DOI QR코드

DOI QR Code

A comparison of trunk and lower extremity muscle activity during the performance of squats and kneeling squats in persons with stroke: a preliminary study

  • Shim, Suyoung (Department of Physical Therapy, IM Convalescent Hospital) ;
  • Chung, Yijung (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)
  • Received : 2019.05.31
  • Accepted : 2019.06.25
  • Published : 2019.06.30

Abstract

Objective: The purpose of this study was to compare the effects of performing squats and kneeling squats on trunk and lower extremity muscle activity in persons with stroke. Design: Cross-sectional study. Methods: Ten persons with stroke (3 male and 7 female) were recruited. The subjects were instructed to randomly perform the 4 different squat conditions: squat with 30 degrees of knee flexion, squat with 60 degrees of knee flexion, squat with 90 degree of knee flexion, and the kneeling squat. During the squat performance, surface electromyograms (sEMG) was used to assess muscle activity of the erector spinae (ES), gluteus maximus (Gmax), gluteus medius (Gmed), and biceps femoris (BF) muscles. Results: Muscle activation of the ES and BF were significantly increased with the kneeling squats compared to the general squats with 30 degrees and 60 degrees of knee flexion (p<0.05), and muscle activation of the Gmax and Gmed were significantly increased with the kneeling squats compared to all other squat conditions (p<0.05). Conclusions: The results suggest that the kneeling squat is an effective exercise to strengthen the proximal muscles of the lower extremities. Rather than applying a difficult general squat to the stroke population, the kneeling squat may be applied as a safer method for training the proximal muscles.

Keywords

References

  1. Patten C, Lexell J, Brown HE. Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy. J Rehabil Res Dev 2004;41:293-312. https://doi.org/10.1682/JRRD.2004.03.0293
  2. Garland SJ, Willems DA, Ivanova TD, Miller KJ. Recovery of standing balance and functional mobility after stroke. Arch Phys Med Rehabil 2003;84:1753-9. https://doi.org/10.1016/j.apmr.2003.03.002
  3. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil 2002;83:1138-44. https://doi.org/10.1053/apmr.2002.33644
  4. Olney SJ, Richards C. Hemiparetic gait following stroke. Part I: characteristics. Gait Posture 1996;4:136-48. https://doi.org/10.1016/0966-6362(96)01063-6
  5. Thielman G, Kaminski T, Gentile AM. Rehabilitation of reaching after stroke: comparing 2 training protocols utilizing trunk restraint. Neurorehabil Neural Repair 2008;22:697-705. https://doi.org/10.1177/1545968308315998
  6. Moreland JD, Goldsmith CH, Huijbregts MP, Anderson RE, Prentice DM, Brunton KB, et al. Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil 2003;84:1433-40. https://doi.org/10.1016/S0003-9993(03)00360-5
  7. Hwang YI, Kim KS. Effects of foot pressure using the elastic band with rings during sit-to-stand in persons with stroke. Phys Ther Rehabil Sci 2017;6:159-63. https://doi.org/10.14474/ptrs.2017.6.4.159
  8. Park J, Chung Y. The effects of an additional weight aquatic exercise program on balance and lower extremity strength in persons with stroke: randomized controlled study. Phys Ther Rehabil Sci 2018;7:6-12. https://doi.org/10.14474/ptrs.2018.7.1.6
  9. Jung JH, Ko SE, Lee SW. Immediate effects of single-leg stance exercise on dynamic balance, weight bearing and gait cycle in stroke patients. Phys Ther Rehabil Sci 2014;3:49-54. https://doi.org/10.14474/ptrs.2014.3.1.49
  10. Gray VL, Ivanova TD, Garland SJ. Control of fast squatting movements after stroke. Clin Neurophysiol 2012;123:344-50. https://doi.org/10.1016/j.clinph.2011.07.003
  11. Robertson DG, Wilson JM, St Pierre TA. Lower extremity muscle functions during full squats. J Appl Biomech 2008;24:333-9. https://doi.org/10.1123/jab.24.4.333
  12. Cho M, Kang JY, Oh JH, Wu JG, Choi EB, Park SE, et al. The effects of performing squats on an inclined board on thigh muscle activation. Phys Ther Rehabil Sci 2017;6:39-44. https://doi.org/10.14474/ptrs.2017.6.1.39
  13. Choi YA, Kim JS, Lee DY. Effects of fast and slow squat exercises on the muscle activity of the paretic lower extremity in patients with chronic stroke. J Phys Ther Sci 2015;27:2597-9. https://doi.org/10.1589/jpts.27.2597
  14. Ki KI, Choi JD, Cho HS. The effect of ground tilt on the lower extremity muscle activity of stroke patients performing squat exercises. J Phys Ther Sci 2014;26:965-8. https://doi.org/10.1589/jpts.26.965
  15. Kurayama T, Tadokoro Y, Fujimoto S, Komiya Z, Yoshida S, Chakraborty S, et al. A comparison of the movement characteristics between the kneeling gait and the normal gait in healthy adults. Gait Posture 2013;37:402-7. https://doi.org/10.1016/j.gaitpost.2012.08.009
  16. Cram JR, Kasman GS, Holtz J. Introduction to surface electromyography. Gaithersburg (MD): Aspen Publishers; 1998.
  17. Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging 1989;10:727-38. https://doi.org/10.1016/0197-4580(89)90010-9
  18. Palmitier RA, An KN, Scott SG, Chao EY. Kinetic chain exercise in knee rehabilitation. Sports Med 1991;11:402-13. https://doi.org/10.2165/00007256-199111060-00005
  19. Dreeben-Irimia O. Physical therapy clinical handbook for PTAs. Burlington (MA): Jones & Bartlett Publishers; 2012.
  20. Gallagher S. Trunk extension strength and muscle activity in standing and kneeling postures. Spine (Phila Pa 1976) 1997;22:1864-72. https://doi.org/10.1097/00007632-199708150-00011