Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.
Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.
Purpose: The purpose of this study is to compare the muscle activity of the hip abductors and the ratio between the hip abductor muscle group according to the range of hip abduction during the clam exercise. Methods: This study was conducted on 18 healthy men in their aged 20 to 29 who had not been diagnosed with spine-related diseases. The subjects performed a clam exercise without rotation of the pelvis in a state of 60° hip flexion and 90° knee joint flexion in the side-lying position. Using Myomotion equipment and EMG, the muscle activity of the hip abductor muscles and the activity ratio between the hip abductor muscle group were measured during the clam exercise by dividing the range into initial, mid-range, and terminal sections. Repeated measures analysis of variants was employed to compare the activity and use of hip abductor muscles according to range of motion during the clam exercise. Results: Gluteus medius muscle activation was significantly increased in the comparison of muscle activity in the initial, mid-range, and terminal sections of hip abduction. Tensor fasciae latae muscle activation was significantly increased in the comparison of muscle activity in all range of motion sections as well. The gluteus medius-tensor fasciae latae muscle activation ratio was significantly increased in the terminal section compared to the initial section. Conclusion: The gluteus medius and tensor fasciae latae had higher muscle activities as they approached the terminal section during the clam exercise, and the hip abduction activity ratio of the gluteus medius and tensor fasciae latae was higher as the range of motion approached the terminal section.
Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said "Go", the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many "touches" as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.
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.
The right hip abductor musculature has been reported to demonstrate "stretch weakness" attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of "stretch weakness",. The purpose of this study was to assess isometric hip abduction torque and surface electromyographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t test was applied at the .05 level of significance. The results were as follows: 1) The difference in apparent leg length of right and left legs was significant at the .05 level. 2) There was a significant difference between right and left pelvic height (standing position) at the 05 level measurements, and scapula height at the .05 level. 3) Power measurements and action potentials of right hip abductor were greater than the left hip abductor regardless of the range of joint motion (inner range, outer range) 4) The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5) In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.05) These results suggest: In healthy right-handed persons, the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle those and muscle action potentials of the right hip abductor are higher than those of the left hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
Purpose : Bridging exercise was used most frequently of lumbar stabilization exercise. There has been no reserch regarding the bridging exercise according to hip abductor activation or hip adductor activation. The purpose of this study is to determine correlation of hip abductor, adductor and abdominal muscles, lower limb muscle. Methods : Participants who met the criteria for this study (n=45). Participants performs bridging exercise on three types (normal bridging exercise, bridging exercise with hip abductor contraction, bridging exercise with hip adductor contraction) for evaluate correlation of each muscles. Results : There was a significant negative correlation between adductor magnus and gluteus medius, adductor magnus and rectus femoris. And there was a positive correlation between gluteus medius and rectus femoris on normal bridging exercise (p<0.05). There was a significant positive correlation between adductor magnus and gluteus medius, transverse abdominis, and between gulteus medius and transverse abdominis on bridging exercise with adductor magnus activation (p<0.05). There was a significant positive correlation between adductor magnus and gluteus medius, rectus femoris, and between gulteus medius and rectus femoris on bridging exercise with gluteus medius activation (p<0.05). Conclusion : When we perform bridging exercise for transverse abdominis activation and increase pressure in the abdmen, bridging exercise with hip adductor contraction is more effective than normal bridging exercise and bridging exercise with hip abductor contraction.
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.
Background: The purpose of this study is to investigate that effect of manual therapy using pelvic compression belt on hip abductor strength and balance ability in total knee replacement (TKR) patients. Methods: The subjects consisted of twenty two post-TKR patients. Participants were randomly assigned to a pelvic belt group (n=11) and a placebo group (n=11). All participants underwent manual therapy including range of motion exercise, soft tissue mobilization around knee joint, strengthening exercise (Quad set, SLR, sidelying hip abduction, standing hamstring curls, sitting knee extension, step-up, wall slide to $45^{\circ}$ knee flexion). Manual therapy was executed five times a week for 2 weeks. Outcome measures included hip abductor strength by using Biodex system 4 pro, anterior to posterior balance, medial to lateral balance, total balance by using Biodex balance system SD. Results: After the completion of the manual therapy, hip abductor strength was showed statistically significant improvements in pelvic belt group (p<.05). Anterior to posterior balance, medial to lateral balance, total balance were showed statistically significant improvements in pelvic belt group and placebo group (p<.05). There was a statistically significant difference between the two groups in hip abductor strength and there was no statistically significant difference in balance. Conclusions: This results suggest that manual therapy using pelvic compression belt has could be used for selective muscle activation of the hip abductor muscle and has useful in hip abductor strength and balance ability in TKR patients.
The right hip adbuctor musculature has been reported to demonstrate 'stretch weakness' attributable to chronic elongation imposed by standing posture common to right-handed healthy persons. Kendall and associates have described the concept of 'stretch weakness'. The purpose of this study was to assess isometric hip abduction torque and surface electro-myographic activity (using MYOMED 432) in a sample of 40 healthy right-handed persons (20 male, 20 female), all of whom agreed to participate in the study, and compare side difference in the hip abductor musculature. In order to assure the statistical significance of the results, the paired t-test was applied at the .05 level of significance. The results were as follows : 1. The difference in apparent leg length of right and left legs was significant at the .05 leve1. 2. There was a significant difference between right and left pelvic height (standing position) at the .005 level measurements, and scapula height at the .05 level. 3. Power measurements and action potentials of right hip adbuctor were greater than the left hip adbuctor regardless of the range of joint motion (inner range, outer range). 4. The difference in muscle power and action potentials according to inner or outer range of both hip abductor were significant at the .05 level. 5. In supine during active left hip abduction, the appearance of action potentials in the right hip abductors is indicative of contra-lateral effect (p<.005). These results suggest : In healthy right-handed persons. the apparent leg length on the right is longer than on the left, and pelvic height is elevated on the right side. Muscle torque and muscle action potentials of the right hip adbuctor art higher than those of the hip abductor in the lengthened position. Therefore, the results in this study are contrary to Kendall's. This type of study should be carried out in many physical therapy departments.
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