【論文摘要】Different Biofeedback Cues Applying in Ergometer Cycling Exercise for Selective Muscle Activation of the Knee Joint

【論文摘要】不同生物回饋方式輔助腳踏車運動應用於膝關節肌肉再教育

Huynh Chung ； 陳立慈(Li-Tzu Chen) ； 黃映琦(Ying-Chi Huang) ； 林秀真(Hsiu-Chen Lin)

《物理治療》 43卷2期 (2018/06) Pp. 135-136

https://doi.org/10.6215/FJPT.2018.75.O21

摘要

Background and Purpose: Quadriceps weakness is one of the impairment causing disability in people with knee osteoarthritis (OA). In healthy knees, the quadriceps muscle is a primary contributor to the joint stability and provides shock absorption during locomotion. Studies showed a reduction in thigh muscle strength is association with knee pain while the increased vastus medialis (VM) size is related to reduced pain, cartilage loss, and joint replacement risk. Therefore, adequate therapy of the VM muscle strength is required in the management of knee OA. Cycling exercise allows people to work on muscle strength and lower extremity mobility while exert a smaller load on lower extremity joints compared to walking or jogging. However, it is still not clear if cycling with difference biofeedback cues will be effective for muscle re-education of the knee joint. This study aimed to evaluate the effect of providing visual feedback of the knee positions in frontal plane or realtime electromyography (EMG) biofeedback on VM activities in healthy subjects during cycling. Methods: Thirty healthy adults were included to conduct two experiences, one week apart. In the first experiment, the participants respectively performed 2-minute cycling in four conditions of hip frontal angles that were neutral, adducted, abducted hip positions, neutral hip combining adduction resistance from Thera band (Thera-band®, Hygenic Corp., Akron, OH, USA) and one condition of EMG biofeedback, 5 minutes apart. In the second one, they were randomized assigned to a 30-minute session of cycling combining with EMG biofeedback or without biofeedback (control group). The outcomes were VM activities and knee frontal-angles. Results: In the first experiment, there was no significant difference in the VM activities on the bike among different conditions of hip joint or EMG biofeedback during 2-minute bike (p ＞ 0.05). In the second one, the VM activities of the EMG biofeedback group was statistically higher than that of control group during the first twenty minutes of the cycling exercise (p ＜ 0.05). No significant differences were found in the VM activities during the last ten minutes (p ＞ 0.05) either in the knee frontal-angle (p ＞ 0.05). Conclusion: This result showed that combining EMG biofeedback is an effective method to increase the activity of VM during cycling exercise in healthy subjects when compared to cycling without any biofeedback. Clinical Relevance: The study helps to understand the roles of real-time biofeedback on the muscle activations and the kinematics of the knee joint during cycling. Additionally, a more efficient stationary cycling exercise program could be expected to reduce disability for the patient with knee pathologies.