• 대한통합의학회지
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• 제12권3호
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• pp.49-59
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• 2024

Purpose : Chronic ankle instability (CAI) can impair strength and balance, leading to activity limitations and restricted participation. Traditionally, ankle stabilization exercises have been applied, and more recently, the effects of hip muscle exercises have been studied. The purpose of this study was to determine the immediate effects of hip exercises (HE) and ankle stabilization exercises (ASE) on dynamic balance, performance and ankle function in subjects with CAI. We also compared the difference in effectiveness between HE and ASE. Methods : A total of 34 subjects with CAI participated, ane were randomly divided into two groups: the HE group and the ASE group. The HE group performed a program consisting of exercises above 70 % MVIC, while the ASE group performed a traditional ankle stabilization exercise program. The subjects in each group completed their respective exercise program for a total of 30 minutes once a day and were assessed before and after the intervention. Dynamic balance was assessed using the Y-balance test (YBT). Performance was assessed using the hop for distance test (HDT), and side-hop test (SHT). Ankle function was assessed using foot and ankle ability measure (FAAM) questionnaires. Results : YBT, HDT, and FAAM values increased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. SHT values decreased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. Conclusion : Although no significant superiority was observed between HE and ASE in this study, both exercise programs were effective in improving dynamic balance, performance, and ankle function in subjects with CAI. These findings suggest that both HE and ASE can be suitable interventions for CAI, highlighting the need for individualized treatment plans. Future research is warranted to explore the long-term effects of exercise programs on CAI subjects of different ages and occupational characteristics.

• Hip & pelvis
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• 제36권2호
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• pp.135-143
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• 2024

Purpose: Hip fractures are associated with increased mortality. The identification of risk factors of mortality could improve patient care. The aim of the study was to identify risk factors of mortality after surgery for a hip fracture and construct a mortality model. Materials and Methods: A cohort study was conducted on patients with hip fractures at two institutions. Five hundred and ninety-seven patients with hip fractures that were treated in the tertiary hospital, and another 147 patients that were treated in a secondary hospital. The perioperative data were collected from medical charts and interviews. Functional Assessment Measure score, Short Form-12 and mortality were recorded at 12 months. Patients and surgery variables that were associated with increased mortality were used to develop a mortality model. Results: Mortality for the whole cohort was 19.4% at one year. From the variables tested only age >80 years, American Society of Anesthesiologists category, time to surgery (>48 hours), Charlson comorbidity index, sex, use of anti-coagulants, and body mass index <25 kg/m² were associated with increased mortality and used to construct the mortality model. The area under the curve for the prediction model was 0.814. Functional outcome at one year was similar to preoperative status, even though their level of physical function dropped after the hip surgery and slowly recovered. Conclusion: The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management.

• 신경치료
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• 제22권3호
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• pp.43-48
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• 2018

Purpose The purpose of this study is to identify the prevalence, risk factors, characteristics, and interventions of hip joint problems in children with cerebral palsy, and to be able to serve as leverage for early detection, prevention, and function recovery. Method The electronic journal site was searched by the search terms "cerebral palsy", "hip joint", "hip joint dislocation", we analyzed and descript the cited articles from domestic and foreign papers in Pubmed 9, Science Direct 7, and K RISS analysis and analysis. Results Children with cerebral palsy showed the different prevalence according to their disability type, severity, and functional level, and we knew that abnormal neuromuscular control, stiffness, and biomechanical changes could be risk factors. Migration Index, Acetabolum Index, Neck shaft angle using by radiography and passive ROM test, special tests were available for the diagnosis and evaluation of the hip joint. Combination of physical therapy and orthopedic surgery was very important intervention, and complementary alternative therapy, orthosis, and postural assistant are effective. Conclusion We suggested that early detection and prevention is the most important periodic examination and that a multidisciplinary approach is a major factor in intervention.

• 대한물리의학회지
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• 제14권4호
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• pp.71-80
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• 2019

PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• PNF and Movement
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• 제16권3호
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• pp.317-332
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• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• Physical Therapy Rehabilitation Science
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• 제6권2호
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• pp.96-104
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• 2017

Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

• 한방재활의학과학회지
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• 제32권2호
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• pp.95-103
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• 2022

Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.

• 대한정형도수물리치료학회지
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• 제19권1호
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• pp.69-77
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• 2013

The pelvic girdle function as an integrated unit with all three bones moving at all three joints, are influenced by the lower extremities below and vertebral column and trunk above sacroiliac movements are caused by spinal motion, whereas iliosacral movements are caused by movements of the lower limbs. Concept of normal functional integration among the lumbar spine, pelvic and hip joint is basic to the understanding of dysfunction in this region and also functional movement of the lumbo-pelvic-hip region are part of the clinical examination, consequently the integrated biomechanics of these region need to be understood. The purpose of this review is to ascertain the integrated biomechanics among the lumbo-pelvic-hip complex by consideration of literature and to give sufficient information to be able to render accurate assessment and treatment for the syndromes described.

• 대한물리의학회지
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• 제13권4호
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• pp.51-58
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• 2018

PURPOSE: This study was conducted to determine if the Harrison hip score (HHS), a tool for assessing hip joint function, and the Burg balance scale (BBS), a general balance assessment tool, actually reflect the balance ability of total hip arthroplasty (THA) patients 3 months after surgery. In addition, this study investigated the initial weight distribution strategy for bilateral lower extremity after THA surgery to understand the balance of THA patients. METHODS: Fourteen 3-month THA patients performed static dual standing and sit-to-stand (STS) tasks. Ground reaction forces on each leg were collected to calculate the weight distribution symmetricity (SWD), and the HHS, functional HHS (f-HHS), and BBS were evaluated. Correlation analyses between SWD and the HHS (also f-HHS) and BBS were then applied to the THA patients. RESULTS: The correlations between functional evaluation tools (HHS, f-HHS, BBS) and SWD were weak strength for the static balance task, but moderate for the dynamic STS task. Among the evaluation tools used in the present study, f-HHS was most useful for evaluation of dynamic balance ability. CONCLUSION: The results suggest that use of HHS, f-HHS, and BBS as functional evaluation tools does not provide meaningful information regarding balance ability, but that they are useful for evaluating dynamic balance ability of THA patients. The dynamic balance ability at 3 months after THA seems to be under development.