DOI QR코드

DOI QR Code

Effects of Closed and Open Kinetic Chain Exercises on Knee Extensor Strength and Balance in Patients with Early Stroke

닫힌사슬운동과 열린사슬운동이 초기 뇌졸중환자의 무릎신전근 근력과 균형에 미치는 영향

  • Kwon, O-Kook (Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University) ;
  • Shin, Won-Seob (Department of Physical Therapy, College of Natural Science, Daejeon University)
  • 권오국 (대전대학교 보건의료대학원 물리치료학과) ;
  • 신원섭 (대전대학교 자연과학대학 물리치료학과)
  • Received : 2014.03.30
  • Accepted : 2014.05.21
  • Published : 2014.05.31

Abstract

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

Keywords

References

  1. Ada L, Dorsch S, Canning CG. Strengthening Interventions Increase Strength and Improve Activity After Stroke: a systematic review. Aust J Physiother. 2006;52(4): 241-8. https://doi.org/10.1016/S0004-9514(06)70003-4
  2. Augustsson J, Esko A, Thomee R, et al. Weight training of the thigh muscles using closed vs. open kinetic chain exercises: a comparison of performance enhancement. J Orthop Sports Phys Ther. 1998 Jan;27(1):3-8. https://doi.org/10.2519/jospt.1998.27.1.3
  3. Blackburn JR, Morrissey MC. The Relationship Between Open and Closed Kinetic Chain Strength of the Lower Limb and Jumping Performance. J Orthop Sports Phys Ther. 1998;27(6):430-5. https://doi.org/10.2519/jospt.1998.27.6.430
  4. Bohannon RW. Muscle Strength and Muscle Training After Stroke. J Rehabil Med. 2007;39(1):14-20. https://doi.org/10.2340/16501977-0018
  5. Braun SM, Beurskens AJ, van Kroonenburgh SM, et al. Effects of Mental Practice Embedded in Daily Therapy Compared to Therapy as Usual in Adult Stroke Patients in Dutch Nursing Homes: Design of a Randomised Controlled Trial. BMC Neurol. 2007;15(7):34.
  6. Canning CG, Ada L, Adams R, et al. Loss of Strength Contributes More to Physical Disability After Stroke than Loss of Dexterity. Clin Rehabil. 2004;18(3):300-8. https://doi.org/10.1191/0269215504cr715oa
  7. Carson RG. Neural Pathways Mediating Bilateral Interactions Between the Upper Limbs. Brain Res Brain Res Rev. 2005;49(3):641-62. https://doi.org/10.1016/j.brainresrev.2005.03.005
  8. Cho JH, Jung SB. Electromyographic Analysis of Isotonic Closed and Open Kinetic Chain Exercises. The Korean journal of physical education. 2001;40(4):633-43.
  9. Choi SS. The Effect of Dual Tasks on Gait and Static Standing in Stroke Patients. Daegu university. Dissertation of Master's Degree. 2009.
  10. Clark DJ, Condliffe EG, Patten C. Reliability of Concentric and Eccentric Torque During Isokinetic Knee Extension in Post-Stroke Hemiparesis. Clin Biomech (Bristol, Avon). 2006;21(4):395-404. https://doi.org/10.1016/j.clinbiomech.2005.11.004
  11. de Haart M, Geurts AC, Huidekoper SC, et al. Recovery of Standing Balance in Post Acute Stroke Patients: a Rehabilitation Cohort Study. Arch Phys Med Rehabil. 2004;85(6):886-95. https://doi.org/10.1016/j.apmr.2003.05.012
  12. Duncan PW, Studenski S, Chandler J, et al. Functional Reach: Predictive Validity in a Sample of Elderly Male Veterans. J Gerontol. 1992;47(3):M93-8. https://doi.org/10.1093/geronj/47.3.M93
  13. Flansbjer UB, Downham D, Lexell J. Knee Muscle Strength, Gait Performance, and Perceived Participation After Stroke. Arch Phys Med Rehabil. 2006;87(7):974-80. https://doi.org/10.1016/j.apmr.2006.03.008
  14. Han SW. A SEMG Analysis of Knee Joint Angle During Close Kinetic Chain Exercise and Open Kinetic Chain Exercises in Quadriceps Muscle. J Korean Soc Phys Ther. 2004;16(3):192-204.
  15. Heller BM, Pincivero DM. The Effects of ACL Injury on Lower Extremity Activation During Closed Kinetic Chain Exercise. J Sports Med Phys Fitness. 2003;43(2):180-8.
  16. Iwasaki T, Shiba N, Matsuse H, et al. Improvement in Knee Extension Strength Through Training by Means of Combined Electrical Stimulation and Voluntary Muscle Contraction. Tohoku J Exp Med. 2006;209(1): 33-40. https://doi.org/10.1620/tjem.209.33
  17. Karandikar N, Vargas OO. Kinetic Chains: a Review of the Concept and its Dlinical Applications. Am J Phys Med Rehabil. 2011;3(8):739-45.
  18. Kim YJ, Kim TY, Oh DW. The Effects of Closed Kinetic Chain Exercise and Open Kinetic Chain Exercise in Improving the Balance of Patients with Hemiplegia. Korean J Orthop Manu Ther. 2009;15(1):22-31.
  19. Kwon SB, Lee HO. Effect of Closed and Open Kinetic Chain Exercise After Cruciate Ligament Reconstruction. J Korean Soc Phys Ther. 2005;17(3):297-310.
  20. Kwon YJ, Bae SS, Park SJ. The Effect of Static Balance Recovery by Open Kinetic Chain and Closed Kinetic Chain Exercises. J Korean Soc Phys Med. 2009;4(1):23-30.
  21. Kwon YJ, Park SJ, Jefferson J, et al. The Effect of Open and Closed Kinetic Chain exercises on Dynamic balance Ability of Normal Healthy Adults. J Phys Ther Sci. 2013;25(6):671-4. https://doi.org/10.1589/jpts.25.671
  22. Lee JH, Kim SB, Lee KW, et al. The Effect of Prolonged in Patient Rehabilitation Therapy in Subacute Stroke Patients. Ann Rehabil Med. 2012;36(1):16-21. https://doi.org/10.5535/arm.2012.36.1.16
  23. Lee NK. The Effects of Closed and Open Kinetic Chain Exercises on Lower Limb Muscle Activity, Balance and Gait in Stroke Patients. Daegu university. Dissertation of Master's Degree. 2011.
  24. Liepert J, Bauder H, Wolfgang HR, et al. Treatment-Induced Cortical Reorganization After Stroke in Humans. Stroke. 2000;31(6):1210-6. https://doi.org/10.1161/01.STR.31.6.1210
  25. Lomaglio MJ, Eng JJ. Muscle Strength and Weight-Bearing Symmetry Relate to Sit-to-Stand Performance in Individuals with Stroke. Gait Posture. 2005;22(2): 126-31. https://doi.org/10.1016/j.gaitpost.2004.08.002
  26. Moxley Scarborough D, Krebs DE, Harris BA. Quadriceps Muscle Strength and Dynamic Stability in Elderly Persons. Gait Posture. 1999;10(1):10-20. https://doi.org/10.1016/S0966-6362(99)00018-1
  27. Ouellette MM, LeBrasseur NK, Bean JF, et al. High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors. Stroke. 2004;35(6):1404-9. https://doi.org/10.1161/01.STR.0000127785.73065.34
  28. Podsiadlo D, Richardson S. The Timed "Up & Go”: a Test of Basic Functional Mobility for Frail Elderly Persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  29. Salbach NM, Mayo NE, Wood-Dauphinee S, et al. A Task-Orientated Intervention Enhances Walking Distance and Speed in the First Tear Post Stroke: a Randomized Controlled Trial. Clin Rehabil. 2004;18(5):509-19. https://doi.org/10.1191/0269215504cr763oa
  30. Shechtman O, Davenport R, Malcolm M, et al. Reliability and Validity of the BTE-Primus Grip Tool. J Hand Ther. 2003;16(1):36-42. https://doi.org/10.1016/S0894-1130(03)80022-4
  31. Sim YB. The Effect of Arm Sling on Balance and Gait Speed in Patients with Hemiplegia. Gachon university. Dissertation of Master's Degree. 2011.
  32. Tagesson S, Oberg B, Good L, et al. A Comprehensive Rehabilitation Program with Quadriceps Strengthening in Closed Versus Open Kinetic Chain Exercise in Patients with Anterior Cruciate Ligament Deficiency: a Randomized Clinical Trial Evaluating Dynamic Tibial Translation and Muscle Function. Am J Sports Med. 2008;36(2):298-307. https://doi.org/10.1177/0363546507307867
  33. Tyson SF, DeSouza LH. Reliability and Validity of Functional Balance Tests Post Stroke. Clin Rehabil. 2004;18(8): 916-23. https://doi.org/10.1191/0269215504cr821oa
  34. Wade DT, Wood VA, Hewer RL. Recovery After Stroke the First 3 Months. J Neurol Neurosurg Psychiatry. 1985;48(1):7-13. https://doi.org/10.1136/jnnp.48.1.7

Cited by

  1. A Comparison of Vastus Medialis Oblique and Vastus Lateralis Electromyography Activities According to Different Tibial Rotation Taping Methods in Healthy People vol.13, pp.2, 2018, https://doi.org/10.13066/kspm.2018.13.2.33
  2. Effects of Ankle Joint Position during Closed Kinetic Chain Exercise on Strength and Balance in Chronic Stroke vol.27, pp.5, 2014, https://doi.org/10.18857/jkpt.2015.27.5.345
  3. 런지 동작 시 발 위치의 앞뒤 간격에 따른 하지 근위부 근육의 근 활성도 비교 vol.13, pp.4, 2014, https://doi.org/10.13066/kspm.2018.13.4.131