• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.1
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• pp.39-47
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• 2013

Objectives : The purpose of this study is to find out the relationship between hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD) in single-segment. Methods : We investigated 314 patients (158 male, 156 female) who were diagnosed as herniation of lumbar intervertebral disc(HIVD) in single-segment. We measured 314 patients' hip internal rotation angle and analysed the relationship between the hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD). Results : 1. Among 314 cases, the hip internal rotation angle was different between male and female. Hip internal rotation angle of male was mainly limited and that of female was mainly excessive. 2. Among 314 cases, the normal group, defined as patients who have specific range of hip internal rotation angle(male : $35^{\circ}{\pm}10^{\circ}$, female : $45^{\circ}{\pm}10^{\circ}$), tends to be occurred HIVD at L4/5 level. The limited group, defined as patients who have less angle than normal group, the excessive group, defined as patients who have more angle than normal group, and the complex group, defined as patients who have more angle of one leg and less angle of the other leg than normal group, tend to be occurred HIVD at L5/S1 level(p<0.05). Conclusions : In single-segment lumbar HIVD patients, The normal hip internal rotation angle mainly leads to L4/5 HIVD, while the limited and excessive hip internal rotation angle mainly lead to L5/S1 HIVD.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.1
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• pp.15-21
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• 2014

Purpose : The aim of this study was to find out differences between muscle activity of quadriceps according to hip angle. Method : 40 healthy adults produced maximum isometric muscle contraction of quadriceps femoris and each part of the quadriceps femoris were measured with a surface EMG in hip joint angle of $90^{\circ}$, $135^{\circ}$, $180^{\circ}$. Result : There was no significant difference between muscle activity of vastus medialis and lateralis according to hip angle. But there was significant difference in muscle activity of rectus femoris and the muscle activity was maximum at 135 degrees of hip angle. Conclusion : In conclusion, maximum muscle activation of rectus femoris is affected by hip angle, and the findings from this study may be helpful for physical therapists in selecting hip position when instructing patients to do Q-setting exercise. So, we suggest that patients perform Q-setting exercise at 135 degrees of hip angle for the best result.

• Physical Therapy Korea
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• v.17 no.2
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• pp.43-50
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• 2010

The purpose of this study was to investigate the effects of Evjenth-Hamberg stretching on the active range of motion (ROM) of the hip joint and the pennation angle of the semitendinosus muscle. Eighty healthy adults participated in this study. The active ROM of the hip joint was measured by a goniometer and the pennation angle of the semitendinosus muscle was measured by ultrasonographic imaging (USI). Both ROM and pennation angle were recorded before and after the static stretching and the Evjenth-Hamberg stretching, respectively. Data were analyzed using paired t-lest and independent t-test at p<.05. The results were as follows: 1) The active ROM of the hip joint increased significantly after both stretching interventions compared with the baseline (p<.001). However, the active ROM of the hip joint increased significantly in Evjenth-Hamberg stretching compared with static stretching. 2) The pennation angle decreased significantly after both stretching interventions compared with the baseline (p<.001). However, the pennation angle decreased significantly in Evjenth-Hamberg stretching compared with static stretching. 3) Reliability data showed that there was a high consistency in USl measurements (ICC=.978). Our findings suggest that the Evjenth-Hamberg stretching was more effective than static stretching in increasing the active ROM of the hip joint and decreasing the pennation angle of the semitendinosus muscle.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.23-28
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• 2018

Purpose: This study examined the effectiveness of iliopsoas self-stretching on the hip extension angle, gluteus maximus (GM) activity, and pelvic compensated angle during prone hip extension (PHE) in subjects with iliopsoas shortness. Methods: Twenty-healthy subjects with iliopsoas shortness were recruited. Electromyography (EMG) was used to examine erector spinae (ES), multifidus (MF), GM, and biceps femoris (BF) while performing PHE. An electromagnetic tracking motion analysis device was used to measure the pelvic compensations. The pelvic compensations while performing PHE were considered to be anterior tilting and rotation. A modified Thomas test was used to monitor the hip extension angle before and after iliopsoas self-stretching. A paired t-test was used to investigate the significant difference after iliopsoas self-stretching during PHE. The level of statistical significance was set to ${\alpha}=0.05$. Results: Muscle activity of GM and hip extension angle were significantly greater after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). BF and pelvic rotation angle were significantly lower after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). The muscle activity of ES was not significantly different between PHE before and after iliopsoas self-stretching (p>0.05). Conclusion: Iliopsoas self-stretching can be effective in selectively strengthening the GM muscles with minimized pelvic compensation in subjects with iliopsoas shortness.

• Physical Therapy Korea
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• v.25 no.4
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• pp.19-26
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• 2018

Background: Alignment of the lower limb is an important factor, influencing balance and gait in kinematics and kinetics, in patients with and without a flat arched foot. Flat arched foot are associated with the range of motion (ROM) of the hip and alignments of the knee joints, is strongly influenced. Objects: The purpose of this research was to investigate the relationship between hip joint ROM and quadriceps angle (Q-angle), by dividing them into two groups according to the presence or absence of flat feet, using a navicular drop test (NDT) and resting calcaneal stance position (RCSP). Methods: Forty elderly patients were allocated to the experimental group (flat foot group, n1=20) or the control group (non-flat group, n2=20). Universal and digital goniometer, tractograph and tape measure were used to determine the related changes in the hip ROM, Q-angle, NDT and RCSP. Results: Data were analyzed using the Pearson correlation coefficients. Active internal ROM of the hip joint (right, r=.803, p<.001), (left, r=.951, p<.001) were highly correlated with NDT, and also, was moderately correlated with Q-angle (right, r=.562, p=.019), (left, r=.757, p<.001). Passive internal ROM of the hip joint (right, r=.742, p=.001), (left, r=.922, p<.001) were highly correlated with NDT, and also, was moderately correlated with RCSP (right, r=-.530, p=.029) and with Q-angle (right, r=.710, p=.001), (left, r=.698, p=.002) in the flat foot group. However, no strong correlation among the hip ROM, NDT, RCSP and Q-angle were found in the non-flat foot group. Conclusion: This research may provide evidence of the correlations between hip internal ROM and flat foot.

• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.241-245
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• 2017

Purpose: This study examined the hip and lumbopelvic movement while the hip was rotating laterally in individuals with chronic low back pain (CLBP). Methods: Sixty healthy subjects and sixty subjects with CLBP were enrolled in this study. Myomotion (Myomotion research pro, Noraxon Inc., German) was used to measure the hip lateral rotation and the lumbopelvic movement. An independent t-test was used to compare the hip lateral rotation and lumbopelvic rotation between the groups. Results: Between healthy males and females, healthy females showed a smaller hip lateral rotation angle (HLRA) than healthy males in the hip lateral rotation test (HLRT). Between the healthy females and females with CLBP, the females with CLBP showed a smaller HLRA and greater lumbopelvic motion than the healthy females in the HLRT, and their lumbopelvic motions occurred earlier during lateral rotation of the hip. Finally, between the males and females with CLBP, the females with CLBP showed a smaller HLRA and greater lumbopelvic motion in the HLRT, and their lumbopelvic motions occurred earlier during lateral rotation of the hip. Conclusion: The results of this study suggest that the CLBP affected the hip lateral rotation, and the lumbopelvic movement depended on gender. In particular, compared to the other groups, the females with CLBP showed a larger lumbopelvic rotation angle and smaller hip lateral rotation angle and lumbopelvic motion occurred early during lateral rotation of the hip.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.115-122
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• 2018

The success of the total hip arthroplasty is revealed as initial stability, range of motion, and long term pain, etc. Depending upon choice of implantation options such as femoral neck offset, diameter of the femoral head, the lateral opening tilt. Especially the impingement between femoral head component and acetabular cup limits the range of motion of the hip. In this sense, estimation or evaluation of the range of motion before and after the total hip arthroplasty is important. This study provides the details of a computer simulation technique for the hip range of motion of intact hip as well as arthroplasty. The suggested method defines the hip rotation center and rotation axes for flexion and abduction, respectively. The simulation uses CT-based reconstructed 3D models and an STL treating software. The abduction angle of the hip is defined as the superolateral rotation angle from sagittal plane. The flexion angle of the hip is defined as the superoanterior angle from the coronal plane. The maximum abduction angle is found as the maximum rotation angle by which the femoral head can rotate superolaterally about the anterior-posterior axis without impingement. The maximum flexion angle is found as the maximum rotation angle by which the femoral head can rotate superoanteriorly about the medial-lateral axis without impingement. Compared to the normal hip, the total hip replacement hip showed decreased abduction by 60 degrees and decreased flexion by 4 degrees. This measured value implies that the proposed measurement technique can make surgeons find a modification of increase in the femoral neck offset or femoral head, to secure larger range of motion.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.43-49
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• 2017

PURPOSE: This study investigated the relationship among hip adduction angle, tibial rotation, and ITB length during an Ober test to determine the most appropriate position for performing the test. METHODS: The study included thirty-nine asymptomatic participants (23 males, 16 females). Their hip adduction angles were measured using the Ober test during three tibial rotation conditions (internal tibial rotation, external rotation, and neutral position). ITB length was calculated by measuring the position of the patella to lateral femoral condyle using ultrasonography (patella-condyle distance; PCD). RESULTS: The relationship among hip adduction angle, tibial rotation, and ITB length was analyzed under the three conditions using the Pearson correlation. The hip adduction angle of the internal tibial rotation, the external rotation, and the neutral position were significantly related to ITB length. Moreover, the hip adduction angle measured during the internal tibial rotation had the highest correlation with ITB length among the three conditions (r=.58, p<.001). CONCLUSION: Internal tibial rotation caused by the Ober test led to increased iliotibial band (ITB) tension and a decreased adduction angle. These findings support that tibial rotation influences the flexibility of ITB. Therefore, therapists should consider the position of the internal tibial rotation when taking measurements using an Ober test.

• Physical Therapy Korea
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• v.21 no.3
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• pp.1-10
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• 2014

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles ($0^{\circ}$, $20^{\circ}$, $40^{\circ}$) with a $30^{\circ}$ hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both $40^{\circ}$ (p=.006) and $20^{\circ}$ (p=.010) compared to a $0^{\circ}$ hip external rotation angle. G Med muscle activity increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. The G Max/HAM activity ratio increased significantly at both $40^{\circ}$ (p=.004) and $20^{\circ}$ (p=.014) compared to a $0^{\circ}$ hip external rotation angle. The G Med/HAM activity ratio increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. In conclusion, $40^{\circ}$ and $20^{\circ}$ hip external rotation angles are recommended to increase G Max activity, and $20^{\circ}$ hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and $30^{\circ}$ hip abduction in healthy subjects.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.9-16
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• 2010

Objectives : This study is planned to classify different biomechanics of men and women, from the comparison of normal range and hip internal rotation angle in chronic low back pain patients. Methods : We measured the hip internal rotation angle of the 30 men and 30 women patients with low back pain that has been over 3 months in BuCheon Jaseng Hospital of Oriental medicine. We set 35-45 degrees as normal range, and found the patients with exceeding normal range, the patients with normal range, and the patients with under normal range. Results : Men appeared to have less hip internal rotation angle than women. Especially, the men's left hip internal rotation angle was less than normal range. On the other hand, women's right hip internal rotation angle was often larger than normal range which was stastically significant. Conclusions : Contraction of hip external rotation muscle including gluteus maxius muscle and piriformis muscle in men, or relaxation of posterior gluteus medius, gluteus maxius and piriformis muscle with contraction of tensor fasciae latae, a part of hip internal rotation muscle, in women seems to be the basis for biomechanics of chronic low back pain.