PROPOSAL

The effects of spinal manipulation at L3/ L4 level on active electromyographic activity of the ipsilateral Vastus medialis Obliques

[Name of the Institute]

Table of Contents

CHAPTER 1: INTRODUCTION3

Background5

Aims and Objectives8

CHAPTER 2: LITERATURE REVIEW9

Comparison vastus medialis and vastus laterals9

Related Research10

Vastus lateralis muscle and portions11

Why is VMO so Important?11

The effects of SM L/S on the corticospinal and spinal reflex12

Anatomy of the knee16

Electromyography (EMG)17

Isokinetic Dynamometer18

Gravitational Effect on Isokinetic Movements20

Hip and Vasti Activation in the Management of Pfps21

Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique23

CHAPTER 3: MATERIALS AND METHODS25

Methods25

Procedures26

Experimental protocol27

Experimental setup28

Surface EMG detection28

Signal processing29

Statistical processing30

Osteoarthritis of the knee33

REFERENCES35

The effects of spinal manipulation at L3/ L4 level on active electromyographic activity of the ipsilateral Vastus medialis Obliques

CHAPTER 1: INTRODUCTION

The quadriceps is comprised of four muscles; each with different responsibilities to assist in the function of the knee. The four muscles are the vastus medalis oblique (VMO), vastus intermedius, vastus lateralis, and rectus femoris. The vastus medialis is made up of two parts: the distal portion is the VMO and the proximal portion is the vastus medialis oblique longus (VML). The primary movement of the quadriceps is extension of the knee in the sagittal plane. The rectus femoris extends the knee and assists in hip flexion. The VML contributes to extension of the knee while the VMO provides medial stabilization of the patella. The four muscles of the quadriceps work together to track the patella. Of the four muscles, the VMO has received the most attention in the literature.

In addition to the fibers positioned in an oblique direction, there is controversy as to whether the VMO is separate from the vastus medialis longus. Some researchers report that the VMO has two separate sections; proximal and distal, as well as its own nerve supply.

The proximal portion would assist with knee extension and the distal portion with patellar tracking.[6] Herrington et al. stated patellar tracking is an alteration in the timing of the vastus lateralis and vastus medialis oblique; in individuals with normal tracking the vastus medialis oblique (VMO) fires first. Therefore, if the VMO is weak other problems may develop. In order to strengthen the VMO, the patient should perform exercises that recruit more muscle fibers of the area. According to Prentice there are three ways in which resistance training will increase neuromuscular efficiency: increase the number of motor units being recruited, increase the firing rate of each motor unit, and the synchronization of motor unit firing.

These changes have been demonstrated to reflect muscle properties and fiber constituency and recruitment strategies [1], and have been applied in several fields such as ergonomics, back analysis, and dentistry [13]. Studies have been performed during isometric constant force contractions as well as during isometric ramp and stepwise contractions using surface electrodes [4] as well as intramuscular wires [6]. Assessment of the repeatability of EMG variables is of considerable relevance for the clinical daily use of such a technique. A validation of the technique is necessary to assure that data recorded in different ...