The active-knee-extension (AKE) test has been used to measure hamstring muscle length. The traditional AKE test measures the popliteal angle to the point of resistance with a 90-degree flexion of the hip fixed by straps, while the stabilized AKE test measures the popliteal angle to the point of resistance with a 90-degree flexion of the hip stabilized using a pressure biofeedback unit providing lumbopelvic stabilization. The purpose of this study was to determine test-retest reliability of the traditional AKE test and stabilized AKE test. Twenty healthy adults participated in the study. The popliteal angles were measured with a digital inclinometer during each test. To assess the test-retest reliability between the 2 test sessions, intraclass correlation coefficients (ICCs) were calculated. The intrasubject coefficient of variation (CVintra) was also calculated. To compare the traditional and stabilized AKE tests for changes in pressure, paired t-tests were applied. The results of this study were as follows: 1) ICCs(3,1) value for test-retest reliability was .96 in the traditional AKE test, and was .98 in the stabilized AKE test. 2) The maximal CVintra was 33.7% in the traditional AKE test and 15.7% in the stabilized AKE test. 3) Differences of 6.1±2.1 mmHg in pressure were measured in the traditional AKE test, and differences of 1.2±1.0 mmHg in pressure were measured in the stabilized AKE test. The results show the traditional and stabilized AKE test to be highly reliable, with test-retest reliability. However, the stabilized AKE test represented less variation and more stabilization than the traditional AKE test. Further study is needed to measure the inter-rater reliability of the stabilized AKE test for generalization and clinical application.

The purpose of this study was to suppose basis data the influence of different chair type and pelvic control on quadriceps muscle activity and strength during knee joint extension isometric exercise in hemiplegic patients. This research were investigated in ten healthy adults and tens hemipelgic patients. Surface electromyography (EMG) and Biodex system were used to collect kinematic data and muscle activity, respectively. Independent t-test, paired t-test and one-way repeated ANOVA were used to determine a statistical significance. The results showed as follows: (1) Posterior pelvic angles in healthy group and hemiplegic group were significantly different on isokinetic equipment (p<.05). (2) Different chair type and pelvic control on quadriceps muscle activity and strength were significantly different in hemiplegic patients (p<.05). From the result of this research, posterior pelvic angle control during knee joint extension isometric exercise in hemiplegic patients on isokinetic equipment is necessary to increase quadriceps muscle strength in hemiplegic patients.

본 연구에서는 1층 1경간 실제크기의 가력 프레임에서 내진보강에 적합한 비좌굴 knee brace을 설치하여 주기하중을 통해 가새의 지진저항능력을 실험하였다. 볼트 고정 채널이 이용된 비좌굴 knee brace는 지진력에 저항하는 코어와 두 개의 철골 플레이트로 만들어졌고 단면의 형태는 코어의 국부좌굴과 횡좌굴에 저항하도록 하였다. 비좌굴 kneebrace는 현장에서 조립이 용이하고, 시공방법 또한 간단하여 공간에 제약이 있는1층에 필로터를 가진 중저층 RC건물의 내진 보수/보강에 효과적으로 사용할 수 있다. 각 실험체에 대한 변수로 중심코어의 크기와 외부 보강재의 크기, 가이드 플레이트의 유무 등으로 정하였으며, 실험을 통해 얻어진 힘-변위 이력곡선을 통해 중심코어의 크기가 가장 큰 영향을 미치는 것으로 나타났다. 또한 가이드 플레이트의 유무에 따라 압축강도 수정계수와 파괴형태가 달라지는 것을 알 수 있었다. 각 실험체에 대한 결과는 AISC 2005 Seismic Provisions 규정에서 제시한 누적 연성도와 누적 소산에너지 측면에서도 충분한 효과를 발휘하는 것으로 나타났다.

In dancers, intact muscular coordination is a well balanced antagonist, which could be a decisive factor in protection against injury as dancers often have hypermobile joints and their ankle joints often bear their full body weight in extreme positions. The purposes of this study were to identify the isokinetic strength to the knee and ankle and the isometric strength of the trunk in female collegiate dancers and controls. Furthermore, the study aimed to investigate the peak torque ratio of knee extension to flexion, ankle plantarflexion (PF) to dorsiflexion (DF), and dominant legs to nondominant. Twenty-one female collegiate dancers (20.0 years of age) and twenty-one female collegiate students (19.3 years of age) performed isokinetic maximum efforts of the knee extensors and flexors at and , the ankle plantarflexors and dorsiflexors at and and isometric maximum efforts of the lumbar extensors at 0˚, 12˚, 24˚, 36˚, 48˚, 60˚, and 72˚. The results were as follows: The isokinetic peak torque of the knee extensors and the ratio of knee extensors to flexors of dancers were significantly higher than those of controls (p<.01). However, the isometric peak torque of the back extensors (p<.01) and isokinetic peak torque of the ankle plantarflexors and dorsiflexors (p<.05) of dancers were significantly lower than those of controls. Further studies are needed to identify the difference in proprioception of the joints between dancers and controls.

Pressure sores are painful and needless complications of critical illness. and manifest as a localized area of ischemic necrosis of tissue caused by pressure. This study analyzed the bed-backrest elevation system combined with hip and knee flexion for lower extremity lower pressure reduction. Eight healthy adults aged 21 to 26 years were recruited. The Body Pressure Measurement Mat of the TekScan system was used to measure the location and magnitude of the peak pressures on the body bed interface. The SPSS statistical package was used to analyze the significance of differences between the general bed-backrest elevation system and the bed-backrest elevation system combined with hip and knee flexion using the paired t-test. The result showed that the body-pressure of the lower extremity was more significantly reduced for the bed-backrest elevation system combined with hip and knee flexion (26.6±4.3 mmHg) than a general bed-backrest elevation system (37.3±5.2 mmHg) (p<.05).

The purpose of this study was to examine the effect of the hip internal rotation on knee extensor and hip abductor electromyographic (EMG) activity during stair up and stair down mobility. Eighteen healthy subjects were recruited. All subjects performed stair up and down movements on a step of 30cm height while maintaining the hip in neutral (condition 1) and hip in internal rotation (condition 2). Surface EMG activity was recorded from five muscles (gluteus maximus, vastus lateralis (VL), vastus medialis oblique (VMO), posterior gluteus medius (Gmed), and tensor fascia latae (TFU)) and hip internal rotation angle was measured using a three dimensional motion analysis system The time period for stair up and down was normalized using the MatLab 6.5 program, and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities according to the hip rotation (neutral or internal rotation) during the entire time period of stair up and down in each phase were compared using a paired t-test. During the entire period of stair up, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). During the entire period of stair down, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). However, the EMG activities of the other muscles were not significantly different between the conditions (p>.05). These results suggest that the stair up and down maintaining hip internal rotation was could be a contributing factor on patellar lateral tracking.

The purpose of this study was to examine the validity and reliability of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-VA3.0 in patients with hip and knee osteoarthritis (OA). The sample consisted of 301 patients who had received treatments at the physical therapy units of 5 medical institutions in Andong City in june 2006. Questionnaires on the WOMAC were recruited by 12 physical therapists. The internal structure and reliability of the scales were evaluated by means of item-internal consistency (Cronbach's alpha coefficient: ), item-discriminant validity, and Pearson's relation coefficient. To explore construct validity, we conducted a principal component factor analysis with varimax rotation analysis. The criterion for factor extraction was an eigenvalue >1.0. The average age of the patients was 62.1 years. All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficients of .81, .91, and .80, respectively. The internal consistency reliability of item-each scale were also internally consistent with Cronbach's coefficient of .89 (Pearson's correlation coefficient: .71~.84), .93 (.89~.91), and .96 (.67~.91), respectively. However, high correlation was found among 3 items (.66~.83, .66~.67, and .67~.83), so the item-discriminant validity was low ( coefficient: .81, .91, .80, respectively). The construct validity by factor analysis was low because it was not consistent With WOMAC-VA3.0. In conclusion, the results reported here confirm the reliability of the WOMAC in patients with OA of the hip and knee. The collection of information on the hip and knee osteoarthritis using this instrument was acceptable to patients. A further prospective multi-center study will be necessary to prove the construct validity.

This study was designed to examine the effects of temporary immobilization of the ankle and knee joints on standing in healthy young adults with the use of a postural control mechanism. The subjects were twenty-four college students (12 males and 12 females, aged between 20 and 28). A Biodex balance system SD 950-302 and its software were used to measure indirect balance parameters in standing. Each subject underwent postural stability tests in 4-different joint conditions: free joints, ankle immobilization only, knee immobilization only, and ankle and knee immobilization. In addition, the postural stability test was conducted once with the subject's eyes open and once with the eyes closed conditions. For data analysis of the postural stability tests, the overall stability index, antero-posterior stability index, and medio-lateral stability index were recorded. The overall stability index (p=.000) and medial-lateral index (p=.003) were significantly greater different conditions with eyes closed in postural stability. Therefore, the eyes closed condition is expected to be used as an effective postural stability training for treatment planning in patients with unstable postures. In addition, training based on the dynamic multi-segment model can improve postural stability and is available to therapeutic programs, helping people with unstable balance to reduce their risk of falling.

The purpose of this study was to compare the joint position sense at the knee joint at 3 different surface conditions by using the active knee joint angle reproduction test in the standing position. Twenty healthy volunteers (10 males and 10 females) age 20~29 years were recruited for this study. The knee joint position senses were assessed at three different surface conditions: on the floor (stable condition), TOGU (soft condition), and seat fit (unstable condition) in a closed kinetic chain. Testing orders were selected randomly. The absolute angle error was defined as the absolute difference between target angles (30°～45° knee flexion) and subject perceived angle of the knee flexion. One way ANOVA was used to compare the absolute angle of error among 3 different conditions. The Independent t-test was used to compare the absolute angle of error between male and female. The error angles were significantly different among surface conditions (1.3°±1.2° for the floor, 2.1°±0.9° for the TOGU, and 4.4°±1.8° for the seat fit, p<.05). There was no significant difference in error angle between male and female. In conclusion, the joint position sense of the knee joint in the closed kinetic chain decreased at unstable surface conditions. The result of this study indicates that surface conditions should be considered when assessing and training the joint position sense of the knee joint in clinical setting.

The purpose of this study was to evaluate inter-rater reliability of the amplitude and first knee extension angles in deep tendon reflex test by using an electrical hammer. Twenty-five healthy adults participated in the study. Compound muscle action potential is elicited by tapping the knee tendon with an electrical hammer in deep tendon reflex tests. The amplitude and knee extension angle were simultaneously measured. The mean value of the amplitude and the knee extension angles through three time trials for each tester, are used for determining the inter-rater and Intra-class Correlation Coefficients (ICCs) reliabilities. According to the results, the ICCs of the amplitude is .280 and that of the knee extension angle is .789. Pearson correlation coefficients of the amplitude of the action potential and the knee extension angles are .685, showing significant statistically moderate correlation. Inter-rater reliability in the amplitude was not significant. More objective and quantitative deep tendon reflex tests should be done to obtain higher reliability in further studies.

The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 ) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a valid and widely used instrument for the assessment of osteoarthritis patients. In this study, data was obtained from the out-patients with painful osteoarthritis of the knee. One hundred-three out-patients were interviewed by physical therapists. In an exploratory way, a Korean version of the KWOMAC was analyzed for unidimensionality, item separation, and item difficulty using the Winsteps programs. Ninety-five patients with osteoarthritis of the knee over 65 years were analyzed for Rash analysis. In the analysis several functional items poorly fit to the model. These items included "heavy domestic duties" and "standing". In the pain domain, one item ("at night while in bed") did not fit the model. In the stiffness domain one item ("after sitting, lying, or resting later in the day") did not fit the model. Although 4 items from the 3 domains (pain, stiffness, function domain) do not fit well, the KWOMAC domains were confirmed by Rasch analysis. Thus the KWOMAC needs to be further examined before it can be used to properly determine the health status of the elderly with OA.

Tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking performance. Six patients with hemiplegia and six age-matched controls participated in the study. The tracking test was administrated. It was composed with regular ranges of to and randomized range .2 to .4 Hz. Using the Mann-Whitney U test, a comparison was made between subjects who had suffered from stroke and subjects who were well coordinated. The Wilcoxon Matched Pairs Signed Ranks Test was used to compare and analyze the paretic and nonparetic sides of the stroke patients. The results of study were as follows: accuracy index of the tracking test was significantly higher on the control side than paretic and nonparetic sides. Accuracy index scores were significantly higher for nonparetic sides with stroke compared with paretic sides with stroke. This study shows tracking is impaired in paretic and nonparetic knee of subjects with stroke.

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 (<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 (<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

The purpose of this study was to examine the effects of static stretching and Evjenth-Hamberg stretching the on range of motion (ROM) of the knee joint. The subjects were composed of twenty healthy males without weight-training experience. The ROM of the knee joint was measured by using an En-Knee. Three tests (performed on the 1st week, 4th week, and 8th week) were conducted to examine the change of each variable. Data were analyzed with a analysis of variance (grouptest) for repeated measures on last factor through SPSS 10.0. The data analysis revealed the change in the ROM was dependent on the stretching method. The results were as follows: The ROM was improved in both methods by each time, but the E-HS was more improved than the SS. In conclusion, this study indicated that the E-HS is more efficient than the SS on the ROM of the knee joint.

The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

The purpose of this study was to determine whether gender differences existed in knee valgus kinematics in college students when performing a vertical drop landing. The hypothesis of this study was that females would demonstrate greater knee valgus motion. These differences in knee valgus motion may be indicative of decreased dynamic knee joint control in females. This study compared the initial knee valgus angle and maximum knee valgus angle at the instant of impact on vertical drop landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and two-dimensional video motion analysis software were used to analyze the kinematic data. There was significant difference in the mean knee valgus angle at initial contact landing between the two groups (Mean=, SD= in males, Mean=, SD= in females). The range of knee valgus angle on landing (Mean=, SD= in males, Mean=, SD= in females) was differed significantly (p<.05). The maximal angle of knee valgus on landing (Mean=, SD= in males, Mean=, SD= in females) was also differed significantly (p<.05). The females landed with a larger range of knee valgus motion than the males and this might have increased the likelihood of a knee injury. The absence of dynamic knee joint stability may be responsible for increased rates of knee injury in females. No method for accurate and practical screening and identification of athletes at increased risk of ACL injury is currently available to target those individuals that would benefit from neuromuscular training before sports participation.