Open Kinetic Chain Exercises Research Articles

Open Versus Closed Kinetic Chain Exercise: a Comparison of Walking Capacity in Chronic Post-Stroke Phase

ABSTRACTIntroduction: The chronic post-stroke phase is often accompanied by various sensory, cognitive, motoric, coordination, and balance impairments. Decreased strength and motoric control contribute to walkingcapacity in patients with stroke. Open Kinetic Chain (OKC) and Closed Kinetic Chain (CKC) were reported to improve strength, functional mobility and balance in the chronic post-stroke phase. However, there is aphysiologically differences between CKC and OKC exercise. This study aims to compare the result of two methods of progressive resistant training (PRT) on walking capacity in the chronic post-stroke phase.Methods: This study is a quasi-experimental pre- and post-controlled trial group design. Twenty subjects were randomized into two groups of equal size: the CKC group (n=10) and the OKC group (n=10). Therewas one subject from each group who dropped out at the end of the study. CKC and OKC groups were trained for 6 weeks. The walking capacity was measured with 2 Minutes Walking Test (2WMT).Results: 2WMT results showed improvement in both groups after 6 weeks of intervention, while CKC group show greater improvement in walking distance 56,17 ± 10,95  to 57,43 compared to OKC group57,04 ± 8,58 to 58,19 ± 8,77 (p<0.002).Conclusions: This study shows CKC group showed slightly better improvement in walking capacity after 6 weeks of progressive resistance training compare to OKC group. However, there were no statisticallydifferences between the groups

Effects of Open and Closed Chain Exercises on Dynamic Balance and Range of Motion in Patients with Knee Osteoarthritis: RCT

Background: Osteoarthritis is a combination of mechanical problems characterized by degradation of articular cartilage, articulating joints and subchondral space. Aim: To compare the effects of open chain kinetic exercises and closed kinetic chain exercises in improving dynamic balance and range of motion in patients with knee osteoarthritis. Study Design: Randomized controlled trial. Methodology: Study was conducted at Chugtai Medical center Lahore and sample of 46 patients were recruited and were randomly allocated in two groups. One group performed OKC exercises and the other group was asked to perform CKC exercises, while both of the groups received a common baseline treatment prior to corresponding intervention. Two session a week were given for a period of one month. Goniometry and Y-balance scale were used to assess ROM and dynamic balance pre and post treatment, respectively. Data was evaluated by using SPSS version 23. Results: In this study, the intra-group analysis illustrated that the increase in range of motion and improvement in dynamic balance was statistically significant in both groups with p-value<0.05. Whereas, the inter-group analysis showed that both interventions were clinically effective in treating knee osteoarthritis with p-value>0.05 during the treatment session of four weeks. Practical Implication: This study highlighted that physical training that includes open kinetic chain (OKC) and closed kinetic chain (CKC) exercises were found to be effective in improving balance and in increasing range of motion by reducing pain among osteoarthritis patients. Conclusion: It was concluded that patients with OKC exercises have shown equal improvement in ROM and dynamic balance compared to those who have been treated with CKC exercises. Keywords: Osteoarthritis, Exercises and Dynamic Balance.

Quadriceps Electromyographic Activity in Closed and Open Kinetic-Chain Exercises with Hip-Adductor Co-Contraction in Sedentary Women.

Background: Different closed and open kinetic-chain exercises with hip-adductor co-contraction have different effects on quadriceps activity. The aim of this study was to investigate the difference in quadriceps activity during the squat (SQ) and knee extension (KE) and straight leg raise (SLR) exercises with and without hip adduction in sedentary women. Methods: Twenty-eight sedentary women aged 44.5 ± 8.5 years were recruited. They performed three exercises with and without hip adduction. Surface electromyography (sEMG) activity was measured on the rectus femoris (RF), vastus medialis oblique (VMO) and vastus lateralis (VL) muscles. The levels of sEMG activities of the three muscles were compared among the six exercises using a repeated-measures ANOVA. Results: The findings showed that RF activity was lowest during the SQ alone and highest during the SLR exercise (p < 0.05 to 0.001). The VMO activity was significantly greater in the SQH than in the five types of exercises (p < 0.05 to 0.001), which led to a significant VMO/VL ratio as well. VL activity increased while the squat with hip adduction and knee extension with hip adduction exercise compared with SQ alone. Conclusion: This study indicates that a closed-chain squat with hip co-contraction can produce the VMO and VMO/VL ratio activity, while an open chain of SLR better activates the RF activity. The findings support the understanding of quadriceps activity in different exercises to be an alternative home-based exercise for physical therapy in women facing muscle weakness.

PENGARUH CLOSED KINETIC CHAIN EXERCISE DAN OPEN KINETIC CHAIN EXERCISE TERHADAP AKTIVITAS FUNGSIONAL PADA PASIEN OSTEOARTHRITIS KNEE DI RUMAH SAKIT GRANDMED LUBUK PAKAM TAHUN 2022

Osteoarthritis is the most common degenerative condition among the elderly. Functional disorders are caused by knee osteoarthritis. A person with osteoarthritis knee typically experiences pain, stiffness, and a decrease in functional activity as a result of limited function. The purpose of this study is to compare the effects of open kinetic chain exercise and closed kinetic chain exercise on increasing functional activity in patients with osteoarthritis of the knee. This is a quasi-experimental type of study. To compare two intervention groups, a two-group pre-test post-test research design was used. In addition, WOMAC is being used to assess functional ability. Exercises should be done twice a week for four weeks. Effect analysis using the paired T-test in treatment groups 1 and 2. The paired T-test on closed kinetic chain exercise and open kinetic chain exercise yielded the same result, P = 0.000 (p0.05), indicating that functional ability influences before and after treatment. Meanwhile, an independent t-test resulted in a value of p = 0.153 (p&gt;0.05), indicating that there are differences in the influence of open kinetic chain and closed kinetic chain on increasing functional ability in patients with osteoarthritis knee. Open kinetic chain exercise and closed kinetic chain exercise have different effects on improving functional ability in people with osteoarthritis knee.

The Effect of Exercise Therapy Interventions on Shoulder Pain and Musculoskeletal Risk Factors for Shoulder Pain in Competitive Swimmers: A Scoping Review.

Shoulder pain is the main cause of missed or modified training in competitive swimmers. Exercise therapy can improve the outcomes, yet uncertainty exists regarding the characteristics of these interventions. The primary aim was to describe the evidence base relating to the effectiveness of exercise therapy interventions on shoulder pain and shoulder musculoskeletal risk factors for shoulder pain in swimmers. The secondary aim was to identify gaps in the literature and provide recommendations for future research and practice. A scoping review methodology was applied through the search of MEDLINE, PubMed, Scopus, Web of Science, and CINAHL databases. The authors included any research studies (except clinical commentaries and conference papers) that assess the effect of exercise therapy on shoulder pain and musculoskeletal risk factors for shoulder pain in swimmers. The literature was critically appraised using the Modified Down and Black checklist. From 452 papers identified, 14 studies were included in this review. An exercise program of 6 to 8 weeks, including strengthening exercises (shoulder external rotator and scapula retractor muscles) and stretches (pectoral muscles), can decrease the incidence of shoulder pain in swimmers. Furthermore, a combination of exercises and stretches with manual therapy techniques can help to decrease shoulder pain in injured swimmers. Regarding risk factors, a strengthening program of more than 12weeks increased shoulder external rotation peak force, endurance, and external rotation/internal rotation ratio; however, this was not associated to decreases in pain. Finally, open kinetic chain exercises and a dry-land program are superior to close kinetic exercises and water training for improving shoulder external rotation strength and endurance. Exercise therapy has positive effects on reducing the incidence of shoulder pain, the management of shoulder pain, and improving shoulder musculoskeletal risk factors in competitive swimmers. However, due to methodological limitations of the studies, caution must be used when applying these results in practice. Future research should focus on high-quality randomized controlled trials for prevention and management of shoulder pain in swimmers.

Comparison between the Effect of Closed Kinetic Chain and Open Kinetic Chain exercises in the strengthening of Vastus Medialis Obliqus in subjects with Patello-Femoral Pain Syndrome - a randomized control trial

Aim: To compare the effects of closed kinetic chain and open kinetic chain exercises in the strengthening of vastus medialis obliqus in subjects with Patello-femoral pain syndrome. Methods: The study was a randomized controlled trial. It was conducted to compare the impact of open and closed kinetic chain exercises to strengthen the Vastus medialis obliqus in PFPS patients. For this purpose, 36 patients both males and females with age 20-40 years having PFPS were allocated randomly to two experimental (group A and group B) and one control group C. Group A, practised open kinetic chain exercises and the second group B practiced closed kinetic chain exercises, the control group C was given general physical therapy exercises, for four weeks. The assessment of Pain and function of the individual taking part in this study were was done before starting the treatment, at 2 weeks and at 4 weeks, using Numerical Pain rating scale and Kujala Anterior knee pain scale, respectively. Results: In conclusion, significant changes i.e. in alleviating pain and enhancing overall functionality has been seen in Group B that performed closed kinetic chain exercises for about 4 weeks. Similarly, there was also a remarked change in pain reduction besides improved function in group A and group C. By comparing all the three groups, significant advantage has been noted with closed kinetic chain exercises as compared to open kinetic chain and conventional PT techniques. Conclusion: Although, both exercise regimens were significant in pain reduction and enhancing function, but close kinetic chain exercises produced remarkable effects. Keywords: Closed kinetic chain exercises, Function Open kinetic chain exercises, Pain, Patello-femoral pain syndrome, PFPS.

Comparison of Effects of Open Kinetic Chain Exercises with Closed Kinetic Chain Exercises on Quadriceps Strength and Knee Functional Activity Level after ACL Reconstruction; A Randomized Controlled Trial

Comparison of Effects of Open Kinetic Chain Exercises with Closed Kinetic Chain Exercises on Quadriceps Strength and Knee Functional Activity Level after ACL Reconstruction; A Randomized Controlled Trial

Comparison of effects of open kinetic chain exercises with closed kinetic chain exercises on quadriceps strength and knee functional activity level after ACL reconstruction - a randomized controlled trial.

Aim: To compare open kinetic chain exercises with closed kinetic chain exercises on strength of quadriceps and knee functional activity level after reconstruction of ACL. Methods: The study design is randomized controlled trial. Data of 36 patients was collected with subjective consent: 36 patients were distributed in 3 groups and each group had 12 patients with age limit from 17-39 years, treatment was given for 6 weeks including 3 days a week with conventional RICE therapy, conventional treatment with open kinetic chain exercises and conventional treatment with closed kinetic chain exercises. Results: SPSS 21 is used to generate results. Significant p value for post treatment ONE WAY ANOVA showed for knee injury and osteoarthritis outcome score is less than 0.05 which means the treatment technique is effective in reducing pain and disability in patients after ACL reconstruction. Significant difference was showed by ONE WAY ANOVA post treatment values for strength of all the muscles of quadriceps and knee functional activity in GROUP A, GROUP B and GROUP C. Vastus Medialis muscle showed p value 0.000, vastus lateralis muscle showed p value 0.000, vastus intermedius and rectus femoris both muscles showed p value 0.000 which are less than 0.05 showing significant difference between three groups. Conclusion: Closed kinetic chain exercises are conclusively better in improving quadriceps strength and Functional status of patients suffering from Anterior cruciate ligament reconstruction than open kinetic chain exercises. Keywords: Open Kinetic chain Exercises, Closed Kinetic chain Exercises, Anterior Cruciate Ligament.

Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations.

Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure with an estimated 120,000 cases performed in the USA each year. Physical therapy plays a critical role in the successful recovery of both surgically and non-surgically managed patients. Interestingly, ACL rehabilitation protocols vary greatly with little consensus among practitioners. Nonetheless, there has been agreement over the last decade to shift from conservative, standardized length protocols to more accelerated, individualized protocols that vary in length and modalities based on patient-specific findings and preferences. This review summarizes the most recent trends, opinions, and modalities in ACL rehabilitation research, with a specific focus on novel methods to treat the specific psychosocial needs of ACL deficient patients. We found that new protocols emphasize early weight bearing, open kinetic chain (OKC) exercises, and other alternative modalities such as neuromuscular electrical stimulation and blood flow restriction. We also found a recent trend toward the use of clinical milestones to determine when a patient is ready for the next phase of a "step-up" rehabilitation program. One particularly nascent topic of research is the inclusion of methods to treat the psychosocial impacts of ACL injury, recovery, and the anxiety around return to sport. Rehabilitation strategy has become increasingly patient-dependent, and the new modalities being utilized are accelerating patient recovery. Return to sport is a particularly important factor for many ACLR patients, and recovery has an important psychological component that has only recently been addressed in the literature, with positive preliminary findings.

The Impact of OKC Exercises and TRX Exercises on Shoulder Joint Proprioception in Overhead Athletes With Shoulder Impingement Syndrome: A Randomized Controlled Trial

Purpose: Sub-acromial impingement syndrome (SAIS) is one of the most common causes of shoulder pain and affects shoulder joint proprioception. The closed kinetic chain (CKC) exercises with sling are more effective and safer than open kinetic chain (OKC) exercises. This study aimed to compare the effectiveness of OKC and total-body resistance exercises (TRX) sling training on shoulder joint position sense (JPS) in overhead athletes with shoulder impingement syndrome (SIS). Methods: This article was a randomized control trial (RCT) study conducted in Kerman City, Iran, in 2019. The research sample included 33 overhead athletes with SIS who were randomly classified into three groups: OKC, sling, and control groups. Joint position sense (JPS) was evaluated in external rotation (ER), internal rotation (IR), and abduction of the dominant arm in the target angle concerning the shoulder range of motion with the Leighton flexometer. The obtained data were analyzed using the analysis of covariance (ANCOVA). Results: The post-intervention results showed that a significant difference was observed between groups (ER, P&lt;0.001; IR, P&lt;0.001; abduction P&lt;0.001). The change in the sling exercises group was significantly higher in ER, and IR, except abduction JPS than in OKC (P=0.001, P=0.001, P=0.235, respectively) and control groups (P&lt;0.001, P&lt;0.001, P&lt;0.001, respectively). Change in the OKC group was significantly higher in ER, IR, and abduction JPS (P=0.001, P=0.019, P&lt;0.001, respectively) than in the control group. The OKC and sling exercise improved the shoulder JPS of overhead athletes with SIS. Conclusion: The study results showed that the sling exercises were more effective than the OKC exercise for the shoulder JPS because these exercises were CKC and performed on an unstable level.

Effect of Open Kinetic Chain on Functional Activities of Patients with Knee Osteoarthritis

In doing daily activities, limbs of the lower extremities are the most important parts of the body. The knee is the main joint to support the body that the joint cartilage becomes inflamed which can cause pain so it can interfere to its functional activities. Nowadays, our society cannot be separated from all physical activities that involve personal or group activities. Walking, squatting, going up and down stairs, and even running are the most physical activities done by the society. Osteoarthritis is a process of degeneration and repairmen of connective tissue, cartilage, synovium, and subchondral bone. Interventions can be given in the form of exercises improving the ability of functional activities, namely open kinetic chain which this exercise can accelerate blood circulation, prevent contractures, increase muscle strength or muscle strength, relax muscles and knee joints. The aim of this study was to determine the effect of open kinetic chain exercise and increased functional activity on knee osteoarthritis. This study used a quasi-experimental and one group pre and post-test design. The sample of this study was 12 people who had been characterized by the inclusion and exclusion criteria. Measurement of the functional activity value was carried out by women and the results of the study were analyzed using the repeated ANOVA measurable test. The data analysis test showed that the open kinetic chain can increase functional activity on knee osteoarthritis from time to time with an increasing average value of 12% in patients’ functional activity within 3 treatments and 24% within 6 treatments. Keywords: Open Kinetic Chain; Functional Activity; Osteoarthritis Knee.

In-vivo tibiofemoral kinematics of the normal knee during closed and open kinetic chain exercises: A comparative study of box squat and seated knee extension

A rehabilitation program after anterior cruciate ligament reconstruction is of great importance to obtain a satisfactory prognosis after surgery. However, there is still an onging debate over whether closed kinetic chain or open kinetic chain exercises should be chosen. Our study was designed to compare the in vivo tibiofemoral kinematics during closed kinetic chain and open kinetic chain exercises.Eighteen healthy volunteers were asked to perform box squat and unloaded/10 kg-loaded seated knee extension. In vivo 3-dimensional analysis of tibiofemoral kinematics of different motions were determined using a dual fluoroscopic imaging system.The study found significantly more tibial anterior displacement during loaded seated knee extension than during unloaded seated knee extension from 25°–50° of knee flexion (p ≤ 0.031). The knees exhibited significantly more internal tibial rotation and lateral tibial translation during the box squat than both seated knee extensions during mid-flexion. In addition, the knees showed less internal-external (IE) range of motion (ROM) from 20°– 75° of flexion (p < 0.001) and medial-lateral (ML) ROM from 75° to full extension (p ≤ 0.006) during box squat than both extensions. This knowledge may help optimize rehabilitation plans for patients post ACL reconstruction.

Efficacy of Open versus Closed Kinetic Chain Exercises on Dynamic Balance and Health Status in Individuals with Osteoarthritis of Knee Joint: A Quasi-experimental Study

Introduction: Osteoarthritis is an inflammatory disorder characterised by changes in the biomechanics, biochemistry and genetic background of joint cartilage and subchondral bone. When distal parts move freely throughout exercises in a weight-bearing position, the phrase open kinetic exercises is employed. Closed kinetic exercises are employed in a weight-bearing position when the body travels through a hard and quick distal phase. Aim: To compare the efficacy of Open Kinetic Chain (OKC) and Closed Kinetic Chain (CKC) exercises on dynamic balance and health status in individuals with osteoarthritis of knee joint. Materials and Method: A single-blinded experimental study was conducted from April 2020 to May 2021 at Dr D.Y. Patil college of Physiotherapy, Pimpri-Chinchwad area, Pune, Maharashtra, India. A sample of 30 subjects with unilateral osteoarthritis of knee joint, between the age of 40-60 years of both genders, were recruited. They were divided into open kinetic group (Group A) and closed kinetic group (Group B) using convenient sampling method. Y-balance and Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) (Pune CRD version) were used as outcome measures-preintervention, post two weeks and post four weeks of intervention. Data normality was tested by Shapiro-wilk test. Significance was tested using paired t-test within the groups for WOMAC and Y-balance test. Unpaired t-test was used between the groups. Results: Among 30 subjects, 17 were males and 13 females. There was a significant improvement in dynamic balance (p-value=0.001) and WOMAC (p-value=0.001) in both the groups. In group A, preintervention mean values for WOMAC was 41.2±10.53, and post four weeks of intervention it was 34.53±10.12 (p-value=0.001). Preintervention mean for Y-balance test was 0.554±14.6 and after four weeks of intervention mean was 0.586±13.8 (p-value &lt;0.001). In group B, preintervention mean for WOMAC was 40.87±8.33, and after four weeks of intervention, mean was 30.47±7.22 (p-value=0.001); while preintervention mean for Y-balance test was 0.583±7.8 and after four weeks of intervention, mean was 0.645±7.0 (p-value=0.001). Between groups, analysis showed p-value=0.051 for both groups post four weeks of intervention. Conclusion: The study concluded that CKC exercises are more effective than OKC exercises in improving dynamic balance and decrease in pain, stiffness, and improving physical function in knee osteoarthritis.

Effects of Open Kinetic Chain Exercise for the Gastrocnemius and Tibialis Anterior Muscles on Balance

Effects of Open Kinetic Chain Exercise for the Gastrocnemius and Tibialis Anterior Muscles on Balance

Anterior Cruciate Ligament Reconstruction Recovery and Rehabilitation: A Systematic Review.

The success of anterior cruciate ligament (ACL) reconstruction is influenced by effective rehabilitation. Previously published, comprehensive systematic reviews evaluating rehabilitation after ACL reconstruction have studied Level-I and II evidence published through 2012. Interval studies continue to evaluate the efficacy of various rehabilitative modalities. A total of 824 articles from 2012 to 2020 were identified using multiple search engines. Fifty Level-I or II studies met inclusion criteria and were evaluated using the Consolidated Standards of Reporting Trials (CONSORT) criteria and National Institutes of Health (NIH) Study Quality Assessment Tools. Accelerated rehabilitation can be effective for patients with semitendinosus-gracilis grafts. Blood flow restriction (BFR) training with high-intensity exercise is not effective for ACL reconstruction recovery. Postoperative bracing does not offer any advantages or improve limb asymmetry. Cryotherapy is an effective analgesic when used perioperatively. The early introduction of open kinetic chain exercises may improve ACL reconstruction outcomes, and high-intensity plyometric exercise is not effective. Estimated pre-injury capacity (EPIC) levels may be more accurate than the Limb Symmetry Index (LSI) when using functional test results to predict reinjury rates, and hip external rotation strength may be the most accurate predictor of the hop test performance. Nerve blocks can provide postoperative analgesia with minimal complication risk. Neuromuscular electrical stimulation is effective when used independently and in combination with rehabilitative exercises. Psychological readiness should be evaluated both objectively and subjectively before allowing patients to safely return to sport. Electromyography biofeedback may help to regain muscular function, and whole-body vibration therapy can improve postural control. Supervised rehabilitation is more effective than unsupervised rehabilitation. Various rehabilitative modalities following ACL reconstruction are effective in improving surgical outcomes and return-to-sport rates. Further evidence and improved study design are needed to further validate modalities including accelerated rehabilitation, BFR training, functional testing, and return-to-sport criteria. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

ACL Reconstruction Rehabilitation: Clinical Data, Biologic Healing, and Criterion-Based Milestones to Inform a Return-to-Sport Guideline.

Anterior cruciate ligament (ACL) reconstruction (ACLR) and postoperative rehabilitation continues to be a multidisciplinary focus in both research and clinical environments. Recent research on ACLR warrants a reexamination of clinicians' current rehabilitation practices to optimize the strikingly variable clinical outcomes after ACLR and return to sport. The purpose of the article and updated guidelines is to use contemporary evidence to systematically revisit our practice guidelines and validate our clinical milestones with data from our university-based practice. Using the PubMed search engine, articles that reported on ACLR rehabilitation and protocols, guidelines, graft type, healing and strain, return to sport, psychological considerations, and secondary injury prevention published from 1979 to 2020 were identified using the search terms ACLR protocols, guidelines, ACLR rehabilitation, ACL graft, ACL open kinetic chain (OKC) exercise and closed kinetic chain (CKC) exercise, ACLR return to sport, ACLR psychological factors, and ACL injury prevention. Clinical review. Level 5. Clinical milestones after ACLR were validated using clinical data collected from 2013 to 2017 at a university-based practice. Variables including knee joint range of motion, effusion, Knee Outcome Survey-Activities of Daily Living Scale, and quadriceps strength index were tracked throughout rehabilitation and analyzed to help inform an updated ACLR rehabilitation guideline. Incorporating the latest research, combined with direct clinical data, provides a current, realistic, and clinically benchmarked strategy for ACLR rehabilitation. Commonly held clinical beliefs regarding rehabilitation after ACL injury must be challenged by the latest research to improve patient outcomes and decrease the risk of reinjury. Key updates to the practice guidelines include the use of frequent and accurate quadriceps strength testing, delayed return-to-sport timeline, immediate use of open kinetic chain exercise, criterion-based progressions for running, sprinting, plyometrics, agility, cutting/pivoting, return to competition, and the inclusion of a secondary prevention program after return to sport. B.

Postoperative Rehabilitation of Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Recent studies have investigated the various components of postoperative rehabilitation protocols following anterior cruciate ligament reconstruction (ACLR). The objective of this article was to access and summarize the latest evidence for postoperative rehabilitation protocols following ACLR to evaluate common timeframes, number of phases, exercises, as well as the length of rehabilitation protocol. Common interventions include vibration training, open-chain and closed-chain exercises, electrical stimulation, postoperative bracing, and aquatic therapy. The eligibility criteria included English-language articles published from 2000 to 2019 pertaining to rehabilitation following ACLR, excluding addresses, commentaries, and editorials. Two blinded reviewers screened, graded, and extracted data from articles. Recommendations on various aspects of rehabilitation were summarized. A total of 3651 articles were retrieved from the database search, and 62 level 1 to 2 studies were available for extraction. On the basis of the evidence, vibration training can be safely incorporated into the postoperative rehabilitation protocol following ACLR. Accelerated rehabilitation may give patients short-term functional benefits. Open kinetic chain exercises may have additional strength and endurance benefits. Postoperative bracing does not confer additional benefits. Long-term use of neuromuscular electrical stimulation seems to be more beneficial than short-term use. Aquatic rehabilitation may be beneficial in the early phases of anterior cruciate ligament rehabilitation.

Effect of conscious abdominal contraction on the activation of periscapular muscles in individuals with subacromial pain syndrome

BackgroundSynergism between shoulder and trunk muscles seems to be effective to increase periscapular muscle activation in asymptomatic subjects. The influence of conscious contraction of the abdominal muscles has not yet been studied in non-athlete subjects with pain. The study aimed to investigate the effect of the instruction for conscious activation of the abdominal muscles on the activity of the scapulothoracic muscles during shoulder exercises in subjects with subacromial pain syndrome. MethodThirty subjects with unilateral pain (mean age 52 ± 11 years) participated in this study. Three isometric and five dynamic exercises for the scapulothoracic muscles were assessed. The group without instruction just repeated the exercises, while the instruction group was evaluated before and after conscious abdominal training. The linear mixed model analysis was used to compare the muscle activation between groups. FindingsDifferences between groups after the conscious abdominal contraction for activation of middle and lower trapezius on the symptomatic side in the “Full can”(p = 0.03; effect size:0.92 middle trapezius); (p = 0.02; effect size:0.96 lower trapezius) and “Knee Push” (p = 0.01; effect size:0.75 lower trapezius). For asymptomatic side, the exercises “External Rotation Kneeling” (p = 0.04; effect size: 0.81 lower trapezius); (p = 0.00; effect size: 2.09 serratus anterior), “Knee Push” (p = 0.04; effect size:1.24 serratus anterior) and “Wall Slide” (p = 0.01; effect size: 1.03 serratus anterior). InterpretationConscious contraction of the abdominal muscle immediately alter the activation of the serratus anterior muscle during closed kinetic chain exercises on the asymptomatic side and increased activation of trapezius on the symptomatic side during shoulder open kinetic chain exercise.

Effect of closed versus open kinetic chain exercise to improve knee muscles strength and balance in elderly population: A hypothetical literature review

Background Chronic knee pain is becoming a significant social issue with ageing. The loss in muscle strength and balance with increasing age often lead to physical and quality of life impairments, as well as increased morbidity. Since knee pain and impaired balance are major issues affecting the quality of life of the elderly population, a preventive approach is required to decrease the incidence of muscle weakness and decrease proprioception. Objective to compare the effectiveness of open kinetic-chain (OKC) and closed kinetic-chain (CKC) exercise in improving the elderly population's knee strength and balance. Method A literature review was done where number of previously published articles were searched from various online platforms to find the effectiveness of OKCE versus CKCE in improving knee muscle strength and balance in elderly population. Result Both CKCE and OKCE were found to improve strength in lower leg musculature but OKCE are comparatively more effective strength training program. However, when it comes to improving balance and proprioception, CKCE were found to be more effective. Conclusion OKCE are better strengthening exercise regimes whereas CKCE are better choice of exercise regimes when it comes to improving balance and proprioception.

Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial.

Exercise programs in the treatment of chronic lumbar pain are quite diverse, but it has been proven that stabilization exercises are the most effective. We compared the lumbar stabilization exercise program in a closed and open kinetic chain (LSCO) and lumbar stabilization exercises and thoracic mobilization program in a closed kinetic chain (LSTMC), and evaluated the clinical effectiveness of each program. Prospective, randomized, controlled trial in 80 chronic low back pain (CLBP) patients with lumbar radiculopathy of both sexes (35 male, 45 female), average age (48.45 ± 10.22 years), divided in two groups that performed different sets of exercises. Participants were given laser therapy, transcutaneous electro-nerve stimulation and an eight-week kinesiotherapy that included exercises to strengthen the deep lumbar spine stabilizers. Retesting was done after four and eight weeks. Statistically significant (p< 0.05) superior recovery of the LSTMC group subjects compared to the LSCO group was achieved at all measurement intervals in the pain intensity and functional disability parameters. Patients who performed the lumbar stabilization and thoracic mobilization exercise program in a closed kinetic chain had the most effective reduction of pain intensity and functional disability.