• 제목/요약/키워드: Hip injuries

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노인의 넘어짐으로 인한 고관절 골절 예방프로그램의 효과: 문헌 고찰 (The Literature Review on the Effectiveness of Fall-related Hip Fracture Prevention Programs)

  • 이세영;김승수;임기택;최우철
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.1-12
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    • 2021
  • While efforts have been made to address fall-related injuries in older adults, the problem is unsolved to date. The purpose of this review is to provide a guideline for fall and injury prevention programs in older adults, based on evidence generated over the past 30 years. Research articles published between 1990 and 2020 have been searched on PubMed, using keywords, including but not limited to, falls, hip fracture, injuries, intervention, older adults, prevention, hip protector, vitamin D, safe landing strategy, and exercise. Total of 98 articles have been found and categorized into five intervention areas: exercise program, hip protector, safe landing strategy, vitamin D intake, and compliant flooring. Furthermore, the articles have been rated based on their study design: class 1, randomized controlled trials; class 2, non-randomized controlled trials; class 3, experimental studies; class 4, all other studies. Exercise programs have shown to decrease the risk of fall, and associated injuries. Hip protectors, safe landing strategy, and vitamin D intake were effective in reducing a risk and incidence of hip fracture during a fall. Furthermore, compliant flooring has also decreased hip fracture risk without affecting balance. An integrated approach combining exercise program, wearing a hip protector, teaching safe landing strategies, scheduled vitamin D intake, and compliant flooring installation, is suggested to address fall-related injuries in older adults.

Bilateral Asymmetric Traumatic Dislocation of the Hip Joint

  • Park, Hee Gon;Yi, Hyung Suk;Han, Kyoo Hong
    • Journal of Trauma and Injury
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    • 제31권1호
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    • pp.43-50
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    • 2018
  • Traumatic hip joint dislocations account for 2-5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

고관절 탈구 정복 후 발견된 좌골 신경 마비의 자기공명영상을 통한 치료방향 결정: 증례 보고 (Role of MRI in Deciding on a Treatment Plan for Sciatic Nerve Palsy after Reduction of a Hip Dislocation: Case Report)

  • 조준호;여운형;김지완
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.229-232
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    • 2013
  • Traumatic fracture-dislocations of the hip frequently result from high-energy injury, and hip dislocations are commonly associated with severe concomitant injuries. Sciatic nerve injury often accompanies traumatic fracture-dislocation of the hip, but neurologic examination at the time of injury is difficult in severely traumatized patients with decreased consciousness. We present such a case of multiple traumas with traumatic hip dislocation and sciatic nerve injury after reduction, and we found that magnetic resonance image (MRI) played an important role in developing a management plan.

스포츠 손상에서의 비구순 파열 (Acetabular Labral Tear in Sports Injury)

  • 황득수;이광진;권육상
    • 대한정형외과스포츠의학회지
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    • 제1권1호
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    • pp.15-20
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    • 2002
  • 목적: 스포츠손상에의한비구순파열환자에서진단및치료에대해고찰해보고자하였다. 대상및방법: 1995년3월부터2000년1월까지스포츠손상후발생한고관절통으로본원에내원한환자에서비구순파열로진단된15예를대상으로하였다. 원인별로달리기5예, 격투기3예, 에어로빅3예, 수영2예, 등산1예, 자전거 1예등이었다. 남자가6명, 여자가9명이었고, 나이는 평균41세였다. 모든 환자는6개월간격으로 추시하였고, 보존적 치료를 시행한 경우최소2년 이상 투약 및 증세관찰을 하였고, 관절경적 수술을 시행한6예에서 수술 전, 수술 후 6개월과 12개월에 Harris Hip Score (이하HHS)를측정하였고, JOA pain scoring system에의해결과를평가하였다. 결과: 보존적치료를 시행한9예에서 HHS는 평균 15점 향상되었고, 그중 4예는 1단계의 통증 지수 향상이 있었는데, 이들 모두Czerny 분류상type IA였다. 관절경적수술을 시행한6예에서수술후 HHS는 32점향상되었고, 6예모두에서2단계이상의통증지수향상이관찰되었다.결론: 스포츠손상환자에서급,만성고관절통을호소하는경우비구순파열은반드시감별진단되어야하며, 이학적검사상의심이될경우자기공명관절조영술을이용한진단이유용할것으로사료된다. 확진이된경우관절경을이용한파열된비구순의변연절제술이효과적인치료방법으로생각된다.

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대퇴부 손상의 치료 (Treatment of Thigh Injuries)

  • 박재형;김형수;김현철;지정민
    • 대한정형외과스포츠의학회지
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    • 제3권2호
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    • pp.100-106
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    • 2004
  • Thigh injuries are relatively uncommon sports injuries. But the incidence is increasing as many kinds of sports activity develops. And the prompt recognition and treatment of these injuries are critical to prevent prolonged disability. Also, despite the simple anatomic structure of the thigh, this region is finely tuned muscular mechanism with both anterior and posterior muscles crossing two joints. So the contracture of thigh muscle can result in not only decreased range of motion of the knee and hip joint, but also painful lumbar spine. So we reviewed recent literatures about the type of thigh injuries, diagnosis, treatment and rehabilitation.

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Leg Length Discrepancy to Influence on Kinematic Changes of the Pelvis and the Hip during Gait

  • Yong, MinSik;Park, SoHyun
    • The Journal of Korean Physical Therapy
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    • 제31권6호
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    • pp.368-371
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of leg length discrepancy on kinematic changes of the pelvis and hip during gait. Methods: A total of ten healthy women with no history of neurological, musculoskeletal surgery or injuries, or pain in the lower limbs were recruited. They were assigned to two groups; the experimental group (LLD) consisting of five subjects leg length discrepancy of 10mm to 18mm and the control group (CON) consisting of five subjects leg length discrepancy of<10 mm. All participants were instructed to perform three walking trials for further analysis by using the Cortex 3.0 software program. Independent T-test and Mann-Whitney test were used to examine the effects of mild LLD on kinematic changes of the pelvis and hip during gait. Results: Angles of hip flexion, hip abduction, pelvic obliquity, and pelvic tilt in the experimental group were not significantly different compared to those of the control group. Conclusion: Mild leg length discrepancy induces kinematic changes in the lower limbs, including decreased hip flexion, increased hip abduction, and increased pelvic obliquity in the shorter limb, and increased hip adduction and increased pelvic obliquity in the longer limb. However, those changes were not significant.

Effects of Different Types of Isometric Hip Contraction on Gluteus Medius and Tensor Fasciae Latae Activity During Squat Exercises

  • Han, Hae-rim;Kim, Jeong-ah;Lim, One-bin;Cynn, Heon-seock;Yi, Chung-hwi
    • 한국전문물리치료학회지
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    • 제22권3호
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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.

Hip Muscle Strength and Ratio Differences in Delivery Workers With and Without Iliotibial Band Syndrome

  • Eun-su Lee;Ui-jae Hwang;Hwa-ik Yoo;Il-kyu Ahn;Oh-yun Kwon
    • 한국전문물리치료학회지
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    • 제30권1호
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    • pp.15-22
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    • 2023
  • 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.

Relationship Between Strength of Hip Muscles and Performance of Close Kinetic Chain Dynamic Lower Extremity Stability Test

  • Lee, Hyeon-ju;Hwang, Ui-jae;Jung, Sung-hoon;Ahn, Sun-hee;Kwon, Oh-yun
    • 한국전문물리치료학회지
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    • 제27권4호
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    • pp.257-263
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    • 2020
  • 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.

Effect of Hip Flexion and Internal Rotation on the Hip Abductor Muscle Activity During Side-Lying Hip Abduction in Subjects With Gluteus Medius Weakness

  • Park, Hye-jin;Cho, Sang-hyun
    • 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.