Background: If the weakness of the knee muscles persists and there is pain at the same time, lumbar mobilization can be used. Objectives: This study investigated the immediate effect of lumbar joint mobilization on postural sway and knee pain in elite volleyball players. Design: Randomized controlled trial. Methods: Twelve male elite volleyball players were recruited for this study. Lumbar joint mobilization was performed in all study subjects. Evaluation items were static and dynamic balance and knee pain change. All evaluations were made immediately after the intervention. Results: C90 area, trace length, and STD Y deviation in the open static balance were significantly decreased after intervention (P<.05). C90 area, trace length, Velocity, STD X deviation, and STD Y deviation in static balance with closed eyes decreased significantly after intervention (P<.05). In dynamic balance, the left and right side. COPs were significantly increased. Pain significantly decreased after intervention (P<.05). Conclusion: This study found that lumbar joint mobilization is an effective method for improving postural sway and knee pain in elite volleyball players.

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weightmatched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

본 연구는 퇴행성 무릎 관절염을 가진 노인여성을 대상으로 12주간의 노르딕 워킹을 통해 신체 기능과 관절염 통증 정도의 개선에 어떠한 효과를 미치는지 규명하는데 목적이 있다. 본 연구의 대상자는 퇴행성관절염으로 진단받은 노인여성 16명(나이: 73.00±3.70year, 신장: 154.30±4.07cm)을 대상으로 무선배정 된 노르딕 워킹 운동그룹(n=9)과 통제그룹(n=7)으로 나누었다. 운동 그룹은 노르딕 스틱을 이용하여 12주간 주 3회, 1회 30분 노르딕 워킹 운동을 실시하였고, 운동 강도는 HRR의 40-60%로 설정하였다. 통제그룹은 동일한 기간 동안 일상생활을 유지하도록 하였다. 종속변인으로 신체조성(체중, 체지방률, 근골격량)과 근력과 유연성(상·하지 근력, 상·하지 유연성), 균형능력(정적균 형, 동적균형) 및 통증정도를 측정하였다. 이러한 지표들의 측정은 운동프로그램을 진행하기 전과 후로 나누어 2번 측정하였다. 자료처리는 SPSS-PC version 25.0을 이용하여 실험집단과 통계집단간의 생리학적 특성 비교를 위해 독립표본 t-test를 사용하였으며, 노르딕 워킹 운동그룹과 통제그룹의 그룹 간, 시기간의 변화를 알아보기 위해 2x2 반복측정 이원배치분산분석을 사용하였다. 연구 결과는 첫째, 12주간의 노르딕 워킹을 통해 신체조성 기능에서 체지방률은 운동 처치 후에 감소하는 결과가 나타났으며(p=.004), 집단 간과 시기 간의 상호작용에서도 감소하는 결과가 나타났다(p=.003). 골격근량은 운동처치 후에 증가하는 결과가 나타났으며(p=.018), 집단 간과 시기 간의 상호작용에서도 증가하는 결과가 나타났다(p=.005). 둘째, 근력과 유연성은 상지근력과 하지유연성에서 집단 간과 시기 간 상호작용에서 증가하는 결과가 나타났으며(p=.009)(p=036), 하지근력에서는 운동집단과 통제집단 간 개선 효과가 나타났다(p=.006). 또한, 상지유연성은 운동처치 후에 증가하는 결과가 나타났다(p=.020). 셋째, 균형능력 요인은 정적균형에서 운동처치 후 개선 효과가 나타났으며(p=.016), 동적균형에서는 차이가 나타나지 않았다(p>.05). 넷째, 통증정도는 운동처치 후 개선 효과가 나타났으며(p=.022), 운동집단과 통제집단 간에 개선 효과도 나타났다(p=.013). 결론적으로 12주간의 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성의 신체조성과 근력과 유연성 에 긍정적인 영향을 미치는 것으로 나타났다. 따라서 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성 에게 신체조성과 안정성, 균형성을 높여 주였으며, 무릎 관절의 통증을 낮춰주어 재활 운동 기능 개선에 효과적인 운동방법이라고 사료된다.

Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman’s rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.

This study aimed to identify the effects of kinesio taping (KT) applied in a proprioceptive neuromuscular facilitation (PNF) pattern on the pain, weight-bearing distribution (WBD), and walking ability of knee osteoarthritis (KOA) patients. Thirty women with KOA were randomly allocated to a control group (n=15) with KT at the quadriceps only, and a PNF pattern group (n=15) with KT at the quadriceps and gastrocnemius muscle. Pain intensity was measured using a visual analogue scale during walking. In addition, WBD, and walking ability were measured before and 30 minutes after KT application. The VAS significantly reduced in both groups after the intervention (p<.05). WBD (p<.05, ES=.32) and walking ability (p<.05, ES=.38) showed a significant change in the PNF pattern group, and in the inter-group comparison, the PNF pattern group showed a significant difference compared to the control groups. These results demonstrate that KT application with PNF pattern effectively attenuate the pain and improves WBD and walking ability in KOA patients.

The purpose of this study was to identify the effects of mechanical traction applied to the knee joint on pain, knee range of motion (ROM), timed up and go (TUG) and Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) in patients with knee osteoarthritis (KOA) of Kellgren-Lawrence radiological rating scale Ⅱ or Ⅲ. Twenty three patients participated in the experiment for a period of four weeks. After baseline assessment, the patients with KOA were randomized into two groups: the traction group (n1=12), which received traction with general physical therapy; and the control group (n2=11), which received general physical therapy only on unilateral knee joints. Patients received interventions once a day, three times a week, for four weeks. Wilcoxon signed-rank test was used to analyze the change of dependent variances within the group during pre and post intervention. Mann-Whitney U test was used to analyze the change of dependent variances as TUG and passive ROM between the two groups. Analysis of covariance was used to analyze the change of dependent variances as numeric pain rating scale (NPRS) and WOMAC score between the two groups. In Wilcoxon signed-rank test, the traction group improved significantly with regard to NPRS (p<.01), passive knee flexion ROM (p<.01), passive knee extension (p<.05), TUG (p<.01) and WOMAC scores (p<.01) after intervention for four weeks, but not for the control group. In the Mann-Whitney U test and analysis of covariance, no significant difference was seen among all the dependent variances after intervention for four weeks between the two groups. These outcomes suggest that further studies should be carried out to determine the effects of mechanical traction prior to using it for the treatment of patients with knee osteoarthritis.

The purpose of this study was to determine the effect of sciatic nerve mobilization technique on perceived pain, straight leg raise test (SLR), and strength of knee extensor, location of symptoms (LOS) in patients with chronic low back pain. 22 patients with chronic low back pain were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 11 patients in each group. All patients received a routine physical therapy (hot pack and transcutaneous electrical nerve stimulation). The mobilization technique of the sciatic nerve was performed for 10 min in the case of the EG subjects. Outcome measurements included the level of the perceived pain, SLR, and strength of the knee extensor, LOS. The measurements were recorded 3 times: before the intervention, after the intervention, and at 1 hour of follow up. The two groups did not significantly differ with regard to the level of perceived pain, SLR, and strength of the knee extensor, LOS before the test (p>.05). In the case of the EG subjects, all the variables measured after the intervention significantly differed from those measured before the intervention (p<.05). However, in the case of the CG subjects, a significant difference was noted only with regard to the level of perceived pain (p<.05). The findings indicate that sciatic nerve mobilization technique exerts a positive effect on the control of subjective symptoms and knee strength in patients with chronic low back pain. Further studies are required to generalize the result of this study.