The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Effects of EMG-Biofeedback Training on Functional Ability and Q-angle in Patellofemoral Pain Syndrome

근전도-생체되먹임 훈련이 무릎넙다리통증의 기능적 능력과 Q-각에 미치는 영향

  • 박승규 (세한대학교 물리치료학과) ;
  • 강재영 (세한대학교 일반대학원 물리치료학과)
  • Received : 2014.03.17
  • Accepted : 2014.04.09
  • Published : 2014.04.25
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Abstract

Purpose: The purpose of this study was to investigate the effect of closed kinetic chain exercise using EMG-biofeedback for selective training of the vastus medialis oblique on functional ability and Q-angle in subjects with patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included in this study. Participants were randomly allocated to the control group (Group I, n=10), closed kinetic chain exercise group (Group II, n=10), and closed kinetic chain exercise using EMG-biofeedback group (Group III, n=10). Intervention was performed in three groups, three times per week, for a period of six weeks. Kujala patellofemoral score and Q-angle were measured before and after the experiment. Results: Some significant differences in kujala patellofemoral score were observed in group II and group III, compared with group I (p<0.01). There was no significant difference on in Q-angle at knee flexion angle $0^{\circ}$. However, some significant differences in Q-angle at knee flexion $60^{\circ}$ were observed in group III, compared with group I (p<0.01). Conclusion: Closed kinetic chain exercise using EMG-biofeedback that provides real-time biometric information on selected muscles in order to increase the efficiency of treatment may be helpful in improvement of functional ability and Q-angle in patellofemoral pain syndrome.

Keywords

References

  1. Nijs J, Van Geel C, Van der auwera C et al. Diagnostic value of five clinical tests in patellofemoral pain syndrome. Man Ther. 2006;11(1):69-77. https://doi.org/10.1016/j.math.2005.04.002
  2. Boling M, Padua D, Marshall S et al. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci sports 2010;20(5):725-30. https://doi.org/10.1111/j.1600-0838.2009.00996.x
  3. Collins NJ. Bisset LM, Crossley KM et al. Efficacy of nonsurgical interventions for anterior knee pain: systematic review and meta-analysis of randomized trials. Sports Med. 2012;42(1):31-49. https://doi.org/10.2165/11594460-000000000-00000
  4. Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med. 2008;26(7):9.
  5. Yip SL, Ng GY. Biofeedback supplementation to physiotherapy exercise programme for rehabilitation of patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil. 2006;20(12):1050-7. https://doi.org/10.1177/0269215506071259
  6. Emami MJ, Ghahramani MH, Abdinejad F et al. Q-angle: an invaluable parameter for evaluation of anterior knee pain. Arch Iran Med. 2007;10(1):24-6.
  7. Messier SP, Davis SE, Curl WW et al. Etiologic factor sassociated with patellofemora pain in runners. Med Sci Sports Exerc. 1991;23(9):1008-15.
  8. Park S, Lee WJ, Park JW. Differences of onset timing between vastus medialis and lateralis during knee isometric contraction on individuals with genu varum or valgum. J Kor Soc Phys Ther. 2014;26(1):9-14.
  9. Han SW. A SEMG analysis of knee joint angle during close kinetic chain exercise and open kinetic chain exercises in quadriceps muscle. J Korean Soc Phys Ther. 2004;16(3):401-11.
  10. Kramer PG. Patella malalignment syndrome: rationale to reduce excessive lateral pressure. J Orthop Sports Phys Ther. 1986;8(6):301-9. https://doi.org/10.2519/jospt.1986.8.6.301
  11. Doucette SA, Child DD. The effect of open and closed chain exercise and knee joint position on patellar tracking in lateral patellar compression syndrome. J Orthop Sports Phys Ther. 1996;23(2):104-10. https://doi.org/10.2519/jospt.1996.23.2.104
  12. Wilk KE, Escamilla RF, Fleisig GS, Barrentine SW et al. A comparison of tibiofemoral joint forces and electromyographic activity during open and closed kinetic chain exercises. Am J Sports Med. 1996;24(4):518-27. https://doi.org/10.1177/036354659602400418
  13. Steinkamp LA, Dillingham MF, Markel MD et al. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993;21(3):438-44. https://doi.org/10.1177/036354659302100319
  14. Dursun N, Dursun E, Kilic Z. Electromyographic biofeedbackcontrolled exercise versus conservative care for patellofemoral pain syndrome. Arch Phys Med Rehabil. 2001;82(12):1692-5. https://doi.org/10.1053/apmr.2001.26253
  15. Kim YK, Song JC, Choi JW et al. Functional electric stimulation-assisted biofeedback therapy system for chronic hemiplegic upper extremity function. J Korean Soc Phys Ther. 2012;24(6):409-13.
  16. McConnell J. Management of patellofemoral problems. Man Ther. 1996;1(2):60-6. https://doi.org/10.1054/math.1996.0251
  17. Park SK, Kim JH. Effects of EMG-biofeedback training on total knee replacement patients' lower extremity muscle activity and balance. J Korean Soc Phys Ther. 2013;25(2):81-7.
  18. Vastus medialis oblique and vastus lateralis electromyographic activities during closed kinetic chain exercises in male athletes with and without patellofemoral pain syndrome. Kyunghee University. Dissertation of Master's Degree. 2008.
  19. Bevilaqua-Grossi D, Felicio LR, Simoes R et al. Electromyographic activity evaluation of the patella muscles during squat isometric exercise in individuals with patellofemoral pain syndrome. Revis Bras Med Esp. 2005;11(3):159-63. https://doi.org/10.1590/S1517-86922005000300001
  20. Kim DY, Kim SH, Lim YE et al. Effect of EMG biofeedback training and taping on vastus medialis oblique for function improvement of patient with patella malalignment. J Korean Soc Phys Ther. 2008;20(3):35-44.
  21. Kujala UM, Jaakkola LH, Koskinen SK et al. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):159-63. https://doi.org/10.1016/S0749-8063(05)80366-4
  22. Yoon NY, Park JS, Jeong HS et al. The comparative study on age-associated gait analysis in normal Korean. J Korean Soc Phys Ther. 2010;22(2):15-24.
  23. Park SK, Yang DJ, Park JM et al. Analysis of patellar tracking and Q-angle during semi-squat exercise. Korean Journal of Sport Biomechanics. 2011;21(1):107-14. https://doi.org/10.5103/KJSB.2011.21.1.107
  24. Wilk KE, Davies GJ, Mangine RE et al. Patellofemoral disorders: a classification system and clinical guidelines for nonoperative rehabilitation. J Orthpo Sports Phys Ther. 1998; 28(5):307-22. https://doi.org/10.2519/jospt.1998.28.5.307
  25. Serrao FV, Cabral CMN, Berzin F et al. Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press. Phys Ther Sport. 2005;6(1):15-23. https://doi.org/10.1016/j.ptsp.2004.03.001
  26. Heintjes E, Berger MY, Bierma-Zeinstra SM et al. Exercise therapy for patellofemoral pain syndrome. Cochrane Database Syst Rev. 2003;(4):CD003472.
  27. Han SW, Yoon JR. Effect of rehabilitation exercise and backward walking and neuromuscular electrical stimulation on the quadriceps muscle function in patients with patellofemoral pain syndrome. Exercise Science. 2008;17(4):463-72. https://doi.org/10.15857/ksep.2008.17.4.463
  28. Crossley K, Bennell K, Green S et al. A systematic review of physical interventions for patellofemoral pain syndrome. Clin J Sport Med. 2001;11(2):103-10. https://doi.org/10.1097/00042752-200104000-00007
  29. Crossley KM, Bennell KL, Cowan SM et al. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil. 2004;85(5):815-22. https://doi.org/10.1016/S0003-9993(03)00613-0
  30. Fehr GL, Junior AC, Cacho EWA et al. Effectiveness of the open and closed kinetic chain exercises in the treatment of the patellofemoral pain syndrome. Revista Brasileira de Medicina do Esporte. 2006;12(2):56-60. https://doi.org/10.1590/S1517-86922006000100011
  31. Sheehan FT, Derasari A, Fine KM et al. Q-angle and J-sign: indicative of maltracking subgroups in patellofemoral pain. Clin Orthop Relat Res. 2010;486(1):266-75.
  32. Herrington L. Does the change in Q angle magnitude in unilateral stance differ when comparing asymptomatic individuals to those with patellofemoral pain? Phys Ther Sport. 2013;14(2):94-7. https://doi.org/10.1016/j.ptsp.2012.02.008
  33. Tunay VB, Baltaci G, Tunay S et al. A comparison of different treatment approaches to patellofemoral pain syndrome. Pain Clin. 2003;15(2):179-84. https://doi.org/10.1163/156856903321579316
  34. Cabral CMN, Melim AMO, Sacco ICN et al. Physical therapy in patellofemoral syndrome patients: comparison of open and closed kinetic chain exercises. Acta Ortop Bras. 2008;16(3):180-85. https://doi.org/10.1590/S1413-78522008000300012