تاثیر یک پروتکل تمرینی متمرکز بر فعال سازی عضله پهن داخلی بر سطح مقطع و فعالیت الکتریکی عضلات پهن داخلی و پهن خارجی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار بیومکانیک ورزشی، گروه تربیت بدنی، دانشگاه گیلان، گیلان، ایران

2 استادیار حرکات اصلاحی، گروه تربیت بدنی، دانشگاه نهاوند، نهاوند، ایران

چکیده

مقدمه و اهداف
در بیماران واجد سندروم فشار خارجی پاتلوفمورال، عضله پهن داخلی ضعیف­تر از عضله پهن خارجی می­باشد. هدف پژوهش حاضر بررسی اثر یک پروتکل تمرینی متمرکز بر فعال­سازی عضله پهن داخلی بر سطح مقطع و فعالیت الکتریکی عضلات پهن داخلی و خارجی می ­باشد.
مواد و روش ­ها
در مطالعه حاضر، 30 زن مبتلا به سندروم فشار خارجی پاتلوفمورال با میانگین سنی 5/7±25/4 سال انتخاب و به­طور تصادفی به دو گروه برابر تقسیم شدند. گروه تجربی، در تمرینات ایزوکینتیک اکستنشن زانو در قوس حرکتی 30 درجه انتهایی با چرخش خارجی بیشینه ساق پا به مدت 8 هفته شرکت نمودند. گروه کنترل در هیچ تمرین منظمی مشارکت نداشتند. قبل و پس از مداخله، سطح مقطع و فعالیت الکتریکی عضلات پهن داخلی و خارجی به­وسیله اولتراسونوگرافی و الکترومایوگرافی اندازه­گیری شد. داده­ها، با آزمون t مستقل و همبسته در سطح معناداری 05/0>P آنالیز گردید.
یافته­ ها
قبل از مداخله، در هیچ­یک از متغیرها بین دو گروه اختلاف معناداری مشاهده نشد (0/05<P)، اما بعد از مداخله، نسبت فعالیت و سطح مقطع عضله پهن داخلی به پهن خارجی در گروه تجربی به­طور معناداری بیشتر از گروه کنترل بود (0/001>P).
نتیجه­ گیری
استفاده از تمرینات ایزوکینتیک اکستنشن زانو مطابق پژوهش حاضر، می­تواند سبب تقویت انتخابی عضله پهن داخلی و کاهش ایمبالانس بین عضلات پهن داخلی و خارجی در بیماران مبتلا به سندروم فشار خارجی پاتلوفمورال گردد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of an Exercise Protocol Focusing on Vastus Medialis Activation on the Cross-Sectional Area and Electrical Activity of the Vastus Medialis and Vastus Lateralis

نویسندگان [English]

  • Seyyed Hossein Hosseini 1
  • Shahabeddin Bagheri 2
1 Assistant Professor of Sport Biomechanics, Department of Physical Education, University of Guilan, Iran
2 Assistant Professor of Corrective Exercises, Department of Physical Education, University of Nahavand, Nahavand, Iran
چکیده [English]

Background and Aims: In patients with lateral patellofemoral compression syndrome, the vastus medialis muscle is weaker than the vastus lateralis muscle. The purpose of the present study was to investigate the effect of an exercise protocol focusing on vastus medialis activation on the electrical activity and cross-sectional areas of the vastus medialis and vastus lateralis muscles.
Materials and Methods: In the current study, 30 females with lateral patellofemoral compression syndrome, aged 25.4±5.7, were selected and randomly divided into two groups. The experimental group participated in isokinetic knee extension exercises at terminal 30° extension arc with maximal external rotation of the leg for eight weeks. The control group did not participate in any regular exercise. Before and after the intervention, the cross sectional areas and electrical activities of the vastus medialis and vastus lateralis muscles were measured using ultrasonography and electromyography. Data were analyzed running independent and paired t-tests at the significance level of p < 0.05.
Results: There were no significant differences in any of the variables between the two groups before intervention (p < 0.05). But after the intervention, the vastus medialis/vastus lateralis activity and cross-sectional area ratio in the experimental group were found to be significantly higher than those of the control group (p < 0.001).
Conclusion: According to the results, using isokinetic knee extension exercises can selectively strengthen the vastus medialis muscle and reduce the imbalance between vastus medialis and lateralis muscles in patients with lateral patellofemoral compression syndrome.

کلیدواژه‌ها [English]

  • Muscular activation
  • Vastus medialis
  • Vastus lateralis
  • Cross sectional area
  • Electrical activity
  1. Cook C, Mabry L, Reiman MP, Hegedus EJ. Best tests/clinical findings for screening and diagnosis of patellofemoral pain syndrome: a systematic review. Physiotherapy 2012; 98: 93-100.##
  2. Saper, MG, Shneider DA. Diagnosis and Treatment of Lateral Patellar Compression Syndrome. Arthrosc Tech 2014; 3(5): e6war33–e638. ##
  3. Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013; 47(4):193-206. ##
  4. Petersen w, Ellermann A, Gösele-Koppenburg A, et al. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc 2014; 22(10): 2264–74. ##
  5. Fukuda TY, Rossetto FM, Magalhães E, Bryk FF. Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. Journal of orthopaedic & sports physical therapy 2010;40(11):736-42. ##
  6. Arnantha H, Robertson C, Killingback A, Adds PJ. Maintenance of exercise-induced changes in the architecture of the VMO: how much is enough? An in-vivo ultrasound study. Orthop Spine Sports Med 2017; 1(1): 1-7. ##
  7. Elniel AR, Robertson C, Killingback A and Adds PJ. Open-chain and closed-chain exercise regimes: an ultrasound investigation into the effects of exercise on the architecture of the vastus medialis oblique. Phys Ther Rehabil 2017; 4:3. ##
  8. Salari F, Anbarian M, Saleh AE, Sahebalzamani M. Effects of a resistance-training program on cross sectional areas of vastus medialis and vastus lateralis muscles in women with patellofemoral pain syndrome. Scientific Journal of Kurdistan University of Medical Sciences 2015; 20(2):32-9. ##
  9. Khoshkhoo M, Killingback A, Robertson CJ, Adds PJ. The effect of exercise on vastus medialis oblique muscle architecture: An ultrasound investigation. Clinical anatomy 2016; 29(6):752-8. ##
  10. Hoseini SH, Farahmand F, Seifi MM. Determining the Optimum Training Conditions for Selective Strengthening of Vastus Medialis Oblique Muscle over Vastus Lateralis through Using Musculoskeletal Modeling. Journal of Sport Biomechanics 2016; 2(2):65-76. ##
  11. Song, CY, and Jan, MH. Leg press exercises in patellofemoral pain- a one-year follow-up study. 27 International Conference on Biomechanics in Sports, Limerick, Ireland, August 2009; 17–21. ##
  12. Lin, Y.F., Lin, J.J., Cheng, C.K., Lin, D.H., & Jan, M.H. Association between sonographic morphology of vastus medialis obliquus and patellar alignment in patients with patellofemoral pain syndrome. Journal of Orthopaedic and Sports Physical Therapy 2008; 38: 196e202. ##
  13. Boling MC, Bolgla LA, Mattacola CG, Uhl TL, Hosey RG. Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome. Arch Phys Med Rehabil 2006; 87:1428-1435. ##
  14. Balcarek, P, Oberthür, S, Frosch, S, Schüttrumpf, JP, Stürmer, KM. Vastus Medialis Obliquus Muscle Morphology in Primary and Recurrent Lateral Patellar Instability. Biomed Res Int 2014; 326586. ##
  15. Travnik, L., Pernus, F., Erzen, I. Histochemical and mor­phometric characteristics of the normal human vastus medialis longus and vastus medialis oblique muscles. Journal of Anatomy 1995; 187: 403-411. ##
  16. Hedayatpour, N., & Falla, D. Non-uniform muscle adaptations to eccentric exercise and the implications for training and sport. Journal of Electromyography and Kinesiology 2012; 22: 329-333.
  17. Clarkson, P.M., & Hubal, M.J. Exercise-induced muscle damage in humans. American Journal of Physical Medicine and Rehabilitation 2002; 81: 52-69. ##
  18. Folland JP, Williams AG. The Adaptations to Strength Training Morphological and Neurological Contributions to Increased Strength. Sports Med 2007; 37(2): 145-168##
  19. Ward, S.R., Eng, C.M., Smallwood, L.H., & Lieber, R.L. Are current measurements of lower extremity muscle architecture accu­rate? Clinical Orthopaedics and Related Research 2009; 467: 1074-82. ##
  20. Seynnes, O.R., Boer, M., Narici, M.V. Early skeletal muscle hypertrophy and architectural changes in response to high-intensity resistance training. Journal of Applied Physiology 2007; 102: 368-373. ##
  21. Franke, RA, Baroni, BM, Rodrigues, R, Geremia, JM, Lanferdini, FJ. Neural and morphological adaptations of vastus lateralis and vastus medialis muscles to isokinetic eccentric training. 2014; 20(3): 317-324. ##
  22. Howatson, G., & Someren, K.A. The prevention and treatment of exercise-induced muscle damage. Sports Medicine 2008; 38: 483-503. ##
  23. Schoenfeld, B.J. The mechanisms of muscle hypertrophy and their application to resistance training. Journal of Strength and Conditioning Research 2010; 24: 2857-2872. ##
  24. Roig, M., O’Brien, K., Kirk, G., Murray, R., McKinnon, P., Shadgan, B. The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. British Journal of Sports Medicine 2009; 43: 556-68. ##
  25. Hilal Z, Robertson CJ, Killingback A, Philip A. The Effect of Exercise and Electrical Muscle Stimulation on the Architecture of the Vastus Medialis Oblique - The ‘Empi’ Electrotherapy System J Ortho & Sport Med. 2018; 1(1): 1-5. ##
  26. Wong YM, Chan ST, Tang KW, Ng GY. Two modes of weight training programs and patellar stabilization. J Athl Train 2009; 44:264–71. ##
  27. Serrão FV, Cabral CMN. Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press. Phys Ther in Sport 2005; 6(1): 15-23. ##
  28. Timm K.E. Postsurgical knee rehabilitation: A five year study of four methods and 5,381 patients. Am J Sports Med 1998; 16: 463-468. ##
  29. Spairani L, Barbero M, Cescon C, Combi F, Gemelli T, Giovanetti G. An electromyographic study of the vastii muscles during open and closed kinetic chain submaximal isometric exercises. Int J Sports Phys Ther 2012; 7:617-26. ##
  30. Mirzabeigi E, Jordan C, Gronley JK, Rockowitz NL, Perry J. Isolation of the vastus medialis oblique muscle during exercise. The American journal of sports medicine 1999; 27(1):50##
  31. Kushion, D., Rheaume, J. EMG Activation of the Vastus Medialis Oblique and Vastus Lateralis During Four Rehabilitative Exercises. The open rehabilitation Journal 2012; 5(1): 1-7. ##
  32. Balogun JA, Broderick K, Dolan-Aiello M. Comparison of EMG Activities in the Vastus Medialis Oblique and Vastus Lateralis Muscles During Hip Adduction and Terminal Knee Extension Exercise Protocols. AJPARS 2010; 2(1): 1-5. ##
  33. Livecchi, NM, Armstrong, CW, Cordova, ML, Merrick, MA, Rankin, JM. Vastus Lateralis and Vastus Medialis Obliquus Activity During a Straight-Leg Raise and Knee Extension With Lateral Hip Rotation. J Sport Rehabil 2002; 11:120-126. ##
  34. Peng, H.T., Kernozek, T.W., Song, C.Y. Muscle activation of vastus medialis obliquus and vastus lateralis during a dynamic leg press exercise with and without isometric hip adduction. Physical Therapy in Sport 2013; 14(1): 44-49. ##
  35. Coqueiro KRR, Bevilaqua-Grossi D, Berzin F, Soares AB. Analysis on the activation of the VMO and VLL muscles during semisquat exercises with and without hip adduction in individuals with patellofemoral pain syndrome. J Electromyogr Kinesiol 2005; 15: 596–603##
  36. Vicente SA, Carolina AC, Jaime MPP, Carlos MA, Entrique C. Anterior Knee Pain and Patellar Instability. 2nd edition, Chapter 6: Biomechanical bases for anterior knee pain and patellar instability, Springer 2011; 69-87. ##
  37. Irish SE, Millward AJ. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. JSCR 2010; 24(5): 1256-1262.
  38. Willis FB, Burkhardt EJ. Preferential vastus medialis oblique activation achieved as a treatment for knee disorders. JSCR 2005; 19(2): 286-291. ##
  39. Park, S, Ko, YM, Jang, GU, Hwang, YT, Park, JW. A Study on the Differences of Quadriceps Femoris Activities by Knee Alignment during Isometric Contraction. J. Phys. Ther. Sci 2014; 26: 1685–1688. ##
  40. Duffell LD, Dharni H, Strutton PH. Electromyographic activity of the quadriceps components during the final degrees of knee extension. J Back Musculoskeletal Rehabil 2011; 24: 215–223. ##