Ascending Stairs vs. Stair Stepper Machine With and Without a Load
Transcription
Ascending Stairs vs. Stair Stepper Machine With and Without a Load
Quadricep EMG Analysis: Ascending Stairs vs. Stair Stepper Machine With and Without a Load Hannah Burnette, SPT, Laurice Morton, SPT, Molly Nuss, SPT, Cindy LaPorte, PT, PhD, Barney LeVeau, PT, PhD Department of Physical Therapy, Alabama State University, Montgomery, AL Background Methods A common activity of daily living (ADL) for community dwelling individuals is to negotiate stairs entering their home. Grocery shopping is also a common ADL. A purpose of physical therapy is to prepare individuals to return to their role as community dwellers as well as to complete necessary ADL. Stepper machines are frequently used in physical therapy practice for lower extremity conditioning and rehabilitation. 1 Surface electrode electromyography (EMG) is a common method used to record the magnitude of muscle activity.4 Surface EMG has been found to be valid and reliable. 2 The participant was asked to walk a straight line; the leg used for step off was used as the testing leg.3 Surface EMG was used to record the activity of the vastus medialis (VM), rectus femoris (RF), and vastus lateralis (VL) muscles during negotiation of stairs as well as using a stepper machine with and without carrying a load. Subjects drew a colored marble to determine if they would begin on the stairs or stepper machine. The subjects were asked on either task to perform the first trail unloaded and to carry a load for the second trail. Subjects were not allowed to use the handrails for the stairs or stepper unless needed for safety. On the stairs, the subjects used the reciprocal gait pattern. Instructions were read before each activity, a demonstration performed, and then the participants completed the task. A metronome was set at 100 beats per minute to standardize the pace of the activities. Purpose Results Discussion/Conclusion The ANOVA for each muscle determined that there was no statistical difference found for the VM, RF, and VL muscle activity between the stepper loaded (SL) compared to the stepper unloaded (SUL) (P>0.05). The stepper machine has no descending component; therefore we could not compare descending stairs to the stepper machine. The activity of ascending stairs compared to the stepper machine loaded and unloaded showed no statistical difference (P>0.05). No statistical difference was found between ascending stairs unloaded (AUL) vs. ascending stairs loaded (AL) as well as between descending stairs unloaded (DUL) vs. descending stairs loaded (DL) (P>0.05). The results suggest that there is no significant difference in muscle activity when ascending stairs and when using the stepper machine; also, carrying a load while negotiating stairs or while using the stepper machine showed no difference in muscle activity. Since no difference was found, was the load great enough to challenge the muscles? Eccentric muscle activity during descending stairs may be the reason for the difference. Even though there was no significant difference between the muscle activities with each exercise, this suggests that stairs can be used as an efficient and effective tool for all therapeutic settings to improve muscle activity in the quadriceps. Clinical Relevance The purpose of this study is to determine if the stepper machine is an appropriate exercise device to use in physical therapy to prepare individuals for the functional activity of negotiating stairs. Also, to determine if carrying a load of 10 pounds, which represents the weight of groceries, has an effect on muscle activity while negotiating stairs. If so, is the stepper appropriate to prepare individuals for the functional activity of negotiating stairs while carrying groceries? •Stairs are an efficient therapeutic tool to use in any physical therapy setting. •The stairs involve both ascending and descending components that challenge the muscles both concentrically and eccentrically. •The expense and lack of availability of a stepper machine in a home health or rural setting makes the stairs an ideal tool for physical therapy. References Subjects Twenty volunteer subjects (10 males and 10 females) with no pathological conditions related to balance, human locomotion, or any cardiopulmonary dysfunctions participated in this study. The participants were between the ages of 23 and 30 (mean age=24.75, SD=1.8). 1. Cook TM, Zimmermann CL, Lux KM, Neubrand CM, Nicholson TD. EMG Comparison of Lateral Step-Up and Stepping Machine Exercise. Journal of Orthopedic and Sports Physical Therapy. 1992; 16(3):108-113. 2. Mathur S, Eng JJ, MacIntyre. Reliability of surface EMG during sustained contractions of the quadriceps. Journal of Eletromyography and Kinesiology. 2005;15:102-110. 3. Sadegi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: a review. Gait and Posture. 2000;12:34-45. 4. Zhang Q, G.Y.F. N. EMG Analysis of Vastus Medialis Obliquus/Vastus Lateralis Activities in Subjects with Patellofemoral Pain Syndrome before and after Home Exercise Program. Journal of Physical Therapy Science. 2007;17:131-137.