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J Athl Train. 1999 Oct-Dec; 34(4): 342–346.
PMCID: PMC1323342

The Effect of Hip Position and Electromyographic Biofeedback Training on the Vastus Medialis Oblique: Vastus Lateralis Ratio

Christina D. Davlin, MS, ATC,* William R. Holcomb, PhD, ATC, CSCS, and Mark A. Guadagnoli, PhD

Abstract

Objective:

Patellofemoral pain syndrome is a patellar tracking dysfunction usually associated with vastus medialis oblique (VMO) weakness, and subsequently, a small VMO: vastus lateralis (VL) ratio. Several early electromyographic (EMG) studies have defined specific limb positions (such as external rotation of the hip) that preferentially activate the VMO. However, whether preferential activation of the VMO successfully translates into increased VMO:VL ratios with training has not been investigated. The purpose of our study was to investigate the effects of hip rotation on the mean VMO:VL EMG ratio using EMG biofeedback training over a 5-day period.

Design and Setting:

Subjects performed isometric quadriceps contractions, in terminal extension, in 1 of 3 hip positions: the anatomically neutral hip position (group A), external hip rotation (group B), and internal hip rotation (group C). Pretest to posttest data were analyzed with a 3 (group) × 2 (test) analysis of variance with repeated measures on the last factor.

Subjects:

Thirty-six healthy female college students with no known right knee musculoskeletal dysfunction.

Measurements:

Activity of the VMO and VL was recorded by EMG and reported as the VMO:VL ratio.

Results:

The main effect for group was not significant, but the main effect for test was significant. No significant interaction between group and test was noted.

Conclusions:

The statistical analysis of our results suggests that hip position during EMG biofeedback training has no effect on the VMO:VL ratio. However, because subjects were able to significantly increase their VMO:VL ratio in 5 days regardless of hip position, EMG biofeedback can be recommended for the facilitation of VMO muscular recruitment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • DeHaven KE, Lintner DM. Athletic injuries: comparison by age, sport, and gender. Am J Sports Med. 1986 May-Jun;14(3):218–224. [PubMed]
  • Fox TA. Dysplasia of the quadriceps mechanism: hypoplasia of the vastus medialis muscle as related to the hypermobile patella syndrome. Surg Clin North Am. 1975 Feb;55(1):199–226. [PubMed]
  • Grabiner MD, Koh TJ, Draganich LF. Neuromechanics of the patellofemoral joint. Med Sci Sports Exerc. 1994 Jan;26(1):10–21. [PubMed]
  • Steadman JR. Nonoperative measures for patellofemoral problems. Am J Sports Med. 1979 Nov-Dec;7(6):374–375. [PubMed]
  • Boucher JP, King MA, Lefebvre R, Pépin A. Quadriceps femoris muscle activity in patellofemoral pain syndrome. Am J Sports Med. 1992 Sep-Oct;20(5):527–532. [PubMed]
  • Souza DR, Gross MT. Comparison of vastus medialis obliquus: vastus lateralis muscle integrated electromyographic ratios between healthy subjects and patients with patellofemoral pain. Phys Ther. 1991 Apr;71(4):310–320. [PubMed]
  • Lieb FJ, Perry J. Quadriceps function. An anatomical and mechanical study using amputated limbs. J Bone Joint Surg Am. 1968 Dec;50(8):1535–1548. [PubMed]
  • Mariani PP, Caruso I. An electromyographic investigation of subluxation of the patella. J Bone Joint Surg Br. 1979 May;61-B(2):169–171. [PubMed]
  • Insall J. Current Concepts Review: patellar pain. J Bone Joint Surg Am. 1982 Jan;64(1):147–152. [PubMed]
  • LeVeau BF, Rogers C. Selective training of the vastus medialis muscle using EMG biofeedback. Phys Ther. 1980 Nov;60(11):1410–1415. [PubMed]
  • Lieb FJ, Perry J. Quadriceps function. An electromyographic study under isometric conditions. J Bone Joint Surg Am. 1971 Jun;53(4):749–758. [PubMed]
  • WHEATLEY MD, JAHNKE WD. Electromyographic study of the superficial thigh and hip muscles in normal individuals. Arch Phys Med Rehabil. 1951 Aug;32(8):508–515. [PubMed]
  • Cerny K. Vastus medialis oblique/vastus lateralis muscle activity ratios for selected exercises in persons with and without patellofemoral pain syndrome. Phys Ther. 1995 Aug;75(8):672–683. [PubMed]
  • Karst GM, Jewett PD. Electromyographic analysis of exercises proposed for differential activation of medial and lateral quadriceps femoris muscle components. Phys Ther. 1993 May;73(5):286–299. [PubMed]
  • Wild JJ, Jr, Franklin TD, Woods GW. Patellar pain and quadriceps rehabilitation. An EMG study. Am J Sports Med. 1982 Jan-Feb;10(1):12–15. [PubMed]
  • DeVries HA. Method for evaluation of muscle fatigue and endurance from electromyographic fatigue curves. Am J Phys Med. 1968 Jun;47(3):125–135. [PubMed]
  • Fridlund AJ, Cacioppo JT. Guidelines for human electromyographic research. Psychophysiology. 1986 Sep;23(5):567–589. [PubMed]
  • Graham GP. Reliability of electromyographic measurements after surface electrode removal and replacement. Percept Mot Skills. 1979 Aug;49(1):215–218. [PubMed]
  • Kramer H, Bräuer D, Küchler G. Uber die Zuverlässigkeit elektromyographischer Messungen mittels Oberflächenelektroden. Acta Biol Med Ger. 1972;29(3):381–388. [PubMed]
  • Ingersoll CD, Knight KL. Patellar location changes following EMG biofeedback or progressive resistive exercises. Med Sci Sports Exerc. 1991 Oct;23(10):1122–1127. [PubMed]
  • Colborne GR, Olney SJ. Feedback of joint angle and EMG in gait of able-bodied subjects. Arch Phys Med Rehabil. 1990 Jun;71(7):478–483. [PubMed]
  • Koga S. Acquisition of self-control of a novel muscular activity with EMG and video feedback. Percept Mot Skills. 1989 Aug;69(1):19–26. [PubMed]
  • Sabourin M, Rioux S. Effects of active and passive EMG biofeedback training on performance of motor and cognitive tasks. Percept Mot Skills. 1979 Dec;49(3):831–835. [PubMed]
  • Leroux A, Boucher JP, Poumarat G. Investigation of quadriceps femoris function through electrical stimulation. J Athl Train. 1997 Apr;32(2):115–118. [PMC free article] [PubMed]

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