Download 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).
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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.