Background: The superimposed technique (ST) involves the application of electrical muscle stimulation (EMS) during voluntary muscle action. The physiological effects attributed to each stimulus may be accumulated by the ST. Although various EMS devices for the quadriceps muscle are being marketed to the general public, there is still a lack of research on whether ST training can provide significant advantages for improving quadriceps muscle strength or thickness compared with EMS alone. Objective: To compare the effects of eight weeks of ST and EMS on the thicknesses of the rectus femoris (RF) and vastus intermedius (VI) muscles and knee extension strength. Methods: Thirty healthy subjects were recruited and randomly assigned to either the ST or EMS groups. The participants underwent ST or EMS training for eight weeks. In all participants, the thicknesses of the RF and VI muscles were measured before and after the 8-week intervention by ultrasonography, and quadriceps muscle strength was measured using the Smart KEMA tension sensor (KOREATECH Co., Ltd.). Results: There were significant differences in the pre- and post-intervention thicknesses of the RF and VI muscles as well as the quadriceps muscle strength in both groups (p < 0.05). RF thickness was significantly greater in the ST group (F = 4.294, p = 0.048), but there was no significant difference in VI thickness (F = 0.234, p = 0.632) or knee extension strength (F = 0.775, p = 0.386). Conclusion: EMS can be used to improve quadriceps muscle strength and RF and VI muscle thickness, and ST can be used to improve RF thickness in the context of athletic training and fitness.

This study examined the correlation between power error (PE) and velocity error (VE) according to the condition and frequency of self-controlled feedback (SCF) during knee extension. One hundred participants were randomly assigned to 30% SCF, 70% SCF, 30% yoked feedback (YF), 70% YF and control group, respectively. The SCF group was provided with feedback when they requested it, whereas the YF group did not influence the feedback schedule. Participants in the control group were not given any visual feedback during the experiment. The isotonic, isometric, and isokinetic dynamometer (PRIMUS RS, BTE, USA) was used to measure the power and velocity error during knee extension. The collected data was analyzed using a Pearson test and SPSS 21.0. The correlation between PE and VE according to the condition and frequency of feedback on each phase during knee extension was significant. Both PE and VE were significantly higher when the feedback was provided with high frequency, passive, and no feedback. Our study suggests that application of SCF can help to improve the proprioception of the healthy person while reducing errors through low frequency and active feedback.

The main focus of this study was to investigate effects of lumbar central posteroanterior (PA) mobilization on isometric knee extension (IKE) ability and patellar tendon reflex amplitude (PTRA) in healthy university students. University students aged 19-26 (male; 10, female; 10) without any neurological disorders participated voluntarily and excluded the subjects with abnormal reflexes. The participation had an average body mass of 64.25±13.52 kg, an average height of 1.66±0.08m, and an average Body Mass Index (BMI) of 23.07±3.21. Every student was randomly assigned to be received squatting exercise and PA mobilization sequentially with 5 days of wash out period. IKE and PTRA were not significantly different between the two groups after the intervention. All the outcome measures were arranged into two data groups; PA mobilization and squatting exercise data group. In the PA mobilization data group, IKE and PTRA significantly increased after the intervention, however, these aspects were decreased in the squatting exercise group. These findings suggest that IKE and PTRA increase immediately after PA mobilization, therefore PA mobilization could be a valuable topic for controlled clinical trials.

Background: The active knee extension (AKE) test commonly used to assess the flexibility of the hamstring muscles. Many researchers have tested the reliability of the AKE test; however, no published studies have examined the intrarater and interrater reliability of the AKE test using a PBU. Objects: The purpose of this study was to determine the intrarater and interrater reliability of the AKE test performed with a pressure biofeedback unit (PBU) on healthy subjects. Methods: Sixteen healthy male participants volunteered and gave informed consent to participate in this study. Two raters conducted AKE tests independently with a PBU. Each knee was measured twice, and the AKE testing was repeated one week after the first round of testing. Results: The interrater reliability’s intraclass correlation coefficients (ICC2,1) were .887∼.986 for the right knees and .915∼.988 for the left knees. In addition, the intrarater (test-retest) reliability (ICC3,1) values ranged between .820∼.915 and .820∼.884 for Raters 1 and 2, respectively. The values for the standard error of mesurement were low for all tests (.81∼2.97˚); the calculated minimum detectable change was 2.24∼8.21˚. Conclusion: These findings suggest that the AKE test performed with a PBU had excellent interrater and intrarater reliability for assessing hamstring flexibility in healthy young males.

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.

The purpose of this study was to determine whether the vastus medialis oblique muscle(VMO) had greater electrical activity than the vastus lateralis muscle(VL) when hip adduction and knee extension exercise were performed. Electrical activity of the VMO and VL was measured on 42 healthy subjects (28 men, 14 women) during maximal voluntary isometric contractions of hip adduction and knee extension by an EMG-BIOFEEDBACK. The results showed that the electromyographic activity of the VMO was significantly greater than that of the VL during the hip adduction exercise. Differences noted with knee extension by performing hip adduction exercises. Isometric hip adduction exercises, therefore, may be advisable in the treatment of patients with patellofemoral pain.