• Physical Therapy Korea
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• v.29 no.1
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• pp.64-69
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• 2022

Background: Gluteus medius muscle is important for the stability of hip joint. The sufficient core stability can be contributed to the performance of gluteus medius muscle in standing position. In addition, the external support may affect core stability in standing position. Objects: The purpose of this study was to investigated the effectiveness of the external support on the strength and muscle activity of hip abductor muscle during hip abduction in standing position in subjects without core stability. Methods: Fifteen subjects participated in this study. The subjects were evaluated by using the double-leg lowering with bent knees to measure the core stability. The strength and muscle activity of hip abductors was measured in standing position with the condition with and without external support using the tensiometer sensor and the surface electromyography. The paired t-test was used to investigate the difference between hip abductor strength and activity according to external support. The level of statistical significance was set at α = 0.05. Results: The hip abductor strength and muscle activity of gluteus medius muscle with external support were significantly greater than those without external support during hip abduction in standing position (p < 0.05). Conclusion: During hip abduction in standing position, the external support may be contributed to the improvement of the hip abductor strength and muscle activity of gluteus medius especially in the subjects without core stability.

• Physical Therapy Korea
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• v.28 no.1
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• pp.59-64
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• 2021

Background: Hip flexor muscles are very important in the hip joint structure as a mover and stabilizer. In addition, isometric hip flexor strength in the supine position needs to be considered with isometric core strength (WICS) to measure a precise strength in a clinical way. Objects: We compared isometric hip flexor strength in the supine position in subjects with and without WICS (between factors) and conditions with and without an external support (within factors). Methods: A total of 34 subjects (16 with WICS, 18 without WICS) participated in this study. We used the double-bent leg-lowering test to divide the subjects in two groups according to the presence of WICS. Isometric hip flexor strength was evaluated in the supine position both with and without an external support condition. The two-way mixed analysis of variance was applied to identify significant differences between groups (with vs. without WICS: between factors) and conditions (with vs. without an external support: within factors). Statistical significance was set at α = 0.05. Results: In subjects with WICS, isometric hip flexor strength was greater with an external support than without it (p = 0.0064). In subjects without WICS, there were no significant differences in isometric hip flexor strength in the presence or absence of an external support (p = 0.075). The isometric hip flexor strength was significantly greater with an external support condition in particular in subjects with WICS. Conclusion: The findings of this study reported that an external support condition in individuals with WICS may contribute to the improvement of isometric hip flexion strength in the supine position. Therefore, isometric core strength should be evaluated to distinguish the weakness between core region and hip flexors.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.123-129
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• 2018

PURPOSE: This study was conducted to investigate the influence of hip abduction angle on the muscle activity of the Gluteus Maximus (GM), Biceps Femoris (BF) and Tensor Fascia Lata (TFL) during Knee Flexed Prone Hip Extension exercise. METHODS: The subjects of this study were 42 healthy individuals. All participant consented to participate in this study. Subjects performed exercise, using the Knee Flexed Prone Hip Extension exercise in three hip abduction position $0^{\circ}$, $15^{\circ}$ and $30^{\circ}$. Subjects rested two minutes, between changing hip abduction position. Data were analyzed using a Noraxon MR-XP 1.08 Master Edition EMG to determine average amplitude, for each angle and muscle. All data were processed by Multivariate analysis of variance (MANOVA). There were a total of three groups. the GM muscle, BF muscle, TFL muscle. RESULTS: GM muscle activity was greatest in the $30^{\circ}$ hip abduction position (p<.05), followed by $0^{\circ}$. Between $0^{\circ}$ and $30^{\circ}$ has significant difference in muscle activity. However, the BF and TFL amplitude were greatest at $0^{\circ}$ hip abduction position followed by $30^{\circ}$. Moreover, the TFL differed significantly between $0^{\circ}$ and $30^{\circ}$, but, BF did not (p<.05). CONCLUSION: Hip abduction at $30^{\circ}$ was found to be the most appropriate position for GM muscle activity.

• Physical Therapy Korea
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• v.23 no.2
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• pp.75-83
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• 2016

Background: Several studies have discussed diverse exercise methods considered to be useful for the selective contraction of the vastus medialis oblique (VMO) muscle for the treatment of patellofemoral pain syndrome. Some studies have reported that exercise methods, including hip adduction, in closed kinetic chain exercises are more effective in terms of the muscle activation of the VMO and the timing of the muscle's initial contraction. We focused on isometric contraction during a closed kinetic chain exercise with hip adduction. Objects: The purpose of this study was to examine muscle activation in the VMO and the vastus lateralis (VL) and the onset time difference between their initial contractions via closed kinetic chain isometric quadriceps femoris exercises including hip adduction. Methods: In total, 36 healthy subjects adopted two hip positions during isometric contraction of the quadriceps femoris in a closed kinetic chain exercise (hip neutral and hip adduction position). Statistical analyses were conducted using a paired t-test (${\alpha}=.05$). Results: Isometric contraction of the quadriceps femoris in a closed kinetic chain exercise caused a greater increase in VMO muscle activity in the hip adduction position [$52.68{\pm}22.21$ percentage of maximal voluntary isometric contraction (%MVIC)]than the hip neutral position ($43.43{\pm}19.85%MVIC$). The onset time difference (VL-VMO) decreased more in the hip adduction position ($-82.14{\pm}34.2ms$) than the hip neutral position ($73.94{\pm}2.94ms$). Conclusion: We recommend this exercise as a clinically useful therapeutic method for patients with patellofemoral pain syndrome due to weakening of the VMO muscle and lateral inclination of the patella.

• The Journal of Korean Physical Therapy
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• v.31 no.3
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• pp.147-150
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• 2019

Purpose: The purpose of this study was to compare the reliability of unilateral hip abductor strength assessment in side-lying with break and make test in subjects with pelvic drop. Hip abduction muscles are very important in the hip joint structures. Therefore, it is essential to evaluate their strength in a reliable way. Methods: Twenty-five subjects participated in this study. Unilateral isometric hip abductor muscle strength was measured in side-lying, with use of a specialized tensiometer using smart KEMA system for make test, of a hand held dynamometer for break test. Coefficients of variation, and intra class correlation coefficients were calculated to determine test-retest reliability of hip abductor strength. Results: In make test, maximal hip abductor strength in the side-lying position was significantly higher compared with break test (p<0.05). Additionally, Test-retest reliability of hip abductor strength measurements in terms of coefficients of variation (3.7% for make test, 16.1% for break test) was better in the side-lying position with make test. All intraclass correlation coefficients with break test were lower than make test (0.90 for make test, 0.73 for break test). Conclusion: The side-lying body position with make test offers more reliable assessment of unilateral hip abductor strength than the same position with break test. Make test in side-lying can be recommended for reliable measurement of hip abductor strength in subjects with pelvic drop.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.335-340
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• 2020

Purpose: This study was performed to investigate the influence of the condition with and without external support on the strength of hip flexor in supine position in subjects without core stabilization. Hip flexor muscles are very functional in the hip joint structures. Therefore, it is essential to evaluate the strength of hip flexor in a clinical and precise way. Methods: Twenty subjects participated in this study. The double bent leg-lower test was used to evaluate subjects without core stabilization. The strength of hip flexor muscles was evaluated in supine position, both with and without external support condition. The paired t-test was used to compare the strength of hip flexor muscles according to external support. The level of statistical significance was at α=0.05. The intra-rater reliability of the repeated measures of hip flexor strength was estimated by calculating the intra-class correlation coefficients (ICC). Results: In subjects without core stabilization, the strength of hip flexor in supine was greater with external support than that without external support (p<0.05). In addition, the intra-rater reliability with an ICC (3, 1) of the strength measurement of hip flexor with external support was higher than that without external support. Conclusion: In subjects without core stabilization, the condition with external support can contribute to the strength of hip flexor in supine position and the strength measurement of hip flexor should be considered with the condition with and without external support.

• 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.26 no.3
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• pp.91-98
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• 2019

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

• Physical Therapy Korea
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• v.16 no.3
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• pp.42-49
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• 2009

This study examined the vastus medialis oblique (VMO) and the vastus lateralis (VL) onset time differences (OTD) during quadriceps contraction in different hip positions. Twelve healthy subjects were recruited (four men, eight women). Surface EMG activities of the VMO and VL were measured during a quadriceps strengthening exercise in a long sitting condition and in a sitting at a chair with feet hanging condition. For each condition, subjects were tested in two hip positions (neutral and adduction). The OTD between the two muscles was calculated for each condition, by subtracting the onset time of the VL from the VMO. Therefore, the negative value of OTD represent earlier EMG onset of the VMO compared to the VL. The OTD was not significantly different between the hip neutral and the hip adduction position in the long sitting condition (p=.064). However, the OTD was significantly different between the hip neutral position ($15.83{\pm}109.51$ ms) and hip adduction position ($-5.58{\pm}121.08$ ms) during the sitting at a chair with feet hanging condition (p=.047). The negative OTD value in the hip adduction condition during quadriceps strengthening exercises is the result of earlier onset of the VMO than VL. Therefore, quadriceps contraction in the hip adduction position can prevent the risk of patella lateral tracking. We expect that quadriceps strengthening exercise in the hip adduction position will be a safe way to prevent patellofemoral pain syndrome resulting from abnormal patella lateral tracking.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.105-110
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• 2016

PURPOSE: The aim of this study was to investigate the influence of hip abduction velocity and position change on the relative onset times of the gluteus medius, the tensor fascia latae, and the quadratus lumborum in healthy subjects. METHODS: For this study, 15 healthy young adults were recruited. The subjects were asked to move their hip joints up to 35 degrees of abduction at a speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$ in the supine and side-lying positions. Electromyography data was collected for the gluteus medius, tensor fascia latae, and quadratus lumborum to determine the onset times. RESULTS: There were significant differences between the fast speed ($70^{\circ}/sec$) and the slow speed ($17.5^{\circ}/sec$) in hip abduction in a supine position and in a side-lying position, relatively. The onset time of the gluteus medius was faster than that of the tensor fascia latae and the quadratus lumborum in the side-lying position at the speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$. CONCLUSION: The findings of this study indicated that hip abduction in a side-lying position is an effective method to recruit the gluteus medius earlier than the tensor fascia latae and the quadratus lumborum. Thus, the exercise position is considered necessory in the purpose of rehabilitation for gluteus medius muscle strengthening program.