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.

Background: Although rectus femoris (RF) eccentric training and static stretching (SS) have been reported effectively on lumbar flexibility, and muscle architecture, most studies are results using machines and long-term effects. Therefore, we want to investigate the effect of Reverse Nordic Hamstring Exercise (RNHE), a self-eccentric training, by immediately comparing it with SS. Objectives: To compare the RNHE and SS of RF to show the effects of lumbar flexibility, and fascicle length (FL). Design: Randomized controlled trial. Methods: A total of 30 study subjects were randomly allocated into an experimental group(Reverse Nordic Hamstring Exercise) and a control group(Static Stretching). Before and after the intervention, the subject performed fingertip to floor test (FFT) to evaluate the flexibility of the lumbar spine and measured FL through the SONON 300L (Healcerion Inc., Seoul, South Korea). Results: There was a significant effect on lumbar flexibility within both groups (P<.05), also there were clear results between the two groups (P<.05). FL showed a significant increase in RNHE (P<.05), but not in SS, and there was a no significant difference between the two groups. Conclusion: RNHE is effective in improving lumbar flexibility, and FL of RF muscle.

Background: Whole body-electromyostimulation (WB-EMS) is widely used for the rehabilitation and recovery of patients with various neuromusculoskeletal disorders. Objects: To objectively measure changes in lower extremity and abdominal muscles after sit-to-stand dynamic movement training using WB-EMS. Methods: A total of 46 healthy adults (23 experimental and 23 control subjects) performed sit-to-stand exercise; the experimental group with WB-EMS, and the control group without WB-EMS. The muscle activity of the lower extremity, and the muscle thickness of the lower extremity and abdominal muscles were measured before and after the intervention. Results: In terms of electromyographic activity, there was a significant interaction effect for the rectus femoris (RF) muscle (F=30.212, p=.000). With regards to ultrasonographic imaging, the muscle thickness of the RF muscle had a significant interaction effect at the muscle contraction ratio (F=8.071, p=.007). The deep abdominal muscles, such as the transverse abdominal (TrA) and internal oblique (IO) muscles, also showed significant interaction effects at the muscle contraction ratio (F=5.474, p=.024, F=24.151, p=.000, respectively) Conclusion: These findings suggest that WB-EMS may help to improve the muscular activity of the RF muscle, and the muscle thickness of the RF muscle and deep muscles such as the TrA and IO muscles.

Background: Various methods are used for recovery of knee flexion range of motion (ROM) due to a tightened rectus femoris muscle (RFM) or limited inferior glide of the patella. Stretching methods are common interventions for restoring the tightened RFM length. Also patellar inferior gliding (PIG) technique can recover tightened RFM length too. However, effect of applying the PIG to passive knee flexion (PKF) has not been studied. Objects: The purpose of this study was to investigate the effect of combining PIG with RFM stretching for improving knee flexion ROM in subjects with RFM tightness. Methods: Twenty-six subjects with RFM tightness were recruited. Two different methods of knee stretching were tested: 1) PKF during modified Thomas test (MTT) and 2) PKF with PIG during MTT. The passive stretching forces was controlled by hand-held dynamometer. The knee flexion ROM angle was measured by a MTT with ImageJ software. Differences between the conditions with and without PIG were identified with a paired t-test. Results: The knee flexion ROM was significantly greater for PKF with PIG (114.44±9.33) than for PKF alone (108.97±9.42) (p<.001). Conclusion: A combination of passive knee flexion exercise and PIG can be more effective than PKF in increasing knee flexion ROM in individuals with RFM tightness.

This study was conducted to identify the effects of high-heel shoes on EMG activities of rectus femoris and biceps femoris in 28 healthy women. Subjects were composed of experimental group (wearing high-heel shoes) and control group (wearing low-heel shoes). Two groups participated in three conditions standing (bare foot wearing athletic shoes and 7.5 cm height shoes). In high-heel shoes condition, EMG activities of rectus femoris of control group were significantly lower than that of biceps femoris of experimental group, but EMG activities of both muscles of experimental group did not should significant difference. In bare foot standing condition, EMG activities of rectus femoris of experimental group were significantly lower than that of biceps femoris but EMG activities of both muscles of control group had no significant difference. These results showed that hamstring lengthening effects was produced when wearing high-heel shoes because the external knee extension moment was increased. In the short term, high-heel shoes effect on the increase of the biceps femoris activities by spindle reflex, but in the long term, the normal amplitude of the same muscle activities by Golgi tendon organ reflex.

The purpose of this study was to investigate which of 4 positions produced the highest action potential in the rectus femoris muscle of normal adult subjects. Testing was performed in supine with the right leg performing a simple straight leg raise with the knee fully extended. The left leg, however, was placed in 4 different positions: 1. Full support with flexion. 2. Flexed on the plinth with knee flexion and foot flat. 3. Same as N0.2 but with knee flexion. 4. Left leg hanging over the end of the plinth with knee flexion, hip flexion and no foot support. This study was designed to compare the level of electromyographic activity of the rectus femoris under 4 positions. Fourty-three healthy young adults performed three trials of each exercise condition in random order in the supine position. Electromyographic activity was recorded from surface electrodes. Rectus femoris action potentials in all 4 positions were significantly different. The highest action potential at the end of movement of the right leg occurred with the left leg hanging over the end of the plinth with knee flexion. It is therefore recommended the straight leg raising be performed with the contralateral leg flexed at over the end of the supporting surface to obtain a maximum rectus femoris isometric contraction.