athletes (5 men and 5 women; 26.2 ± 1.3 y, 71.7 ± 12.4 kg; 1.75 ± 0.09 m; 23.5 ± 3.9 kg/m2). Intervention: Knee JPS was measured in a CKC. Main Outcome Measures: Absolute angular error (AAE) of knee JPS in a CKC. Results: Intraclass correlation coefficient (ICC) and standard error of the mean (SEM) were calculated to determine the validity and reliability of the inclinometer. Data showed that the inclinometer had a high level of validity compared with an isokinetic dynamometer (ICC = 1.0, SEM = 1.39, P < .001), and there was very good intra- and intertester reliability for reading the inclinometer (ICC = 1.0, SEM = 0.85, P < .001). Compared with AutoCAD video analysis, inclinometer validity was very high (ICC = 0.980, SEM = 3.46, P < .001) for measuring AAE during knee JPS in a CKC. In addition, the intertester reliability of the inclinometer for obtaining AAE was very high (ICC = .994, SEM = 1.67, P < .001). Conclusion: The inclinometer provides a valid and reliable method for assessing knee JPS in a CKC. Health and sports professionals could take advantage of this tool to monitor proprioceptive deterioration in athletes.

The Validity and Reliability of Knee Proprioception Measurement Performed With Inclinometer in Different Positions

2017 ◽  
Vol 26 (6) ◽  
Author(s):  
Sinem Suner-Keklik ◽  
Gamze Cobanoglu-Seven ◽  
Nihan Kafa ◽  
Mustafa Ugurlu ◽  
Nevin Atalay Guzel
Keyword(s):  
Clinical Laboratory ◽  
Measuring Method ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Stability ◽  
Kinetic Chain ◽  
Validity And Reliability ◽  
Arithmetic Average ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain

Context: Proprioception is the basic element of the spontaneous control of movement, balance and joint stability. Therefore, it is necessary for the execution of walking and daily and sport activities. Loss of proprioception of the knee, which may cause a new injury, is important to evaluate the position sense of the joint during the rehabilitation period. However, the evaluation methods that are used are very expensive, complicated and nonportable, or the measuring method is difficult to implement. Objective: We demonstrated the validity and reliability of knee proprioception measurements performed in the open kinetic chain position and closed kinetic chain position with a dual inclinometer. Design: We assessed the validity and intratester reliability of a digital inclinometer for measuring the knee joint position sense in different positions. Setting: Clinical laboratory. Participants: We enrolled 22 participants (age = 21.8 ± 0.95 y, height = 172 ± 9.1 cm, weight = 64.9 ± 14 kg) into the study. Intervention: The same investigator used an inclinometer to take knee proprioception measurements in open and closed kinetic chain positions. Main Outcome Measures: The relative angular error was calculated by taking the arithmetic average of the difference between the target angle and reproduced angle and was the main outcome measure. Results: We found that the dynamometer-inclinometer had a moderate ICC value (ICC = 0.594, SEM = 1.60, P = .005), whereas inclinometer t1 vs inclinometer t2 (ICC = 0.778, SEM = 0.62, P < 0.001) and closed kinetic chain position t1 and closed kinetic chain position t2 (ICC = 0.888, SEM = 0.63, P < 0.001) had high ICC values. Conclusion: Knee proprioception measurements performed with a dual inclinometer were reliable in the closed kinetic chain position in healthy, sedentary individuals and were valid and reliable in the open kinetic chain position.

Comparison of Open versus Closed Kinetic Chain Test Positions for Measuring Joint Position Sense

1995 ◽  
Vol 4 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Susan B. Andersen ◽  
Donna M. Terwilliger ◽  
Craig R. Denegar
Keyword(s):  
Knee Joint ◽  
Repeated Measures ◽  
Knee Flexion ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Kinetic Chain ◽  
Test Position ◽  
Closed Kinetic Chain ◽  
Open Versus

The purpose of this study was to determine if a difference exists in the reproducibility of knee joint flexion angles in an open versus a closed kinetic chain. Thirty generally healthy subjects (12 males, 18 females; mean age 23.8 years) participated. Subjects actively reproduced small, medium, and large knee flexion angles (with target angles of 15°, 45°, and 75°, respectively) in an open and a closed kinetic chain while being videotaped. Goniometric measurements were taken from the videotape of initial and reproduced joint angles. Data were analyzed using ANOVA with repeated measures on kinetic chain test position and joint angle. Subjects more accurately reproduced knee flexion angles in a closed kinetic chain position. The main effect for angle and the interaction of angle and test position were nonsignificant. The results indicate that knee joint position is more accurately reproduced in closed kinetic chain. Closed kinetic chain testing is also a more functional assessment of joint position sense, and thus closed kinetic chain assessment of lower extremity joint position sense is recommended.

scholarly journals Patellofemoral pain syndrome alters joint position sense: a case-control study

2014 ◽  
Vol 13 (3) ◽  
pp. 331-339
Author(s):  
Fabio Navarro Cyrillo ◽  
Cristina Maria Nunes Cabral
Keyword(s):  
Pain Syndrome ◽  
Absolute Error ◽  
Patellofemoral Pain Syndrome ◽  
Position Sense ◽  
Patellofemoral Pain ◽  
Joint Position Sense ◽  
Joint Position ◽  
Kinetic Chain ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain

Introduction: The evaluation of changes in joint position sense (JPS) of the knee may be crucial for the identification of disorders that could start during the development of patellofemoral pain syndrome (PFPS). Objective: To evaluate JPS of the knee in PFPS. Methods: Twenty nine women (15 healthy and 14 with PFPS) reproduced knee flexion angles of 45° and 60° during open kinetic chain exercises and of 45° during closed kinetic chain exercises. Results: The absolute error in the active reproduction of 45° in open kinetic chain exercises was significantly higher in the experimental group. There were significant differences in absolute and relative errors between the groups for active reproduction at 45° in open and closed kinetic chain exercises. Conclusions: This study suggests that PFPS alters JPS during active reproduction of the 45° angle in both open and closed kinetic chain exercises.

Closed and Open Kinetic Chain Exercise for the Upper Extremity

1996 ◽  
Vol 5 (1) ◽  
pp. 88-102 ◽  
Author(s):  
Kevin E. Wilk ◽  
Christopher A. Arrigo ◽  
James R. Andrews
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Glenohumeral Joint ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Kinetic Chain ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Anterior Cruciate ◽  
Scientific Rationale

The use of closed kinetic chain exercise has grown in the past several years. Closed kinetic chain exercises for the lower extremity have been firmly established in the literature and have been strongly recommended as an integral part of rehabilitation of the patient with anterior cruciate ligament injury. While the scientific and clinical rationale for using closed kinetic chain exercise for the lower extremity appears obvious, the scientific rationale for using closed kinetic chain exercise for the upper extremity is less clear. The purpose of this manuscript is to discuss the scientific rationale for closed kinetic chain for the upper extremity patient. In addition, exercise drills to enhance dynamic stability of the glenohumeral joint are discussed, and a rationale for using these exercises for specific glenohumeral joint pathologies is provided. The concepts of closed and open kinetic chain as applied to the lower extremity may not apply to the upper extremity due to the unique anatomical and biomechanical features as well as the function of the shoulder. It is recommended that clinicians use both closed kinetic chain and open kinetic chain exercises when treating the shoulder patient.

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