Dissertations / Theses on the topic 'Nerve to vastus medialis'

The purpose of this study was to determine the effectiveness of a modified sitting position straight leg raise on vastus medialis oblique (VMO) strength and EMG activity as compared to a traditional straight leg raise. A total of twenty-three subjects were recruited for this study. The subjects were randomly assigned to one of the following groups: (group I) modified straight leg raise (MSLR), and (group II) straight leg raise (SLR). The exercise program was three weeks long. University procedures for the protection of human subjects were followed. The subjects began with a 5 minute warm-up on a Cybex stationary bike set at 90 revolutions / minute. The subject then had electrodes placed on the Vastus Lateralis (VL) and Vastus Medialis Oblique (VMO). A Macintosh computer was used to record the EMG data. The subject then performed a standard Cybex test for knee flexion and extension. The Cybex dynamometer was placed at the knee joint line, the chair back tilt was at 85 degrees, the hip, chest, and thigh restraints were all fastened. The subjects in group I (Modified sitting SLR) and II (SLR) then returned the next day for their first rehabilitation lesson. Each subject group then participated in their respected exercise program for a total of three weeks. After three weeks of rehabilitation, the subjects retested using the same procedures followed in the pretest. A two tailed t-test was used to determine significance of the difference between means of the two groups. No significant differences were found between the two groups.<br>School of Physical Education

The purposes of the present study were to resolve a number of major inconsistencies found in the literature on the structure of the quadriceps femoris muscle and to extend knowledge of its structure using descriptive, qualitative methodology. The quadriceps femoris muscle was investigated in 41 cats, and the findings were confirmed in 6 human cadavers. Two aponeuroses with major biomechanical functions (rectus-vastus and vastus aponeurosis), neither of which had been previously described in the literature, were characterized in both species. The study also resolved many major inconsistencies in the literature: The muscle sometimes described as vastus intermedius (VI) was found to be the articularis genu, the muscle sometimes described as vastus medialis (VM) was found to be the VI, the rectus femoris head was found to have an additional proximal nerve branch not previously recognized, no anomalous 5th head was ever found, and the distal VM were not found to have 2 heads (in either cats or humans). The authors’ anatomical descriptions and bimechanical models of the muscles, tendons, and neurovascular should provide a helpful foundation for future studies on the quadriceps. Two general recommendations are made: 1) that the feline model be considered a viable model to elucidate human knee pathomechanics; and 2) that regardless of the anatomical structure of interest, orthopedic nurses, orthopedic surgeons, and research investigators should routinely use the research literature for anatomical guidance instead of standard anatomical textbooks. © 2002, Sage Publications. All rights reserved.

Made available in DSpace on 2016-06-02T20:18:25Z (GMT). No. of bitstreams: 1 TeseACS.pdf: 1629824 bytes, checksum: 9ffe05e7af325db5e778585c64e4910a (MD5) Previous issue date: 2005-03-22<br>Universidade Federal de Sao Carlos<br>The purpose of this work was to analyze the electrical activity (EMG) of the vastus medialis obliquus (VMO) and vastus lateralis longus (VLL) and vastus lateralis obliquus (VLO) in association with the evaluation of the maximum isometric torque (MIT) of the quadriceps muscle, during the maximum voluntary isometric contraction (MVIC) of knee extension in open kinetic chain (OKC) at 20o, 30o, 50o and 60o of knee flexion, also, pain and fatigue and the aspects in relation to patellae positioning: the sulcus angle (SA), the congruence angle (CA), patellar tilt angle (PTA) and lateral patellar displacement (LDP). Twenty four female subjects were evaluated (12 with patellofemoral pain syndrome PFPS and 12 clinically normal controls). For the EMG analysis simple surface differential active electrodes and a Signal Conditioner Module (MCS 1000-v2) were used. The electromyographic signal was quantified by the Root Mean Square (RMS), in µV, and normalized by the MVIC of 90o of knee extension. The subjects made 5 MVIC of knee extension, at 30o of flexion for the EMG and MMIT analysis and the NMRI with the quadriceps muscle relaxed were obtained at the same angles. The following statistic tests were used: ANOVA Analysis of Variance with Repeated Measurements for the EMG and MMIT analysis; the Mann-Whitney U test for the NMRI; and the One Way Analysis of Variance for the evaluation of intensity and discomfort from pain and fatigue (p &#8804; 0.05). The results showed a higher electrical activity of the VLL muscle in relation to the VMO in the group with FPPS. The control group, the VMO and VLL did not present a significant difference in all studied angles. In both groups, VMO and VLL showed a higher electrical activity in comparison with VLO, in all angles. The MMIT values of the quadriceps did not differ among groups, however it did differ between angles. The highest MMIT value was 60o. The NMRI analysis revealed that the FPPS group presented higher values of SA and lower values of CA in relation to the Control group. The results showed an increase in pain and fatigue of the subjects with PFPS after the MVIC and in comparison with the Control group. The data of this study, on the experimental conditions, suggest that: a higher electrical activity of the VLL in addition with the increase in SA and decrease in CA in the subjects with PFPS can be factors favoring such individuals patellar instability. Pain and fatigue were greater in subjects with PFPS. The results showed that the EMG and the NMRI were instruments capable of differentiating the groups that were studied.<br>A proposta deste estudo foi analisar a atividade elétrica (EMG) dos músculos vasto medial oblíquo (VMO), vasto lateral longo (VLL) e vasto lateral oblíquo (VLO) associada à avaliação do torque isométrico máximo (TIM) do músculo quadríceps, durante contração isométrica voluntária máxima (CIVM) de extensão de joelho em cadeia cinética aberta (CCA) a 20o, 30o, 50o e 60o de flexão de joelho, juntamente com a análise da intensidade e desagradabilidade da dor e fadiga muscular; e os parâmetros de posicionamento da patela: Ângulo do Sulco (AS), Ângulo de Congruência (AC), Ângulo de Inclinação Patelar (AIP) e Deslizamento lateral da patela (DLP). Foram avaliadas 24 voluntárias, do sexo feminino, entre 18 e 34 anos (22,52 ± 3,94), sedentárias, que segundo critérios de inclusão e exclusão, avaliando os sinais e sintomas, foram classificas como sendo: 12 portadoras de Síndrome da Dor Femoropatelar, sintomáticas e as outras 12 consideradas clinicamente Normais. Para análise da EMG, foram utilizados eletrodos ativos diferenciais simples de superfície, com um ganho de 100 vezes e um Módulo Condicionador de Sinais (MCS 1000-v2), com ganho de 10 vezes. Os sinais eletromiográficos foram amostrados de forma sincrônica, analisados por meio do Root Mean Square RMS (µV) e normalizados pela CIVM extensão do joelho à 90 graus. Utilizou-se um dinamômetro isocinético para o registro do Torque Isométrico Máximo (TIM), um equipamento de Ressonância Magnética Nuclear por Imagem (RMNI) para verificar os posicionamentos da patela e uma escala visual analógica (EVA) para analise da dor e fadiga muscular, em mm. Os indivíduos realizaram 5 CIVM de extensão de joelho nos ângulos de 20o, 30o, 50o e 60o de flexão para análise da EMG e do TIM. A 30o de flexão de joelho, foram realizadas as RMNI com músculo relaxado. Foram utilizados os testes estatísticos: ANOVA - Análise de Variância de Medidas Repetidas para analisar a EMG e o TIM; o teste Mann-Whitney U para análise da RMNI e Análise de Variância One Way para avaliação da intensidade e desagradabilidade de dor e fadiga muscular (p &#8804; 0,05). Os resultados evidenciaram maior atividade elétrica do músculo VLL em relação ao VMO, no grupo com SDFP, enquanto que no grupo Controle, os músculos VMO e VLL não apresentaram diferença significativa entre si, em todos os ângulos estudados. Em ambos os grupos, os músculos VMO e VLL apresentaram maior atividade elétrica que o VLO, em todos os ângulos. Não houve diferença significativa do TIM entre os 2 grupos, mas sim entre os ângulos e o maior valor do TIM foi a 60 graus. A análise da RMNI revelou que o grupo com SDFP apresentou maiores valores do AS e menores do AC em relação ao grupo Controle. Os resultados mostraram ainda um aumento da dor e da fadiga nos indivíduos com SDFP após as CIVM quando comparar ao grupo Controle. Os dados desta pesquisa, nas condições experimentais utilizadas, sugerem que: uma maior atividade elétrica do VLL juntamente com o aumento do AS e a diminuição do AC nos indivíduos com SDFP, poderiam ser considerados como fatores que predispõem a instabilidade patelar destes indivíduos. A dor e a fadiga foram maiores nos indivíduos com SDFP. Os resultados revelaram que tanto a EMG quanto a RMNI foram instrumentos capazes de diferenciar os grupos estudados.

Made available in DSpace on 2014-12-17T15:16:08Z (GMT). No. of bitstreams: 1 DeniseDA_DISSERT.pdf: 659589 bytes, checksum: a95e9f3f95d4524998e52ab9a5dd9577 (MD5) Previous issue date: 2010-04-13<br>Patellofemoral pain syndrome (PFPS) is described as anterior or retropatellar pain knee in the absence of other pathologies and is frequently associated with dysfunction of the vastus medialis oblique (VMO). However, several studies have demonstrated the inability to selectively activate this muscle through exercise. To evaluate the effect of Neuromuscular Electrical Stimulation (NMES) selective VMO in women with syndrome. We evaluated thirty-eight women: twenty in the control group (24.15 ? 2.60 years) and eighteen diagnosed with PFPS (25.56 ? 3.55 years). Both groups were evaluated before and after a protocol of electro stimulation. To measure for comparing groups before and after treatment, we assessed the extensor torque concentric and eccentric knee through an isokinetic dynamometer, the intensity (Root Mean Square - RMS) and the onset of activation (onset) of VMO compared to the vastus lateralis (VL) in two types of exercise: open and closed kinetic chain. . Statistical analysis was performed using SPSS 15.0, with a significance level of 5%. Results: Our data showed an increase in the intensity of activation (RMS) of the VMO muscle after NMES in both study groups. During concentric contraction the RMS of the VMO before the NMES was 105.69 ? 32.26 &#956;V and after a single intervention was 122.10 ? 39.62 &#956;V (p = 0.048) for the control group. In the group with PPS, we found a similar behavior, with RMS of the VMO before NMES of 96.25 ? 18.83 &#956;V and 139.80 ? 65.88 &#956;V after the intervention (p = 0.0001). However, there was no evidence in the RMS value of VL muscle. The onset was calculated by subtracting the onset of VL by the onset of VMO. For the group with PFPS, the onset before the intervention was -0.007 ? 0.14 ms, indicating a delay of the VMO relative to VL, and after NMES was 0.074 ? 0.09 ms (p = 0.016), showing an activation previous VMO to VL. The same occurred for the control group. We also observed that NMES increased knee extensor power during the concentric contraction in both groups. Before the intervention the mean power was 28.97 ? 9.01 W for the PPS group and after NMES was 34.38 ? 7.61 W (p = 0.0001). Conclusion: We observed an increase in electromyographic activity of the VMO and also an anticipatory effect of this muscle<br>A S?ndrome da Dor Femoropatelar (SDFP) ? freq?entemente associada ? disfun??o do Vasto Medial Obl?quo (VMO). Diversos estudos t?m demonstrado a impossibilidade de ativar seletivamente este m?sculo por meio de exerc?cios. Avaliar os efeitos de uma ?nica sess?o de Estimula??o El?trica Neuromuscular (EENM) seletiva do m?sculo VMO, em sujeitos com SDFP. Foram avaliadas 38 mulheres sendo 20 pertencentes ao grupo controle (24,15 ? 2,60 anos) e 18 com diagn?stico de SDFP (25,56 ? 3,55 anos). Ambos avaliados antes e ap?s um protocolo de eletroestimula??o. Para medida de compara??o dos grupos antes e depois do tratamento, foram avaliados, o desempenho isocin?tico, a intensidade de ativa??o muscular (Root Mean Square RMS) e o in?cio da ativa??o (onset) do VMO comparado ao vasto lateral (VL). Para an?lise estat?stica foi utilizado o programa SPSS 15.0, com um n?vel de signific?ncia de 5%. Resultados: Nossos dados mostraram um aumento na intensidade de ativa??o (RMS) do m?sculo VMO ap?s a EENM, em ambos os grupos de estudo. Durante a contra??o conc?ntrica o RMS do VMO antes da EENM foi 105,69 ? 32,26 &#956;V e depois de uma ?nica interven??o foi de 122,10 ? 39,62 &#956;V (p=0,048) para o grupo controle. No grupo com SDFP, encontramos um comportamento semelhante, com RMS do VMO antes da EENM de 96,25 ? 18,83 &#956;V e 139,80 ? 65,88 &#956;V depois da interven??o (p=0,0001). Entretanto, n?o foi evidenciada altera??o no valor RMS do m?sculo VL. O onset foi calculado atrav?s da subtra??o do onset do VL pelo onset do VMO. Para o grupo com SDFP, o onset antes da interven??o foi de -0,007 ? 0,14 ms, evidenciando um atraso do VMO em rela??o ao VL, e ap?s a EENM foi 0,074 ? 0,09 ms (p=0,016), mostrando uma ativa??o do VMO anterior ao VL. O mesmo ocorreu para o grupo controle. Observamos tamb?m que a EENM aumentou a pot?ncia extensora do joelho, durante a contra??o conc?ntrica em ambos os grupos. Antes da interven??o a m?dia da pot?ncia era de 28,97 ? 9,01 W para o grupo SDFP e depois da EENM foi de 34,38 ? 7,61 W (p=0,0001). Conclus?o: Observou-se um aumento na atividade eletromiogr?fica do VMO ap?s a eletroestimula??o, al?m de um efeito antecipat?rio deste m?sculo

The purpose of this experiment was to investigate skeletal muscle blood flow and glucose uptake in m. biceps (BF) and m. quadriceps femoris (QF) 1) during recovery from high intensity cycle exercise, and 2) while wearing a compression short applying ~37 mmHg to the thigh muscles. Blood flow and glucose uptake were measured in the compressed and non-compressed leg of 6 healthy men by using positron emission tomography. At baseline blood flow in QF (P = 0.79) and BF (P = 0.90) did not differ between the compressed and the non-compressed leg. During recovery muscle blood flow was higher compared to baseline in both compressed (P&lt;0.01) and non-compressed QF (P&lt;0.001) but not in compressed (P = 0.41) and non-compressed BF (P = 0.05; effect size = 2.74). During recovery blood flow was lower in compressed QF (P&lt;0.01) but not in BF (P = 0.26) compared to the non-compressed muscles. During baseline and recovery no differences in blood flow were detected between the superficial and deep parts of QF in both, compressed (baseline P = 0.79; recovery P = 0.68) and non-compressed leg (baseline P = 0.64; recovery P = 0.06). During recovery glucose uptake was higher in QF compared to BF in both conditions (P&lt;0.01) with no difference between the compressed and non-compressed thigh. Glucose uptake was higher in the deep compared to the superficial parts of QF (compression leg P = 0.02). These results demonstrate that wearing compression shorts with ~37 mmHg of external pressure reduces blood flow both in the deep and superficial regions of muscle tissue during recovery from high intensity exercise but does not affect glucose uptake in BF and QF. © 2013 Sperlich et al.<br><p>:doi 10.1371/journal.pone.0060923</p>

Les propriétés des surfaces sportives peuvent impacter directement la performance et le risque de blessure en modulant la part d’énergie transmise à l'athlète lors de l'impact du pied sur la surface. Les pelouses naturelle et synthétique sont couramment utilisées sur les terrains de football et de rugby. Depuis quelques années, une nouvelle génération de pelouse dite naturelle renforcée a fait son apparition dans les clubs professionnels mais son influence sur la biomécanique du geste sportif est encore mal connue. Cette thèse vise à évaluer l'influence de trois types de surfaces (gazon naturel renforcée, gazon synthétique et tartan) sur les interactions muscle-tendon et les coordinations neuromusculaires des muscles gastrocnemius medialis (GM) et vastus lateralis (VL) lors de mouvements de réception uni et bilatérale ainsi que de saut. L’analyse des données échographiques dynamiques, de cinématique 2D et d’activité musculaire nous a permis de montrer que : i) les propriétés mécaniques des surfaces peuvent altérer les interactions entre les faisceaux musculaires et les tissus tendineux ainsi que l’amplitude d’activation musculaire ; ii) la pelouse naturelle renforcée semble avoir des propriétés plus optimales que la pelouse synthétique lors de sauts et réceptions ; iii) il existe des différences de comportement marquées entre le GM et VL qui dépendent du type de surface, du type de mouvement et de son intensité. Cela souligne l’importance de ne pas se limiter à l’étude des propriétés mécaniques des surface pour comprendre leur influence sur le mouvement sportif. Par ailleurs, l’étude des comportements musculo-tendineux in vivo en condition écologique permet de mieux comprendre les interactions complexes entre l’homme et la surface<br>Sports surface properties can substantially alter the overall performance and risk of injury. Surface mechanical properties influence the loading of the human musculoskeletal system by modulating the amount of foot-impact energy transmitted to the athlete. Natural grass and synthetic turf are commonly used pitches in football and rugby. More recently, reinforced natural grass technology has been used at the elite-level facilities, but its influence on player is not well defined. This thesis aimed at evaluating the influence of three different surfaces (reinforced natural grass, synthetic turf and athletic track) on the muscle-tendon interactions and neuromuscular coordination of gastrocnemius medialis (GM) and vastus lateralis (VL) muscles during landings and jumping tasks. Analysis of dynamic ultrasound imaging, 2D kinematics and electromyographic data showed that: i) surface mechanical properties influenced muscle-tendon interactions as well as the level of muscle activity; ii) the reinforced natural grass surface seems to optimize the muscular response during the movement and iii) GM and VL muscles displayed specific behaviors relative to the type of movement, its intensity and the type of surface. This emphasizes that the human response cannot be predicted by only analyzing the mechanical surface properties and highlights the important role of in vivo ecological testing to better understand player-surface interaction

STUDY OBJECTIVE: To investigate the exit point of the motor branch of the nerve to vastus medialis (mNVM) from the posterior division of the femoral nerve. An enhanced understanding of the origin and course of the mNVM will minimize the risk of anesthetizing it when performing a local anesthetic adductor canal nerve block for postoperative analgesia following total knee arthroplasty. METHODS: Anatomical donors, obtained through generous donation to the Anatomical Gift Program at Boston University School of Medicine (BUSM), were used in this study. Dissection of the mNVM was performed in 22 body donors (44 lower limbs). Before the dissection, the thigh length, from the anterior superior iliac spine (ASIS) to the base of the patella was measured. Additionally, following the dissection, the distance from the exit point of the mNVM to the base of the patella was measured. Then, the ratio between the two distances was calculated to provide a straightforward and efficient estimate of the mNVM branch point. SUMMARY OF RESULTS: The mean ± SD thigh length in the 44 lower limbs was 43 cm ± 2.9cm. The mNVM exited the posterior division of the femoral nerve 19.2 cm ± 1.90 cm superior to the base of the patella. The exit point of the mNVM from the posterior division of the femoral nerve was 0.56 ± 0.04 of the distance from the ASIS to the patella base. Pearson correlation was performed in order to examine the relationship between the distance of mNVM from the base of the patella to the total length of the thigh in the 44 limbs. This relationship was significant with P = 0.003. The One-Way Anova revealed no significant difference between male and female body donors in the ratio of the exit point of the mNVM relative to the length of the thigh. CONCLUSION: The mNVM emerges from the posterior division of the femoral nerve at 0.56 ± 0.04 of the thigh lengths as measured from the ASIS to the base of the patella. This finding provides clinicians with a practical and useful guide for determining the injection point for an adductor canal nerve block, a procedure utilized for postoperative analgesia following total knee arthroplasty. Protecting the mNVM during the block will avoid weakening the vastus medialis muscle and may result in greater patient participation in postoperative physical therapy, safer gait and may reduce the risk of falls.

博士<br>國立臺灣大學<br>物理治療學研究所<br>96<br>This dissertation was designed to investigate the mechanical properties of the vastus medialis and the vastus lateralis in patients with patellofemoral pain syndrome. In this dissertation, the mechanical properties indicated the electromechanical delay and the viscoelasticity of the tendon structures of the vastus medialis and the vastus lateralis. From the literature review, the measurements for the electromechanical delay and viscoelasticity of the vastus medialis and the vastus lateralis were questionable. Hence the study was divided into three stages for three purposes. In the first stage, the electromechanical delay of the vastus medialis and vastus lateralis is determined by measuring the interval between the time of onset of muscle activities and the time of onset of mechanical output. However, individual mechanical output of the vastus medialis and vastus lateralis cannot be obtained with the conventional method because of regarding the knee extension force as the mechanical output. Therefore, the objective of this stage study was to develop a new method for measuring the electromechanical delay of the vastus medialis and vastus lateralis individually. Twelve healthy volunteers participated in the experiment. The motor point of the target muscle was electrically stimulated to evoke a muscle twitch. Simultaneously, the electrical stimulation signal was transmitted to ultrasound apparatus via the electrocardiography input channel. The ultrasound apparatus was used to capture the patellar movement elicited by the muscle twitch. The electromechanical delay was measured from the onset of the electrical stimulation to the onset of patellar movement. The results showed that the intra-class correlation coefficients for the reproducibility of the electromechanical delay measurements of the vastus medialis and vastus lateralis were greater than 0.8. The electromechanical delay of the vastus medialis and vastus lateralis were 18.3 ± 2.2 ms and 24.8 ± 5.8 ms, respectively. This new method provides a more precise measurement of the electromechanical delay in the vastus medialis and vastus lateralis than does the conventional method because of the use of patellar movement as the mechanical output. In the second stage, twelve patellofemoral pain syndrome patients and twelve healthy subjects with gender, age, height and weight matched were recruited to participate to the study. The new method was applied to all the subjects and the resultant electromechanical delay of the vastus medialis and vastus lateralis were compared between these two groups. The result of this stage study was demonstrated that the percentage of people whose the electromechanical delay of vastus medialis being larger than that of vastus lateralis in subjects with patellofemoral pain syndrome are significantly greater than those in healthy individuals. According to the result, we speculated that the mechanical properties of vastus medialis and vastus lateralis might have adaptive changes in patients with patellofemoral pain syndrome. In the third stage, we further investigated the relationships of the length of electromechanical delay and the viscoelasticity of musculature. Previous scholars believed that the time taken for the stretching of the series elastic component by the contractile element is considered a major portion of electromechanical delay. Therefore, the viscoelasticity of the series elastic component is related to the length of electromechanical delay. The area of load-unload loop is an index of hysteresis and related to the viscoelasticity of tendon structures. Therefore, the area of load-unload loop of the vastus medialis and vastus lateralis was measured and compared between healthy individuals and patellofemoral pain syndrome patients. The elongation of the tendon structures is one part to form the load-unload loop. In previous studies, however, the measurement of the elongation of tendon structures is questionable due to the displacement of the tendon structures of vastus lateralis being measured. We would like to modify the previous method to measure the more precise elongation of the tendon structures of vastus medialis and vastus lateralis. The isokinetic dynamometer was used to provide the resistance during subject performing ramped isometric knee extension exercise; simultaneously, the muscle activities of the vastus medialis and vastus lateralis were detected by the electromyography recording system. Besides, the elongations of the tendon structures of the vastus medialis and vastus lateralis during ramped isometric contraction were captured by the B mode ultrasonography. A customized switch was used to synchronize the signals of muscle activity and the ultrasonography. The results of this stage study were showed that the percentage of people whose the area ratio of hysteresis loop of vastus medialis being larger than that of vastus lateralis in subjects with patellofemoral pain syndrome are significantly greater than those in healthy individuals. According to the result, we speculated that the viscoelasticity of vastus medialis and vastus lateralis might have a change in patellofemoral pain syndrome patients. The greater energy loss of vastus medialis contraction in daily activity and the decreased speed of muscle force transmission in patellofemoral pain syndrome patients. Consequently, the electromechanical delay of vastus medialis is smaller than that of vastus lateralis and that might deteriorate the abnormal patellar tracking.

碩士<br>長庚大學<br>復健科學研究所<br>96<br>Background: Patellofemoral pain syndrome (PFPS) is a common complaint in the sporting and general populations. Clinically this condition presents as diffuse pain, exacerbated by activities such as stair climbing, prolonged sitting, squatting, and kneeling. Despite the prevalence of PFPS, its etiology is not well understood. The most commonly accepted hypothesis is the abnormal lateral tracking of the patella. Patellar tracking is the outcome of an interaction between passive structures, muscle, and neuromotor control systems. Recent studies have provided evidence of a dysfunction in the activation of vastus medialis oblique (VMO) and vastus lateralis (VL) in people with PFPS. Kinesiotaping is a novel method of taping utilizing a specialized type of tape by the same name. The proposed therapeutic mechanisms of kinesiotaping include correcting muscle function and decreasing pain. Clinically kinesiotaping has been used in treating the chronic disease of the knee joint. However, little scientic evidence nor consensus is available for this novel treatment. The purpose of this study is to investigate the effects of kinesiotaping on the electromyography (EMG) activity of VMO and VL (include onset timing and activation amplitude) and pain condition in a stair stepping task by participants with and without PFPS. Method: This study employed a pre- and post-treatment design. Fifteen subjects with a diagnosis of PFPS (10 females and 5 males; age 32.27±9.04 ) and 15 asymptomatic healthy controls (10 females and 5 males; age 31.87±8.25) were recruited. The EMG of both muscles were recorded while subjects performed a stair stepping task with and without kinesiotaping. In addition, a visual analogue scale and the Cincinnati Knee Score were used to evaluate the overall therapeutic effects. Result: In the patellofemoral pain group when the patellofemoral joint is non-taped, VL activated earlier than VMO during step-up (8.6ms) and step-down (21.24ms); when taped, VMO activated earlier than VL during step-up (5.53ms) and step-down (0.77ms). Percieved pain and knee function also significantly improved (p<0.05). In contrast, the healthy group did not show suchlike changes. However, no similar change was noted in the VMO/ VL EMG ratio for both groups. Conclusions: Kinesiotaping is capable of reducing pain, promoting knee function, and altering the timing of VMO and VL activation in subjects with patellofemoral pain during step-up and step-down. Significance: This study supports the utilization of Kinesiotaping in treating PFPS. Future study should incorporate the long term effect of this regimen.

碩士<br>臺北巿立體育學院<br>舞蹈碩士班<br>96<br>The purpose of this research is to investigate the Quadriceps angle (Q angle) as it applies to the ballet dancer’s vastus medialis obliquus muscles (VMO) and vastus lateralis muscles (VL) in order to effectively avoid the occurrence of unnecessary injury. Hopefully it will provide some solid information for dancers and instructors. The subjects of this research are six professional ballet dancers and eight college student dancers from their respective departments of ballet. By using E.M.G. signal valuation these dancers were separated into large and small Q angle groups, both wearing hard ballet shoes and each performing three sets of the appointed combination action of basic ballet movement, the muscle tele-combinations of VMO and VL variety, and SPSS software was used to record and analyze the nonparametric statistical results. The results indicated that although both the large Q angle dancer and the small Q angle dancer reached standard level leg raising action in the third and fourth stages of movement III, other stage actions did not pass to the standard level. The recruitment of VMO and VL muscles with the large Q angle and small Q angle indicates the obvious results. The exception would be in the first stage of movement III where the right leg is used as the supporting leg and the left leg extends forward with the sole brushing the floor (Battement Tendu Devant). This experiment has shown that the large Q angle dancers’ use of VMO and VL is not balanced. The muscle power of VMO is hardly used at all, especially in the leg extension. Therefore, it is recommended that dancers should receive proper balanced training in the use of muscles. The large Q angle dancers in particular should learn how to enhance the muscle power of VMO in order to achieve a balance of VMO and VL, thus reducing the incidence of injury, dislocation and wearing out of the patella.

碩士<br>國立臺灣大學<br>物理治療學研究所<br>88<br>The muscle imbalance of vustus medialis oblique (VMO) and vastus lateralis (VL) may produce excessive compression force on patellofemoral joint and is regarded to one of factors to cause patellofemoral pain syndrome (PFPS). Therefore, conservative treatment for the patients of PFPS is focused on strengthening of VMO. In the past, however, there were few studies to search for the relationship of VMO and VL as well as to compare the myoelectric signal of VMO and that of VL. The purposes of this study are to realize the difference between the myoelectric signals of VMO and that of VL, and the myoelectric signals ratio of those two, during isometric maximal voluntary contraction in different knee angles. Twenty-eight healthy students whose age from 20 to 30 were included. Subjects performed maximal isometric contraction providing resistance from Cybex dynamometer at 0°,15°,30°,45°,60°,75°,90°and 105°of knee flexion randomly. The myoelectric signals of VMO and VL were detected by surface electrodes, simultaneously as subjects did isometric contraction. The result of this study demonstrates the myoelectric signal amplitude of VMO and VL growing as greater as knee flexion increasing. The greatest myoelectric signals of VMO can be observed at knee flexion 105°while VL at flexion 90°.And the ratios of myoelectric signals of VMO to VL have no significant difference among the different knee flexion, except at flexion 45°. It is concluded that both VMO and VL, their myoelectric signal amplitude show growing as greater as knee flexion increasing comparably. And there is no significant difference between the myoelectric signal amplitude of VMO and that of VL for full range of knee motion.

碩士<br>國立臺灣師範大學<br>運動競技學系<br>104<br>Purpose: Numerous investigations have aimed to decrease muscle vibration and change muscle activation on compression garment. Therefore, using the concept of the double layers of fabrics on vastus medialis oblique might reduce sport injuries. The purpose of this study was to analyze the effects of the compression pant on performance. Method: There were 12 healthy male participants recruited in this study. They had to wear three different pants including the double layers compression pant, compression pant, loose pant in counter- balanced order and performed the muscle vibration, the isometric strength of knee extension and sit-to-stand test. The repeated measures one-way ANOVA was used to evaluate the muscle vibration. The 2-way repeated ANOVA were used to evaluate the isometric strength of knee extension and sit-to-stand test before and after the eccentric exercise. Significant level was set at α = .05. Result: The results showed that the double layers compression pant could decrease muscle vibration and alter the timing of VMO and VL activation than wearing the loose pant. However, the isometric strength of knee extension and the VMO/VL EMG ratio were not significantly different in the three pants. Conclusion: The double layers on vastus medialis oblique in the compression wear could decrease muscle vibration and alter the timing of VMO and VL activation than wearing the loose pant. It could be used as reference for new product development in the future.

博士<br>國立陽明大學<br>醫學工程研究所<br>96<br>Background: It has been presumed that patellofemoral pain syndrome (PFPS) results from patellar malalignment. However, the precise role the VMO plays in mediating the underlying pathology is unclear. Study Hypothesis: The morphology of the VMO is correlated to patellar malalignment in patients with PFPS. Study Design: Cross-sectional study. Methods: One hundred and twelve patients with PFPS were studied. Six sets of computed tomography axial images were assessed in which knee flexion was 00, 150, or 300, and the quadriceps muscle either relaxed or contracted. Measurements of serial cross-sectional areas of the VMO and patellar malalignment were made. Correlation and stepwise regression models between the VMO variables and patellar malalignment (lateral shift and patella tilt) were calculated. Additionally, the above statistics was further investigated into the 4 subgroups of patellofemoral malalignment. Results: Significant correlations were found between measures of cross-sectional areas of VMO, and patellar tilt at knee flexion 00 and 300 positions. Based on regression model, VMO was determined to be equivocally predictive of patellar tilt (R2= 0.078). In sharp contrast, this explanation was most apparent in the subgroup of patients with extreme patellar tilt and lateral shift (R2 up to 0.824). Conclusions: There existed significant correlations between VMO variables and some patellar alignments in the knees of patients with PFPS. Clinical Relevance: VMO is important to consider in the rehabilitation of patients with patellofemoral pain syndrome, especially those with extreme patellar tilt and lateral shift.

Thesis (M.Tech,: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 62, 19 leaves :|bill. ;|c30 cm<br>To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence.

碩士<br>國立臺灣大學<br>物理治療學研究所<br>93<br>Background：Patellofemoral pain syndrome（PFPS） is a common knee disorder characterized by anterior or retropatellar pain associated with activities that load the patellofemoral joint. Previous studies reveal that the vastus medialis obliquus（VMO） is an important dynamic medial stabilizer of the patellar. Insufficiency of the VMO leads to lateral shift of the patella and the increases the patellofemoral contact force. An in vitro study conducted by Hubbard JK. et al. claimed that there were no significant relationship between several morphologic characteristics of the VMO and the extent of patellofemoral joint deterioration. We consider that the condition might be different in vivo, so we chose ultrasonogrphy as the measurement tool to examine the morphology of the VMO in PFPS patients and healthy controls. Purpose：To determine if there are significant differences in several morphologic parameters of the VMO between patients with PFPS and healthy controls under 50. Method：31 PFPS patients and 31 matched healthy adults under 50 were recruited for the study. The HDI 5000 ultrasonography machine was used to evaluate morphologic parameters of the VMO, including the percent of patella attachment, fiber angle, the volume attached to the patella, and the change of shape of the VMO. Result：51 data were collected in each of the two groups and were perfectly matched by age, gender, and BMI. The only parameter that revealed significant difference was the percent of patella attachment (p<0.05). The mean percentage of the PFPS group was 40.61%, while that of the healthy group was 46.46% (±7.6%). The actual length of the VMO attachment on the patella was 2.07cm (±0.63cm) in the PFPS group and 2.43cm (±0.48cm) in the healthy group, revealing a 0.4 cm difference. Furthermore, we found that there is a moderate correlation between VMO volume attached to the patella and the percentage of VMO insertion in both groups, R=0.695（p<0.000）in the PFPS group and R=0.517（p<0.000） in the healthy group. On the other hand, comparing the affected and non-affected side of the 14 unilateral affected PFPS patients, all parameters failed to reveal significant difference. Discussion：Training programs for PFPS patients usually include strength training of the VMO muscle, but the only morphological parameter which revealed significant difference in our study, the percent of VMO attachment, was not capable of being trained. For those PFPS patients who have a proximally inserted VMO, strength training might not be effective and surgery might be a better choice for treatment. Conclusion：The only parameter which revealed significant difference between the two groups is the percent of VMO attachment (p<0.05). There is a moderate correlation between the percent of VMO attachment and VMO volume.

Thesis (M.Thec.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 110 leaves ; ill. ; 30 cm<br>According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

M.Tech.<br>The purpose of this unblinded controlled study was to determine the effective of dry needling of the Vastus Medialis Oblique muscle when utilised in conjunction with conservative chiropractic management for Patellofemoral Pain Syndrome (PFPS). The subjects of the trial were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty patients suffering from chronic Patellofemoral Pain Syndrome were chosen for the study and they were divided into two groups of fifteen. The first group received conservative chiropractic care which consisted of manipulation of the sacroiliac joint, mobilisation of the knee and patella joints and stretching and strengthening exercises consisting of Quadriceps standing self stretch and Quadriceps setting as the strengthening exercise. The second group received the above treatment but also underwent dry needling of the Vastus Medialis Oblique muscle. The objective data for this research was recorded using a lower limb isometric dynamometer and the subjective data was recorded with a pain scale. Both sets of data were recorded on the first, third and fifth treatments. The results of the trial showed that there was a significant increase in strength with a reduction in pain levels for both groups but there was no statistically significant difference when comparing the two groups. The dry needling group did however improve at a faster rate than the other group but it did even out after the five treatments. What was noteworthy is that the males of the study improved their strength by a much greater extent than the females which is uncommon for PFPS. The end result of this study is that overall, dry needling of the Vastus Medialis Oblique muscle is not highly beneficial in the long term management of PFPS but does have its benefits in the early stages of the treatment in order to relieve the acute pain and increase the Quadriceps muscle strength rapidly.

Title: Analysis of electromyographic activity of selected muscles in exercises on selected balance surfaces. Objective: The objective of this dissertation was to document, compare and analyze electromyographic activity of m. gluteus maximus et medius, of m. erector spinae at the level L3 and of m. quadriceps vagus medialis et lateralis in exercises on selected unstable surfaces - on a cylindrical board and in balance sandals. Methods: The work was elaborated as a pilot study. Surface electromyography was used for objectification. The researched group consisted of 7 volunteers (5 women and 2 men), who had no serious injuries and surgeries in their anamnesis and none of them did any sports for a long period. Electromyographic activity of the above mentioned muscles was compared when doing two clearly defined exercises (stand on one lower extremity and hovering/gait on the spot) in balancing sandals and on a cylindrical board in sagittal plane. Results: The results only confirmed two hypotheses out of five ones. Namely it was the hypothesis no. 2 that the lowest activity of m. gluteus maximus was reached while doing exercise no. 3 - hovering/gait on the spot on a cylindrical board and the hypothesis no. 3 that the highest activity of m. erector spinae was reached while doing exercise no. 4 -...