scholarly journals Comparison of Lower Extremity Kinematics and Hip Muscle Activation During Rehabilitation Tasks Between Sexes

2010 ◽  
Vol 45 (2) ◽  
pp. 181-190 ◽  
Author(s):  
Maureen K. Dwyer ◽  
Samantha N. Boudreau ◽  
Carl G. Mattacola ◽  
Timothy L. Uhl ◽  
Christian Lattermann

Abstract Context: Closed kinetic chain exercises are an integral part of rehabilitation programs after lower extremity injury. Sex differences in lower extremity kinematics have been reported during landing and cutting; however, less is known about sex differences in movement patterns and activation of the hip musculature during common lower extremity rehabilitation exercises. Objective: To determine whether lower extremity kinematics and muscle activation levels differ between sexes during closed kinetic chain rehabilitation exercises. Design: Cross-sectional with 1 between-subjects factor (sex) and 1 within-subjects factor (exercise). Setting: Research laboratory. Patients or Other Participants: Participants included 21 women (age  =  23 ± 5.8 years, height  =  167.6 ± 5.1 cm, mass  =  63.7 ± 5.9 kg) and 21 men (age  =  23 ± 4.0 years, height  =  181.4 ± 7.4 cm, mass  =  85.6 ± 16.5 kg). Intervention(s): In 1 testing session, participants performed 3 trials each of single-leg squat, lunge, and step-up-and-over exercises. Main Outcome Measure(s): We recorded the peak joint angles (degrees) of knee flexion and valgus and hip flexion, extension, adduction, and external rotation for each exercise. We also recorded the electromyographic activity of the gluteus maximus, rectus femoris, adductor longus, and bilateral gluteus medius muscles for the concentric and eccentric phases of each exercise. Results: Peak knee flexion angles were smaller and peak hip extension angles were larger for women than for men across all tasks. Peak hip flexion angles during the single-leg squat were smaller for women than for men. Mean root-mean-square amplitudes for the gluteus maximus and rectus femoris muscles in both the concentric and eccentric phases of the 3 exercises were greater for women than for men. Conclusions: Sex differences were observed in sagittal-plane movement patterns during the rehabilitation exercises. Because of the sex differences observed in our study, future researchers need to compare the findings for injured participants by sex to garner a better representation of altered kinematic angles and muscle activation levels due to injury.

1995 ◽  
Vol 4 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Peter A. Schaub ◽  
Teddy W. Worrell

During knee rehabilitation, squats are a commonly used closed kinetic chain exercise. We have been unable to locate data reporting electromyographic (EMG) activity of lower extremity musculature during maximal effort squats and the contribution of gastrocnemius and gluteus maximus muscles. Therefore, the purposes of this study were (a) to quantify EMG activity of selected lower extremity muscles during a maximal isometric squat and during a maximal voluntary isometric contraction (MVIC), and (b) to determine ratios between the vastus medialis oblique (VMO) and vastus lateralis (VL) during maximal isometric squat and MVIC testing. Twenty-three subjects participated in a single testing session. Results are as follows: intraclass correlations for MVIC testing and squat testing ranged from .60 to .80 and .70 to .90, respectively. Percentage MVIC during the squat was as follows: rectus femoris 40 ± 30%, VMO 90 ± 70%, VL 70 ±40%, hamstrings 10 ± 10%, gluteus maximus 20 ± 10%, and gastrocnemius 30 ± 20%. No statistical difference existed in VMO:VL ratios during MVIC or squat testing. We conclude that large variations in muscle recruitment patterns occur between individuals during isometric squats.


1994 ◽  
Vol 3 (2) ◽  
pp. 154-167 ◽  
Author(s):  
Jose E. Rivera

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.


2009 ◽  
Vol 18 (1) ◽  
pp. 91-103 ◽  
Author(s):  
Samantha N. Boudreau ◽  
Maureen K. Dwyer ◽  
Carl G. Mattacola ◽  
Christian Lattermann ◽  
Tim L. Uhl ◽  
...  

Context:Functional exercises are often used in strengthening programs after lower extremity injury. Activation levels of the stabilizing hip muscles have not been documented.Objective:To document the progression of hip-muscle activation levels during 3 lower extremity functional exercises.Design:Cross-sectional.Setting:Laboratory.Participants:44 healthy individuals, 22 women and 22 men.Intervention:Subjects, in 1 testing session, completed 3 trials each of the lunge (LUN), single-leg squat (SLSQ), and step-up-and-over (SUO) exercise.Main Outcome Measures:Root-mean-square muscle amplitude (% reference voluntary muscle contraction) was measured for 5 muscles during the 3 exercises: rectus femoris (RF), dominant and nondominant gluteus medius (GMed_D and GMed_ND), adductor longus (ADD), and gluteus maximus (GMX).Results:The RF, GMAX, and GMed_D were activated in a progression from least to greatest during the SUO, LUN, and SLSQ. The progression for the GMed_ND activation was from least to greatest during the SLSQ, SUO, and then LUN. Activation levels of the ADD showed no progression.Conclusion:Progressive activation levels were documented for muscles acting on the hip joint during 3 functional lower extremity exercises. The authors recommend using this exercise progression when targeting the hip muscles during lower extremity strengthening.


2011 ◽  
Vol 20 (3) ◽  
pp. 287-295 ◽  
Author(s):  
Justin M. Stanek ◽  
Todd A. McLoda ◽  
Val J. Csiszer ◽  
A.J. Hansen

Context:Selected muscles in the kinetic chain may help explain the body’s ability to avert injury during unexpected perturbation.Objective:To determine the activation of the ipsilateral rectus femoris (RF), gluteus maximus (MA), gluteus medius (ME), and contralateral external obliques (EO) during normal and perturbed gait.Design:Single-factor, repeated measures.Setting:University research laboratory.Participants:32 physically active, college-age subjects.Intervention:Subjects walked a total of 20 trials the length of a 6.1-m custom runway capable of releasing either side into 30° of unexpected inversion. During 5 trials, the platform released into inversion.Main Outcome Measures:Average, peak, and time to peak EMG were analyzed across the 4 muscles, and comparisons were made between the walking trials and perturbed trials.Results:Significantly higher average and peak muscle activity were noted for the perturbed condition for RF, MA, and EO. Time to peak muscle activity was faster during the perturbed condition for the EO.Conclusion:Rapid contractions of selected postural muscles in the kinetic chain help explain the body’s reaction to unexpected perturbation.


2009 ◽  
Vol 44 (3) ◽  
pp. 238-248 ◽  
Author(s):  
Cara L. Lewis ◽  
Shirley A. Sahrmann

Abstract Context: The consistency of muscle activation order during prone hip extension has been debated. Objective: To investigate whether women use a consistent and distinguishable muscle activation order when extending the hip while prone and to explore the effects of verbal cues on muscle activation and movement. Design: Single-session, repeated-measures design. Setting: University laboratory. Patients or Other Participants: Eleven healthy women (age  =  27.7 ± 6.2 years [range, 22–37 years]). Intervention(s): We tested the participants under 3 conditions: no cues, cues to contract the gluteal muscles, and cues to contract the hamstrings muscles. Main Outcome Measure(s): We measured hip and knee angle and electromyographic data from the gluteus maximus, medial hamstrings, and lateral hamstrings while participants performed prone hip extension from 30° of hip flexion to neutral. Results: When not given cues, participants used the consistent and distinguishable muscle activation order of medial hamstrings, followed by lateral hamstrings, then gluteus maximus (195.5 ± 74.9, 100.2 ± 70.3, and 11.5 ± 81.9 milliseconds preceding start of movement, respectively). Compared with the no-cues condition, the gluteal-cues condition resulted in nearly simultaneous onset of medial hamstrings, lateral hamstrings, and gluteus maximus (131.3 ± 84.0, 38.8 ± 96.9, and 45.1 ± 93.4 milliseconds, respectively) (P > .059); decreased activation of the medial hamstrings (P < .03) and lateral hamstrings (P < .024) around the initiation of movement; increased activation of gluteus maximus throughout the movement (P < .001); and decreased knee flexion (P  =  .002). Compared with the no-cues condition, the hamstrings-cues condition resulted in decreased activation of the medial hamstrings just after the initiation of movement (P  =  .028) and throughout the movement (P  =  .034) and resulted in decreased knee flexion (P  =  .003). Conclusions: Our results support the contention that the muscle activation order during prone hip extension is consistent in healthy women and demonstrates that muscle timing and activation amplitude and movement can be modified with verbal cues. This information is important for clinicians using prone hip extension as either an evaluation tool or a rehabilitation exercise.


Author(s):  
Calvin H.N. Yuen ◽  
Christine P.Y. Lam ◽  
Kate C.T. Tong ◽  
Jessica C.Y. Yeung ◽  
Chloe H.Y. Yip ◽  
...  

(1) Background: Squatting is one of the common closed-kinetic chain (CKC) exercises for knee rehabilitation. Some patients cannot perform squatting exercises on land occasionally due to knee pain. Several studies had suggested that lower limb muscle activities are lower in water than on land while performing CKC exercises. The purpose of this study is to investigate the surface electromyography (sEMG) activities of Rectus femoris (RF) and Biceps femoris (BF) muscles when doing a squatting exercise in water and on land. (2) Methods: This was a cross-sectional experimental study. A total of 20 healthy participants (10 males, 10 females) were recruited by convenience sampling. The sEMG of RF and BF muscles in water and on land were collected and the knee motions were videotaped. Participants were instructed to perform closed kinetic-chain back squatting exercises at a specific speed (30 beats per minute) in water and on land at angular speed of 45°/s. Eight repetitions of the squatting exercise (0–90° knee flexion) were performed. The mean percentage maximal voluntary contraction (%MVC) between two muscles was compared in two conditions. The %MVC of RF and BF muscles at different specific knee flexion angles (30°, 60° and 90° knee flexion) was also identified. (3) Result: Muscle activities of RF (p = 0.01) and BF (p < 0.01) muscles were significantly lower in water than on land. The %MVC of RF and BF muscles was found to be 15.01% and 10.68% lower in water than on land respectively. For different knee angle phases, the differences in %MVC between land and water had significant difference for both RF muscles and BF muscles. (4) Conclusion: This study found a difference of mean percentage MVC of RF and BF muscles between land and water in different phases of squatting. The water medium reduced the two muscles’ activities to a similar extent. The result showed that the aquatic environment allows an individual to perform squatting with less muscle activation which may serve as an alternative knee exercise option for patients who encounter difficulty in land squatting due to lower limb muscle weakness or a high level of knee pain.


2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Michèle N. J. Keizer ◽  
Juha M. Hijmans ◽  
Alli Gokeler ◽  
Anne Benjaminse ◽  
Egbert Otten

Abstract Purpose It has been reported that there is no correlation between anterior tibia translation (ATT) in passive and dynamic situations. Passive ATT (ATTp) may be different to dynamic ATT (ATTd) due to muscle activation patterns. This study aimed to investigate whether muscle activation during jumping can control ATT in healthy participants. Methods ATTp of twenty-one healthy participants was measured using a KT-1000 arthrometer. All participants performed single leg hops for distance during which ATTd, knee flexion angles and knee flexion moments were measured using a 3D motion capture system. During both tests, sEMG signals were recorded. Results A negative correlation was found between ATTp and the maximal ATTd (r = − 0.47, p = 0.028). An N-Way ANOVA showed that larger semitendinosus activity was seen when ATTd was larger, while less biceps femoris activity and rectus femoris activity were seen. Moreover, larger knee extension moment, knee flexion angle and ground reaction force in the anterior-posterior direction were seen when ATTd was larger. Conclusion Participants with more ATTp showed smaller ATTd during jump landing. Muscle activation did not contribute to reduce ATTd during impact of a jump-landing at the observed knee angles. However, subjects with large ATTp landed with less knee flexion and consequently showed less ATTd. The results of this study give information on how healthy people control knee laxity during jump-landing. Level of evidence III


Author(s):  
Maximilian Hinz ◽  
Stephanie Geyer ◽  
Felix Winden ◽  
Alexander Braunsperger ◽  
Florian Kreuzpointner ◽  
...  

Abstract Purpose Proximal rectus femoris avulsions (PRFA) are relatively rare injuries that occur predominantly among young soccer players. The aim of this study was to evaluate midterm postoperative results including strength potential via standardized strength measurements after proximal rectus femoris tendon refixation. It was hypothesized that the majority of competitive athletes return to competition (RTC) after refixation of the rectus femoris tendon without significant strength or functional deficits compared to the contralateral side. Methods Patients with an acute (< 6 weeks) PRFA who underwent surgical refixation between 2012 and 2019 with a minimum follow-up of 12 months were evaluated. The outcome measures compiled were the median Tegner Activity Scale (TAS) and mean RTC time frames, Harris Hip Score (HHS), Hip and Groin Outcome Score (HAGOS) subscales, International Hip Outcome Tool-33 (iHOT-33), and Visual Analog Scale (VAS) for pain. In addition, a standardized isometric strength assessment of knee flexion, knee extension, and hip flexion was performed to evaluate the functional result of the injured limb in comparison to the uninjured side. Results Out of 20 patients, 16 (80%) patients were available for final assessment at a mean follow-up of 44.8 ± SD 28.9 months. All patients were male with 87.5% sustaining injuries while playing soccer. The average time interval between trauma and surgery was 18.4 ± 8.5 days. RTC was possible for 14 out of 15 previously competitive athletes (93.3%) at a mean 10.5 ± 3.4 months after trauma. Patients achieved a high level of activity postoperatively with a median (interquartile range) TAS of 9 (7–9) and reported good to excellent outcome scores (HHS: 100 (96–100); HAGOS: symptoms 94.6 (89.3–100), pain 97.5 (92.5–100), function in daily living 100 (95–100), function in sport and recreation 98.4 (87.5–100), participation in physical activities 100 (87.5–100), quality of life 83.1 ± 15.6; iHot-33: 95.1 (81.6–99.8)). No postoperative complications were reported. Range of motion, isometric knee flexion and extension, as well as hip flexion strength levels were not statistically different between the affected and contralateral legs. The majority of patients were “very satisfied” (56.3%) or “satisfied” (37.5%) with the postoperative result and reported little pain (VAS 0 (0–0.5)). Conclusion Surgical treatment of acute PRFA yields excellent postoperative results in a young and highly active cohort. Hip flexion and knee extension strength was restored fully without major surgical complications. Level of evidence Retrospective cohort study; III.


1998 ◽  
Vol 85 (3) ◽  
pp. 927-934 ◽  
Author(s):  
Li Li ◽  
Graham E. Caldwell

The purpose of the present study was to examine the neuromuscular modifications of cyclists to changes in grade and posture. Eight subjects were tested on a computerized ergometer under three conditions with the same work rate (250 W): pedaling on the level while seated, 8% uphill while seated, and 8% uphill while standing (ST). High-speed video was taken in conjunction with surface electromyography (EMG) of six lower extremity muscles. Results showed that rectus femoris, gluteus maximus (GM), and tibialis anterior had greater EMG magnitude in the ST condition. GM, rectus femoris, and the vastus lateralis demonstrated activity over a greater portion of the crank cycle in the ST condition. The muscle activities of gastrocnemius and biceps femoris did not exhibit profound differences among conditions. Overall, the change of cycling grade alone from 0 to 8% did not induce a significant change in neuromuscular coordination. However, the postural change from seated to ST pedaling at 8% uphill grade was accompanied by increased and/or prolonged muscle activity of hip and knee extensors. The observed EMG activity patterns were discussed with respect to lower extremity joint moments. Monoarticular extensor muscles (GM, vastus lateralis) demonstrated greater modifications in activity patterns with the change in posture compared with their biarticular counterparts. Furthermore, muscle coordination among antagonist pairs of mono- and biarticular muscles was altered in the ST condition; this finding provides support for the notion that muscles within these antagonist pairs have different functions.


2020 ◽  
Vol 55 (6) ◽  
pp. 615-622
Author(s):  
Andrea Baellow ◽  
Neal R. Glaviano ◽  
Jay Hertel ◽  
Susan A. Saliba

Context Patellofemoral pain (PFP) is one of the most prevalent knee conditions observed in women. Current research suggests that individuals with PFP have altered muscle activity, kinematics, and kinetics during functional tasks. However, few authors have examined differences in lower extremity biomechanics in this population during the drop-vertical jump (DVJ). Objective To determine how lower extremity electromyography, kinematics, and kinetics during a DVJ and lower extremity isometric strength differed between women with and those without PFP. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants Fifteen healthy women (age = 20.23 ± 1.39 years, height = 169.32 ± 5.38 cm, mass = 67.73 ± 9.57 kg) and 15 women with PFP (age = 22.33 ± 3.49 years, height = 166.42 ± 6.01 cm, mass = 65.67 ± 13.75 kg). Intervention(s) Three trials of a DVJ. Main Outcome Measure(s) Surface electromyography, kinematics, and kinetics were collected simultaneously during a DVJ. Lower extremity strength was measured isometrically. Independent-samples t tests were performed to assess group differences. Results Normalized muscle activity in the vastus medialis (healthy group = 120.84 ± 80.73, PFP group = 235.84 ± 152.29), gluteus maximus (healthy group = 43.81 ± 65.63, PFP group = 13.37 ± 13.55), and biceps femoris (healthy group = 36.68 ± 62.71, PFP group = 11.04 ± 8.9) during the landing phase of the DVJ differed between groups. Compared with healthy women, those with PFP completed the DVJ with greater hip internal-rotation moment (0.04 ± 0.28 N/kg versus 0.06 ± 0.14 N/kg, respectively) and had decreased knee-flexion excursion (76.76° ± 7.50° versus PFP = 74.14° ± 19.85°, respectively); they took less time to reach peak trunk flexion (0.19 ± 0.01 seconds versus 0.19 ± 0.02 seconds, respectively) and lateral trunk flexion (0.12 ± 0.07 seconds versus 0.11 ± 0.04 seconds, respectively). Conclusions During the DVJ, women with PFP had increased hip internal-rotation moment and decreased knee-flexion excursion with less time to peak trunk flexion and lateral flexion. Muscle activation was increased in the vastus medialis but decreased in the gluteus maximus and biceps femoris. This suggests that altered motor-unit recruitment in the hip and thigh may result in changes in biomechanics during a DVJ that are often associated with an increased risk of injury.


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