• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.31-39
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• 2021

Background: Patellofemoral pain syndrome (PFPS) is common knee disorder encountered in clinical: notably, altered hip biomechanic may contribute to PFPS. In this study, We investigated the effects of hip joint mobilization on pain, balance, and gait in patients with PFPS. Methods: Patients were randomly assigned to a control group (n=18) or an experimental group (n=20). Both groups received exercise therapy thrice a week for 4 weeks. The experimental group performed additional hip joint mobilization thrice a week for 4 weeks. Measurement were obtained in each patient pre-intervention and post-intervention (after 4 weeks). Results: The assessed items included the visual analog scale (VAS), one leg standing test (OLS), timed up and go test (TUG), and the 10m walk test (10MWT). Post-intervention assessment showed significantly improved results in both groups (p<.01). A significant intergroup difference was observed only in the results of the 10MWT (p<.05). Conclusion: Our results indicate that hip joint mobilization with exercise therapy may be useful to improve PFPS.

• Physical Therapy Korea
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• v.19 no.4
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• pp.61-69
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• 2012

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.2
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• pp.23-29
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• 2012

Background: The present study was conducted with 30 adult males in order to examine the muscle activity of the trunk and the lower extremities at diverse initial bending angles of the hip joint during bridge exercise on a stable surfaces and on an unstable surface that is widely performed for stabilization. Methods: The initial angles of the hip joint used were $0^{\circ}$, $45^{\circ}$ and $90^{\circ}$ and the subjects were divided into a matt experimental group and a balance training group. Results: In maximum values of muscle activity at different exercise methods and angles, the matt experimental group showed statistically significant differences in the muscle activity values of the rectus abdominis muscle, the erector spinae muscle, the rectus femoris muscle and the peroneus muscles between different angles while the balance training group showed significant differences only in the muscle activity values of the erector spinae muscle between different initial angles of the hip joint. The matt experimental group showed significant differences in muscle activity between initial angles $0^{\circ}$ and $90^{\circ}$, between $45^{\circ}$ and $90^{\circ}$ in the rectus abdominis muscle, between $0^{\circ}$ and $90^{\circ}$ in the erector spinae muscle, between $45^{\circ}$ and $90^{\circ}$ in the rectus femoris muscle and between $0^{\circ}$ and $90^{\circ}$ in the peroneus muscles while the balance training group showed significant differences between $0^{\circ}$ and $90^{\circ}$ in the erector spinae muscle. Conclusions: Therefore, it is thought that bridge exercises should be applied to patients using diverse methods.

• Physical Therapy Korea
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• v.26 no.3
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• pp.32-41
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• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• Physical Therapy Korea
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• v.24 no.1
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• pp.79-85
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• 2017

Background: The wall squat is considered an effective exercise because it can reduce the knee load and prevent excessive lumbar movement. However, the relationship between wall squat performance and strength of knee extensors and hip extensors remained unclear. Objects: The purpose of this study was to compare the strengths of the knee extensors and hip extensors between groups with low and high wall squat performance. Method: Nineteen males (low performance group: 9 subjects, high performance group: 10 subjects) participated in this study and performed wall squats. The subjects who were performing less than 30% of the average wall squat count were classified into the low wall squat performance group (less than or equal to 4 times) and the subjects who performed more than 30% of the average wall squat count were classified into the high wall squat performance group (greater than or equal to 8 times). Knee extensor and hip extensor strength were measured with a strength measurement system. An independent t-test was used to compare the strengths of the knee extensors and hip extensors between the groups with low and high wall squat performance. Results: The ratios of knee extensor and hip extensor strength to bodyweight were greater in the high wall squat performance group than in the low wall squat performance group (knee extensors: p<.001; hip extensors: p=.03). In the high- and low-performance groups, the ratios of knee extensor strength to bodyweight were $42.74{\pm}5.72$ and $30.76{\pm}8.54$, respectively, and the ratios of hip extensor strength to bodyweight were $31.95{\pm}10.61$ and $20.66{\pm}11.25$, respectively. Conclusion: Our findings suggest that knee extensor and hip extensor strength are needed for high wall squat performance. Thus, exercise to increase the knee and hip extensors strength can be recommended to improve squat performance.

• PNF and Movement
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• v.19 no.1
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• pp.43-55
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• 2021

Purpose: The purpose of this study was to determine the effects of contract relaxation and a combination of isotonics in proprioceptive neuromucular facilitation (PNF) on hip and lumbopelvic motions of male patients with chronic low back pain. Methods: As the subjects of this study, a total of 45 male patients with chronic low back pain were divided into groups: 15 who underwent contract relaxation (CR) of the PNF of their hip joints, 15 who underwent a combination of isotonics (CI) of the PNF, and 15 who underwent both techniques. A device for analyzing three-dimensional motion was used to measure hip medial rotation angles, lumbopelvic rotation angles, and hip medial rotation angles at the start of lumbopelvic rotation during hip medial rotation. A two-way repeated measures ANOVA was used to compare the average values. Results: There were interactions in the hip medial rotation angles, lumbopelvic rotation angles and hip medial rotation angles at the start of lumbopelvic rotation based on the methods and periods of exercise (p < 0.05). The CR and the CR+CI groups displayed more increased hip medial angles when compared to the CI group. The CR+CI group had more decreased lumbopelvic rotation angles when compared to the CR and the CI groups. The CR+CI group had more increased hip medial rotation angles at the start of lumbopelvic rotation when compared to the CR and the CI groups. Conclusion: It can be concluded that the combination of stretching and stability exercises was effective in male patients with chronic low back pain who showed limited hip medial rotation.

• Hip & pelvis
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• v.34 no.1
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• pp.10-17
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• 2022

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion: Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.361-368
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• 2011

The purpose of this study was to investigate the effect of isometric hip adduction and abduction on the muscle activities of vastus medialis oblique(VMO) and vastus lateralis(VL) during leg squat exercises. This study consisted of 21 healthy subjects who had no medical history of anterior knee pain or lower extremity disorders. The ball and belt were used to isometrically adduct and abduct the hip joint during the leg squat exercise, respectively. The surface electromyograms of VMO and VL were analyzed, and the findings were used to calculate the VMO:VL ratio during 3 different quadriceps-strengthening exercises(leg squat, LS leg squat with isometric hip adduction, LSHD leg squat with isometric hip abduction, LSHB). The muscle activities of VMO and VL and the VMO:VL ratios were compared using the paired t-test with Bonferroni adjustment. The results showed that the muscle activities of VMO and VL during LSHD were greater than those during LSHB. The VMO:VL ratio was the highest during LSHD. This finding suggests that LSHD using a ball is more effective than LS and LSHB in selectively increasing the muscle activities of VMO. Therefore, we suggest that leg squat exercise with isometric hip adduction using a ball would be useful for maintaining correct patella tracking and for selectively strengthening VMO.

• Physical Therapy Korea
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• v.28 no.3
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• pp.161-167
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• 2021

Understanding sciences behind fall-related hip fractures in older adults is important to develop effective interventions for prevention. The aim of this review is to provide biomechanical understanding and prevention strategies of falls and related hip fractures in older adults, in order to guide future research directions from biomechanical perspectives. While most hip fractures are due to a fall, a few of falls are injurious causing hip fractures, and most falls are non-injurious. Fall mechanics are important in determining injurious versus non-injurious falls. Many different biomechanical factors contribute to the risk of hip fracture, and effects of each individual factors are known well. However, combining effects, and correlation and causation among the factors are poorly understood. While fall prevention interventions include exercise, vision correction, vitamin D intake and environment modification, injury prevention strategies include use of hip protectors, compliant flooring and safe landing strategies, vitamin D intake and exercise. While fall risk assessments have well been established, limited efforts have been made for injury risk assessments. Better understanding is necessary on the correlation and causation among factors affecting the risk of falls and related hip fractures in older adults. Development of the hip fracture risk assessment technique is required to establish more efficient intervention models for fall-related hip fractures in older adults.

• The Journal of Korean Physical Therapy
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• v.17 no.1
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• pp.69-79
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• 2005

The purpose of study were to determine the effect of Elastic Band Exercise Based of PNF L/E pattern(EBEBP) on the balance in the elderly people. 24 health elderly women aged 65 to 85 years participated who live in Sun-cheon city Jeon-nam. Participants were divided into exercise(12) and control(12) group to randomized. Exercise participants received strengthening exercise for 30minutes in two times a week for 4weeks while control group continued their normal activities. Exercise used to yellow elastic band which 4 patterns of PNF by 1) hip extension - adduction - external rotation with knee extension, 2) hip extension-abduction-internal rotation with knee extension. 3) hip flexion - adduction - external rotation with knee flexion, 4) hip flexion - abduction - internal rotation with knee flexion. All subjects participated in 3 tests Berg Balance Test(BBT), One-Leg Standing Test(OLST), Functional Reaching Test(FRT). Exercise and control group were tested before and at the end of the test. This collected date were analysed by using paired t-test and independent t-test. The results of this study are as follows; 1. The experimental group was statistically significant difference in balance performance clinical test of BBT(p<0.01), OLST(p<0.01), FRT(p<0.001). 2. The control group was no significant difference in balance performance clinical test of BBT, OLST, FRT(p>0.05). 3. After the exercise, there was significant difference in the BBT(P<0.01), OLST(P<0.05), FRT(P<0.001) between the experimental group and control group in EBEBP. Thus, elastic band exercise based of PNF L/E pattern can result in improved muscle strength and balance in the elderly people. Further studies are required to show long-term effects of exercise training on the elderly people.