• 척추신경추나의학회지
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• 제8권1호
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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.

• 대한통합의학회지
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• 제5권4호
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• pp.41-48
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• 2017

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

• 대한정형도수물리치료학회지
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• 제17권2호
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• pp.41-48
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• 2011

Background: Patellofemoral pain syndrome is very common knee problem and altered hip rotation may play a role in patellofemoral pain. The purpose of this case study is to describe the manual therapy of and the therapeutic exercise for a patient with asymmetrical hip rotation and patellofemoral pain. Method: The patient was a 29 years old woman with an 3 month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the VAS was Max 6 to Min 4. Left hip internal rotation was less than right hip internal rotation, and manual muscle testing showed weakness of the left hip internal rotator and abductor muscles. The intervention consisted of manual therapy and therapeutic exercise for three times a weeks, two weeks for increasing right hip medial rotation, improving left hip muscle strength, and eliminating anterior right knee pain. Result: After intervention for 2weeks, passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her VAS score was Max 2 to Min 0. Conclusion: Manual therapy and therapeutic exercise is effective in improving for patient had patellofemoral pain with pattern of asymmetrical hip rotation.

• 척추신경추나의학회지
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• 제5권2호
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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.

• 한국전문물리치료학회지
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• 제26권3호
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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.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.47-52
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• 2018

Background: A limited hip rotational range of motion (ROM) has been considered to be one of characteristics of low back pain (LBP) in athletes. Although LBP frequently occurs in jiu-jitsu athletes, no previous has compared hip rotational ROM between jiu-jitsu athletes with and without LBP. Objects: The aim of the study was to compare ROM for hip internal rotation (IR) and external rotation (ER), and total hip rotation between jiu-jitsu athletes with and without LBP. Methods: Jiu-jitsu athletes were recruited for the LBP group ($n_1=15$) and control group without LBP ($n_2=15$). IR, ER, and total rotational range of hip joint were measured using a goniometer. Analysis of variance was used to compare the ROM between groups and sides. Results: The LBP group showed a significantly lower range of passive hip IR, passive total rotation, active IR, active ER, and active total rotation than the control group (p<.05). Dominant side of passive hip IR and active IR had a significantly lower ROM than non-dominant side (p<.05). In passive ER ROM, non-dominant side was significantly greater than dominant side (p<.05). Conclusion: Compared to jiu-jitsu athletes without LBP, athletes with LBP exhibit a loss of hip rotational ROM. Based on these results, clinicians and athletic trainers should measure hip rotational ROM when designing the management plan for jiu-jitsu athletes with LBP.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.24-31
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• 2006

The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

• The Journal of Korean Physical Therapy
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• 제3권1호
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• pp.97-108
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• 1991

The purpose of this article is to know the standard figures of joint range of motion, in conjuction with age and sen, for normal adults. The results of assessment and analysis io shoulder and hip joint range of motion are as follows : 1) The average shoulder joint range of motion in normal adults are $160.5^{\circ}$ in flexion, $53.5^{\circ}$ in extension, $159.3^{\circ}$ in adduction, $62.3^{\circ}$ in internal rotation, $83.9^{\circ}$ in external rotation, The average hip joint range of motions are $116.8^{\circ}$ in flexion, $16.1^{\circ}$ in extension, $41.1^{\circ}$ in abduction, $33.8^{\circ}$ in abduction, $40.0^{\circ}$ in interne rotation, $41.2^{\circ}$ in external rotation. 2) There is no significant difference in shoulder and hip joint range of motion between male and female (p>0.05). 3) As to the inter-relation in age and range of motion, the left flexion and extension, internal rotation and right extension in shoulder joint is decreased gradually with increasing age, and left flexion (knee flexion, knee extension) and right flexion (knee extension) in hip joint is decreased with increasing age (p<0.01). 4) Relating to age and sex, the twenties male shows highest range of motion in shoulder and hip joint, with .the fifties female shows, lowest range of motion.

• 한국운동역학회지
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• 제25권3호
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• pp.293-300
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• 2015

Objective : The purpose of this study was to compare the kinematic data of the horizontal rotation movements of shoulder, hip, knee during two-handed backhand drive stroke according to two different ball directions. Methods : The kinematic variables were analyzed such as the joint angles of the lower body, horizontal rotation angles of the shoulder, hip, inter-knee segment, body twist angle and difference in angle of forward swing. Two-handed backhand drive stroke was analyzed through a three-dimensional motion analysis. The collected data were analyzed by a paired t-test, and the statistical significant value was set at ${\alpha}=.05$. Results : The findings of this study were as follows; First, there was no difference in the total angles of lower limb joints from the forward swing position to impact posterior. Second, there was no difference in the horizontal rotation angles of E1 shoulder, hip, and E2 shoulder but the horizontal rotation angles of E1 knee, E2 hip, knee, E3, and E4 shoulder, hip, and knee were different in all events. Third, there was no difference in the body twist angle of the maximum horizontal rotation. In addition, there was no difference in the angle of the body twist by the ball direction in the shoulder-hip, the hip-knee and the shoulder-knee. Conclusion : Horizontal rotation angle determines ball directions.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.57-67
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• 2016

Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.