• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.23-29
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• 2023

Background: There is still controversy as to whether hip external rotation and dorsiflexion selectively activate the vastus medialis obliquus (VMO) during straight leg raise exercise. Due to the anatomical characteristics, hip adduction must be preceded to activate the VMO. In this study, the activities of the rectus femoris (RF), vastus lateralis (VL), VMO were measured by adding the hip adduction movement to the straight leg raise exercise with hip 45° external rotation and straight leg raise exercise with hip 45° external rotation and dorsiflexion. Through this, we want to find out whether the VMO is selectively activated. Methods: Thirteen healthy participants performed straight leg raise exercise with hip 45° external rotation, straight leg raise exercise with hip 45° external rotation and dorsiflexion, straight leg raise exercise with hip 45° external rotation and adduction, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion was randomly performed. Through this, EMG data of the RF, VL, VMO were collected. Results: During the straight leg raise exercise, hip adduction increased the activity of the VMO and VL, no significant difference was found(p>.05). However, in the VMO/VL ratio, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion activated the VMO and the VL at a ratio of about 1:1, It showed a significantly higher rate than straight leg raise exercise with hip 45° external rotation(p<.05). Conclusion: During the straight leg raise exercise, hip adduction is considered to be an important movement that can selectively induce the activity of the VMO. Therefore, follow-up studies on this should be conducted.

• Physical Therapy Korea
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• v.22 no.3
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• pp.71-80
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• 2015

Hip muscle activation and strengthening exercise programs are often used to prevent and treat various lower extremity injuries. Common exercise programs include squat exercises. The purposes of this study were to investigate gluteus medius (GMED) and tensor fasciae latae (TFL) muscle activity, and to assess the GMED/TFL ratio during squat exercises involving different isometric hip contraction conditions. Different types of isometric hip contraction were standard squat without hip contraction, squats with isometric hip adduction, and squats with isometric hip abduction. Twenty (10 males and 10 females) healthy subjects ($23.7{\pm}2.8$ years old) were recruited. Subjects performed the squat exercises with the back supported by a wall and knees flexed to $60^{\circ}$. Surface electromyography (EMG) was used to measure GMED and TFL activity. One-way repeated analysis of variance was used to compare GMED and TFL muscle activity and the GMED/TFL ratio. GMED and TFL EMG activity was significantly higher during squats with isometric hip adduction and abduction compared with the standard squat without hip contraction (p<.05). Between the isometric hip adduction and abduction contraction conditions, only the TFL EMG activity was significantly higher during squats with isometric hip adduction than isometric hip abduction (p<.05). The GMED/TFL ratio was significantly higher during squats with isometric hip adduction than isometric hip abduction (p<.05). Squats with isometric hip adduction and abduction improved GMED and TFL muscle activity. Furthermore, the GMED/TFL ratio was higher during isometric hip adduction than isometric hip abduction. Our data indicate that squat exercises involving isometric hip adduction enhance GMED muscle activity.

• 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.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.32 no.6
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• pp.354-358
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• 2020

Purpose: This study aimed to verify the effects of bridge exercise with resistance to one hip joint adductor muscle on the thickness of external and internal oblique abdominal muscles, transversus abdominis muscle, and erector spinae muscle. Methods: The subjects were divided into two exercise groups: 15 for Bridge Exercise Group (BEG) and 15 for One Hip joint Adduction Bridge Exercise Group (OHABEG). The study used an ultrasonic instrument to measure trunk muscle thickness. OHABEG performed a bridge exercise with one hip Joint adduction. BEG performed a bridge exercise without resistance. Results: The external oblique abdominal, internal oblique abdominal, and the transversus abdominis muscles showed a significant increase by period and time in intra-group interactions (p<0.05), while there was no significant difference in inter-group changes (p>0.05). The erector spinae muscle had a significant increase in each period (p<0.05) but no significant difference in time, intra-group interactions, and in inter-group changes (p>0.05). Conclusion: These results demonstrated that bridge exercise with one hip joint adduction had positive effects on trunk muscle thickness. These results confirm that a bridge exercise with one hip joint adduction has a positive effect on the muscle thickness of trunk, suggesting the possibility of using it as a rehabilitation treatment for a lumbar stabilization exercise and as a basic data.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.47-54
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• 2020

Background: This study examined the changes in the leg muscle activities of 30 healthy subjects according to different pressures caused by isometric hip adduction during squat exercise. Methods: With their knee flexed at 60°, the subjects performed isometric hip adduction with a pressure of 0, 20, 40, and 60mmHg. Surface electromyography was used to measure their muscle activities. Changes in the activities of the muscles, such as the gluteus maximus (GMAX), Gluteus medius (GM), vastus medialis oblique (VMO), vastus lateralis oblique (VLO), biceps femoris (BF), and Tensor fasciae latae (TFL) muscles, were analyzed. Results: The activities of the VMO, VLO, GM, BF, and GMAX muscles were significantly different after exercise compared to that before exercise (p<.05). The activities of all the leg muscles measured were highest at a pressure of 60mmHg during isometric hip joint adduction. Conclusion: The pressure produced by isometric hip joint adduction during squat exercise increased the leg muscle activities of the subjects. These results will provide basic data on effective squat exercise to alleviate knee joint diseases.

• Physical Therapy Korea
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• v.2 no.1
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• pp.36-43
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• 1995

The purpose of this study was to determine whether the vastus medialis oblique muscle(VMO) had greater electrical activity than the vastus lateralis muscle(VL) when hip adduction and knee extension exercise were performed. Electrical activity of the VMO and VL was measured on 42 healthy subjects (28 men, 14 women) during maximal voluntary isometric contractions of hip adduction and knee extension by an EMG-BIOFEEDBACK. The results showed that the electromyographic activity of the VMO was significantly greater than that of the VL during the hip adduction exercise. Differences noted with knee extension by performing hip adduction exercises. Isometric hip adduction exercises, therefore, may be advisable in the treatment of patients with patellofemoral pain.

• 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 Korean Neurosurgical Society
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• v.41 no.1
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• pp.22-26
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• 2007

Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.