Kinetic Chain Exercises Research Articles

열린사슬운동과 닫힌사슬운동에서 어깨 굽힘 각도에 따른 어깨안정화 근육의 근활성도 비교

Purpose: The purpose of this study was to investigate any visible difference in shoulder stability muscle activity along the bending angle(<TEX>$70^{\circ}$</TEX>, <TEX>$90^{\circ}$</TEX>, <TEX>$110^{\circ}$</TEX>) to perform the open kinetic chain(OKC) and closed kinetic chain(CKC) exercise. Method: This study was performed on normal 20 males subjects. Exercise was carried out in two ways OKC and CKC. Shoulder stability muscles are examined activity in the bending angles. In the OKC and CKC exercise to subjects with stretched out waist straightened, and than push forward the shoulder. Muscular activation was examined using the WEMG-8. Result: The results of this study were as follows. 1. Only in the trapezius muscle, it showed specific interaction between exercise methods and angles. When it comes to muscle activity, there was no significant difference in all muscles except for the anterior fibers of the deltoid muscle during both CKC and OKC exercise. 2. The average value of maximum muscle activity was significantly increased with increasing order of angles. But in CKC exercise, the muscle activity of infraspinatus tended to decrease with increasing angles. Conclusion: To summarize the research results, the muscle activity in upper fibers of the trapezius, anterior fibers of the deltoid, and serratus anterior was significantly different depending on the angle of the shoulder in both CKC and OKC exercise.

Muscle Activation and Onset Times of Hip Extensors during Various Loads of a Closed Kinetic Chain Exercise

The aim of this study was to determine the muscle activity and onset time of hip extensors during a closed kinetic chain exercise (deadlift) at sub-maximal loads of 30%, 40%, 50%, and 75% of one repetition maximum (1RM). Twelve healthy males with at least three years of resistance training experience volunteered for the study. Biceps femoris (BF) and gluteus maximus (GM) muscle activity, onset time, peak and mean power were measured during the concentric phase of the deadlift. There was no main effect (p > 0.05) or no interaction effect for the onset time in BF and GM and for each load BF and GM had similar muscle activity. Increasing the external load during deadlift had no adverse effect on the relative onset time and it did not promote BF onset to occur before GM onset, thus both muscles were simultaneously activated, which should not compromise a delay in GM.

WITHDRAWN: Exercise therapy for patellofemoral pain syndrome.

BACKGROUND: Patellofemoral pain syndrome (PFPS) is a common problem among adolescents and young adults, characterised by retropatellar pain (behind the kneecap) or peripatellar pain (around the kneecap) when ascending or descending stairs, squatting or sitting with flexed knees. Etiology, structures causing the pain and treatment methods are all debated in literature, but consensus has not been reached so far. Exercise therapy to strengthen the quadriceps is often prescribed, though its efficacy is still debated. OBJECTIVES: This review aims to summarise the evidence of effectiveness of exercise therapy in reducing anterior knee pain and improving knee function in patients with PFPS. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group and Cochrane Rehabilitation and Related Therapies Field specialised registers, the Cochrane Controlled Trials Register, PEDro - The Physiotherapy Evidence Database, MEDLINE, EMBASE, CINAHL, up till December 2001 for controlled trials (randomised or not) comparing exercise therapy with control groups, or comparing different types of exercise therapy. SELECTION CRITERIA: Only trials focusing on exercise therapy in patients with PFPS were considered. Trials in patients with other diagnoses such as tendinitis, Osgood Schlatter syndrome, bursitis, traumatic injuries, osteoarthritis, plica syndrome, Sinding-Larssen-Johansson syndrome and patellar luxations were excluded. DATA COLLECTION AND ANALYSIS: From 750 publications 12 trials were selected. All included trials studied quadriceps strengthening exercises. Outcome assessments for knee pain and knee function in daily life were used in a best evidence synthesis to summarise evidence for effectiveness. MAIN RESULTS: One high and two low quality studies used a control group not receiving exercise therapy. Significantly greater pain reduction in the exercise groups was found in one high and one low quality study, though at different time points. Only one low quality study reported significantly greater functional improvement with exercise. Five studies compared exercise therapies that could be designated closed kinetic chain exercise (foot in contact with a surface) versus open kinetic chain exercise (foot not in contact with a surface). Two of these studies were of high quality, but no significant differences in improvement of function or reduction of pain were apparent between the types of exercise in any of the studies. The remaining four studies, all of which were of low quality, focused on other treatment comparisons. AUTHORS' CONCLUSIONS: The evidence that exercise therapy is more effective in treating PFPS than no exercise was limited with respect to pain reduction, and conflicting with respect to functional improvement. There is strong evidence that open and closed kinetic chain exercise are equally effective. Further research to substantiate the efficacy of exercise treatment compared to a non-exercising control group is needed, and thorough consideration should be given to methodological aspects of study design and reporting.

Exercise for treating patellofemoral pain syndrome.

Exercise for treating patellofemoral pain syndrome.

Effect of exercise at light loads with manipulative resistance on infraspinatus, trapezius (upper fiber) and deltoid (middle fiber) muscle activities in shoulder joint elevation.

[Purpose] To clarify rotator cuff muscular activity in the raised position of the closed kinetic chain (CKC) exercise. [Subjects] Twenty-nine cases were studied, 19 men and 10 women (average age 21.5 ±4.7 years old, average body weight 60.1 kg ±11.4). [Methods] To determine the effects of the closed kinetic chain exercise on the upper limb, we measured the surface EMG of the infraspinatus muscle, the trapezius (upper fiber) and the deltoid (middle fiber) with the arm elevated. [Results] Our results show that at an elevation angle of 150° in the scapular plane of the upper limb, with 5% body weight load, the EMG activities of the infraspinatus muscle are approximately 30% of maximum voluntary contraction (MVC). [Conclusion] The raised position of the CKC exercise is effective in physical therapy for functional recovery of the infraspinatus muscle.

Retraction: Effect of exercise at light loads with manipulative resistance on infraspinatus, trapezius (upper fiber) and deltoid (middle fiber) muscle activities in shoulder joint elevation.

[This retracts the article on p. 627 in vol. 27.].

Preferential vastus medialis oblique activation and its effectiveness in patellofemoral pain syndrome: A review of literature-an update

To review recent literature regarding evidences for best possible exercises and methods that are proposed for preferential vastus medialis oblique (VMO) activation and effectiveness of preferential VMO activation in patellofemoral pain syndrome (PFPS) patients. The review of recent literature supports preferential VMO activation as one of the efficient management protocols in PFPS patients. Although there is quite heterogeneity in the available research, a majority of research suggests close kinetic chain (CKC) exercises to be more beneficial also the CKC squatting exercise with full maximum voluntary isometric contraction hip adduction has been an exercise quite supported by the recent researches for preferential VMO activation. It can be augmented via other methods like taping, biofeedback, motor imagery, unstable surface to enhance the VMO activation. In accordance with the review of recent literature, preferential VMO activation also has been very well correlated with a reduction in pain, enhancement in function in PFPS patients.

The effect of trunk rotation during shoulder exercises on the activity of the scapular muscle and scapular kinematics

In patients with shoulder disease, kinetic chain exercises including hip or trunk movement are recommended. However, the actual muscle activation and scapular kinematics of these exercises are not known. The purpose of this study was to examine the effect of trunk rotation on shoulder exercises that are devised to improve scapular function. Thirteen healthy young men participated in this study. Scaption, external rotation in the first and second positions, and prone scapular retraction at 45°, 90°, and 145° of shoulder abduction were performed with and without trunk rotation. Electromyography was used to assess the scapular muscle activity of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA), and electromagnetic motion capture was used to assess scapular motion. The muscle activity ratio, which is the activity of the UT to the MT, LT, and SA, was calculated. These data were compared between 2 conditions (with and without trunk rotation) for each exercise. Adding trunk rotation to scaption, the first external rotation, and the second external rotation significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation. In addition, trunk rotation with scapular retraction at 90° and 145° of shoulder abduction significantly decreased the UT/LT ratio. Our findings suggest that shoulder exercises with trunk rotation in this study may be effective in patients who have difficulty in enhancing LT activity and suppressing excessive activation of the UT or in cases in which a decreased scapular external rotation or posterior tilt is observed.

만성 뇌졸중 환자의 열린사슬운동과 닫힌사슬운동이 하지의 근활성도에 미치는 영향

만성 뇌졸중 환자의 열린사슬운동과 닫힌사슬운동이 하지의 근활성도에 미치는 영향

Upper Quarter Y-Balance Test Score of Patients with Shoulder Impingement Syndrome

Objectives:The Upper Quarter Y Balance Test (UQYBT) is a reliable upper extremity closed kinetic chain test that can be used to assess unilateral upper extremity performance in a closed chain manner. However, UQYBT was tested only in recreational athletes and there are no studies investigating UQYBT scores in patients with various upper extremity musculoskeletal injuries. The purpose of this study was to examine differences in performance on the Upper Quarter Y Balance Test between patient with shoulder impingement syndrome and healthy controls.Methods:A sample of fifteen patients with shoulder impingement syndrome (mean age 32.2±4.2 years) and fifteen healthy control (mean age 33.8±6.2 years) performed the UQYBT. UQYBT was collected bilaterally in three directions (medial, inferolateral, and superolateral). The maximum reach distance for each direction was normalized to upper extremity length (spinous process of C7 to tip of middle finger) and used for analysisResults:A significant difference in performance between patients with shoulder impingement syndrome and healthy controls existed in the medial direction (P<0.05) and the inferolateral direction (P<0.05) where the healthy controls performed better. There was no significant difference in superolateral performance.Conclusion:The results of this study suggest that patients with shoulder impingement syndrome will perform worse on the UQYBT in the medial and inferolateral directions than healthy controls. Thus, upper extremity closed kinetic chain exercises should be added in shoulder rehabilitation programs.

Intralimb joint coordination of the lower extremities in resistance training exercises

To facilitate the greatest transfer of improvements to athletic performance or daily activity, the resistance training exercises employed by athletic or recreationally trained individuals must be selected considering biomechanical similarity to meet the specific demands of their sport or activity. The purpose of this study was to compare intralimb joint coordination in eight experienced lifters performing three conventional strength-training exercises: the forward lunge, the dead lift, and the forward step-up. Lower-extremity angular displacement curves, maximum joint excursions, and mean absolute relative phases were determined. Results revealed general in-phase, interjoint relationships while comparing exercises. Forward lunge interjoint relationships were more out-of-phase when compared with the other two exercises. It is suggested that in-phase coordination was the predominant pattern employed while performing the closed kinetic chain exercises normally used in strength training, in particular for knee-hip relationship. Nevertheless the forward component of movement can change the coordination strategy when performing lunges.

Patellofemoral pain syndrome alters joint position sense: a case-control study

Introduction: The evaluation of changes in joint position sense (JPS) of the knee may be crucial for the identification of disorders that could start during the development of patellofemoral pain syndrome (PFPS). Objective: To evaluate JPS of the knee in PFPS. Methods: Twenty nine women (15 healthy and 14 with PFPS) reproduced knee flexion angles of 45° and 60° during open kinetic chain exercises and of 45° during closed kinetic chain exercises. Results: The absolute error in the active reproduction of 45° in open kinetic chain exercises was significantly higher in the experimental group. There were significant differences in absolute and relative errors between the groups for active reproduction at 45° in open and closed kinetic chain exercises. Conclusions: This study suggests that PFPS alters JPS during active reproduction of the 45° angle in both open and closed kinetic chain exercises.

The Effects of Closed Kinetic Chain Exercise Using EMG Biofeedback on PFPS Patients` Pain and Muscle Functions

This study aimed to examine the effects of closed kinetic chain exercise using electromyography (EMG) biofeedback for selective strengthening of the vastus medialis oblique (VMO) on patllofemoral joint pain and functional characteristics of patllofemoral joint muscles. The subjects of this study were 30 patellofemoral pain syndrome (PFPS) patients and they were equally and randomly assigned to a control group (I), a closed kinetic chain exercise group (II), and an EMG biofeedback closed kinetic chain exercise (III). They received intervention three times per week (for 30 minutes per each time) for six weeks. Measurement methods included visual analogue scale (VAS) and EMG. According to the study result, there were significant differences in groups II and III compared to group I in VAS (p<.01). During a squat position, there were significant differences in groups II and III compared to group I in median frequency (MDF) and VMO/vastus lateralis (VL) muscle activity ratios (p<.05). According to the this study result, PFPS patients’ muscle functions improved by enhancing muscle control and response ability using EMG biofeedback with which real-time bioinformation on the muscles is provided during closed kinetic chain exercise in order to raise treatment efficiency.

Shoulder Muscle Activation Levels During Four Closed Kinetic Chain Exercises With and Without Redcord Slings

During resistance training protocols, people are often encouraged to target the scapular stabilizing musculature (middle and lower trapezius and serratus anterior) while minimizing shoulder prime mover activation (upper trapezius and large glenohumeral muscles) in their training regime, especially in overhead athletes with scapular dyskinesis. To increase the activation levels in the stabilizing muscles without drastically increasing the activation in the prime movers, unstable surfaces are frequently used during closed kinetic chain (CKC) exercises. However, the specific influence of Redcord slings (RS) as an unstable surface tool on the shoulder muscle activation levels has rarely been investigated, despite these results may be used for adequate exercise selection. Therefore, a controlled laboratory study was performed on 47 healthy subjects (age, 22 ± 4.31 years; height, 176 ± 0.083 cm; weight, 69 ± 8.57 kg) during 4 CKC exercises without and with RS: half push-up (HPU), knee push-up (KPU), knee prone bridging plus (KPBP), and pull-up. When using RS, serratus anterior muscle activation decreased during the KPU and KPBP exercise. In addition, a drastic increase in pectoralis major muscle activation was found during the HPU and KPBP exercise. Consequently, the use of RS does not necessarily imply that higher levels of scapular stabilizer muscle activation will be attained. These findings suggest that RS might be an appropriate training tool when used within a general strengthening program but should not be preferred over a stable base of support when training for specific scapular stabilization purposes.

닫힌사슬운동과 열린사슬운동이 초기 뇌졸중환자의 무릎신전근 근력과 균형에 미치는 영향

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

Comparison of the Duration of Hamstring Flexibility Improvement Following Termination of Modified Dynamic Stretching, Hold-Relax, and Static Stretching

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions- modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)-in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer(R)). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

Dynamic knee stability and ballistic knee movement after ACL reconstruction: an application on instep soccer kick

The instep soccer kick is a pre-programmed ballistic movement with a typical agonist-antagonist coordination pattern. The coordination pattern of the kick can provide insight into deficient neuromuscular control. The purpose of this study was to investigate knee kinematics and hamstrings/quadriceps coordination pattern during the knee ballistic extension phase of the instep kick in soccer players after anterior cruciate ligament reconstruction (ACL reconstruction). Seventeen players from the Portuguese Soccer League participated in this study. Eight ACL-reconstructed athletes (experimental group) and 9 healthy individuals (control group) performed three instep kicks. Knee kinematics (flexion and extension angles at football contact and maximum velocity instants) were calculated during the kicks. Rectus femoris (RF), vastus lateralis, vastus medialis, biceps femoralis, and semitendinosus muscle activations were quantified during the knee extension phase. The ACL-reconstructed group had significantly lower knee extension angle (-1.2±1.6, p<0.021) and increased variability (1.1±1.2, p<0.012) when compared with the control group. Within the EMG variables, the RF had a significantly greater activity in the ACL-reconstructed group than in the control group (79.9±27.7% MVC vs. 49.2±20.8% MVC, respectively, p<0.034). No other statistically significant differences were found. The findings of this study demonstrate that changes in ACL-reconstructed individuals were observed on knee extension angle and RF muscle activation while performing an instep kick. These findings are in accordance with the knee stability recovery process after ACL reconstruction. No differences were observed in the ballistic control movement pattern between normal and ACL-reconstructed subjects. Performing open kinetic chain exercises using ballistic movements can be beneficial when recovering from ACL reconstruction. The exercises should focus on achieving multi-joint coordination and full knee extension (range of motion). III.

The effects of closed kinetic chain exercises and open kinetic chain exercises using elastic bands on electromyographic activity in degenerative gonarthritis.

[Purpose] The purpose of this study was to examine the effects of closed kinetic chain exercises (CKCEs) and open kinetic chain exercises (OKCEs) with elastic bands on the electromyographic activity of patients with degenerative gonarthritis. [Subjects] The study subjects were 30 degenerative gonarthritis patients who were divided into a CKCE group (CKCEG, n=10), an OKCE group (OKCEG, n=10), and a control group (CG, n=10). [Methods] The CKCEG and the OKCEG performed exercises with elastic bands, and the CG took part in a quadriceps strengthening exercise. All three groups performed the exercises three times per week for four weeks. The electromyographic activities of the subjects’ vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), semitendinosus (ST), and biceps femoris (BF) muscles were measured and compared. [Results] Within-group comparisons revealed that the electromyographic activities of the VM, RF, VL, ST, and BF muscles increased significantly in the CKCEG. The OKCEG displayed significant increases in the electromyographic activity of the VM, RF, ST, and BF muscles, and the CG showed significant increases in the electromyographic activities of the RF, VL, ST, and BF muscles. In between-group comparisons after the intervention, the electromyographic activities of the VM, RF, and VL muscles of the CKCEG were significantly higher than those of the CG. The electromyographic activities of the VM, RF, and ST muscles of the OKCEG were significantly higher than those of the CG. [Conclusion] We consider CKCEs with elastic bands are an effective intervention for increasing the electromyographic activities of the VM, RF, VL, ST, and BF muscles of degenerative gonarthritis patients, and OKCEs with elastic bands are an effective intervention for increasing the electromyographic activities of the VM, RF, ST, and BF muscles of degenerative gonarthritis patients.

A Study to Compare effectiveness of Closed Kinetic Chain Exercises Verus Open Kinetic Chain Exercises in Patients with Osteoarthritic Knee Joints

Introduction : The goal of individualized programme requires critical analysis of potential benefits and limitations between Open kinetic chain(OKC) and Closed kinetic chain(CKC) in Osteoarthritis knee .OKC exercises involve motions where the distal segment is free to move in space, without causing simultaneous motions at adjacent joints while in CKC exercise distal segment is fixed or stabilized on a support surface. Aim of Study : To study the effects of Closed Kinetic Chain Exercise and Open Kinetic Chain Exercise in Osteoarthritis Knee. Methodology : A Clinical trial consisted of 30 patients, diagnosed with tibiofemoral OA, as per the Inclusion&Exclusion Criteria were recruited from orthopedic Out-patient Department to Physiotherapy Department, Civil Hospital, Ahmedabad. Patients were divided into two,one group was given OKC and other group CKC exercises. The functional outcome were pain measured on visual analogue scale (VAS)&Function by Western Ontario and McMaster universities Osteoarthritis Index (WOMAC) taken on the 1st day&after 8 weeks. Results : There is no significant difference as per Wilcoxen Signed Rank and Wilcoxen Sum rank test between CKC and OKC Exercises along with conventional therapy in reducing pain and improving Physical Function in patients with Osteoarthritis Knee. Discussion : CKC exercises, in acute phase was painful compared to OKC exercises due to weightbearing position. But later on as patients always want improvement in their activity like squatting, walking, stair climbing, CKC help them in their functional rehabilitation. So ultimate rehabilitation programme of Osteoarthritis Knee patient should include both OKC exercises and CKC exercises. Conclusion : CKC exercise along with conventional therapy as effective as OKC exercise for improving the pain and functional disability

Evaluation of open and closed kinetic chain exercises in rehabilitation following anterior cruciate ligament reconstruction.

[Purpose] To compare outcomes of anterior cruciate ligament (ACL) reconstruction after open kinetic chain (OKC) exercises and closed kinetic chain (CKC) exercises. [Subjects and Methods] The subjects comprised 11 female and 47 male patients who are randomly divided into two groups: which performed a CKC exercise program Group I and Group II which performed an OKC exercise program. Pain intensity was evaluated using visual analogue scale (VAS). Knee flexion was evaluated using a universal goniometer, and thigh circumference measurements were taken with a tape measure at baseline and at 3 months and 6 months after the treatment. Lysholm scores were used to assess knee function. [Results] There were no significant differences between the two groups at baseline. Within each group, VAS values and knee flexion were improved after the surgery. These improvements were significantly higher in the CKC group than in the OKC group. There were increases in thigh circumference difference at the 3 and 6 month assessments post-surgery. A greater improvement in the Lysholm score was observed in the CKC group at 6 months. [Conclusion] The CKC exercise program was more effective than OKC in improving the knee functions of patients with ACL reconstruction.