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Background Patients with patellofemoral pain syndrome show weakness of the vastus medialis oblique(VMO) and gluteus maximus (GMax) muscles. Closed chain exercises, such as squats, are more effective in a knee injury rehabilitation program than open chain exercises. Squat exercise accompanied by upper limb movements can selectively activate the VMO and GMax, and it is necessary to determine which loaded shoulder movements are more effective. Objectives The purpose of this study was to compare the VMO, VL, and GMax muscles activities during a squat exercise with shoulder horizontal abduction (SHA) and scapular plane abduction (SPA) using an elastic tubing band. Methods Seventeen female adults participated in this study. The subjects were trained to familiarize themselves with the measurement process in advance for 10 minutes before measuring. During squat exercise with loaded shoulder movements, the VMO, VL and GMax muscle activities were measured through electromyography (EMG). Data were analyzed by one-way repeated-measures analysis of variance, and a Bonferroni adjustment was performed if a significant difference was found. Statistical significance levels were set at α = 0.05. Results Muscle activities of the VMO, VL and GMax have significantly differed among loaded shoulder movements (without tubing band (WT), SHA, SPA). In addition, the muscle activity of all muscles was higher in SHA than in WT, and higher in SPA than in WT. VMO/VL Ratio was significantly increased during squat exercise with SHA movement. Conclusions Our results indicate that squat exercises with loaded shoulder movements were more effective in the VMO and GMax muscle activity compared to squat exercises without upper limb movements. These findings support that additional loaded shoulder movement is a more effective strategy to facilitate the VMO and GMax muscle activation during a squat exercise.
Park et al. (Sun,) studied this question.