• Journal of The Korean Society of Integrative Medicine
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• v.2 no.1
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• pp.15-21
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• 2014

Purpose : The aim of this study was to find out differences between muscle activity of quadriceps according to hip angle. Method : 40 healthy adults produced maximum isometric muscle contraction of quadriceps femoris and each part of the quadriceps femoris were measured with a surface EMG in hip joint angle of $90^{\circ}$, $135^{\circ}$, $180^{\circ}$. Result : There was no significant difference between muscle activity of vastus medialis and lateralis according to hip angle. But there was significant difference in muscle activity of rectus femoris and the muscle activity was maximum at 135 degrees of hip angle. Conclusion : In conclusion, maximum muscle activation of rectus femoris is affected by hip angle, and the findings from this study may be helpful for physical therapists in selecting hip position when instructing patients to do Q-setting exercise. So, we suggest that patients perform Q-setting exercise at 135 degrees of hip angle for the best result.

• Physical Therapy Korea
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• v.26 no.3
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• pp.91-98
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• 2019

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

• Physical Therapy Korea
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• v.30 no.2
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• pp.144-151
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• 2023

Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.275-282
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• 2012

Purpose : Bridge exercise has been commonly used in clinical rehabilitation settings to improve trunk control, and hip adductor muscles were a related muscle that may affect trunk muscle activation. The aim of this study was to investigate whether the co-contraction of hip adductor muscles may affect trunk muscle activation during bridge exercises. Methods : Thirty-eight healthy young subjects (19 men and 19 women) performed bridge exercises (with and without hip adduction movement). Surface electromyography (EMG) data were collected from the dominant-side internal oblique (IO), rectus abdominis (RA), multifidus (MF) and erect spine (ES) during bridge exercises to compare trunk muscles activation patterns. Result : The EMG activities of IO and RA appeared to be significantly higher during bridge exercise with hip adductor co-contraction than during bridge exercise alone (p<.01), but there were no significant differences in those of MF and ES. Furthermore, there were significant differences in the IO:RA EMG ratio during bridge exercise with hip adductor co-contraction (p<.05). Conclusion : These findings suggest that integration of hip adduction during bridge exercise may be beneficial in increasing deep muscles' activity for trunk stabilization.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.295-301
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• 2020

Purpose: The purpose of this study was to compare the electromyographic activity and onset time of the gluteus maximus (GM) and hamstring (HAM), lumbopelvic kinematics during three different prone table hip extension exercises in healthy individuals. Methods: Twenty subjects were participated. Electromyography device was used to measure the muscle activities and onset time of the GM and HAM muscles. An electromagnetic tracking motion device was used to measure lumbopelvic compensations. The subjects were asked to perform three different prone table hip extension [Prone table hip extension with the abdominal drawing-in maneuver on a chair (PTHEA), PTHEA with the ipsilateral knee flexion (PTHEAF), PTHEAF with hip 30 abduction (PTHEAFA)]. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The electromyographic activity and onset time were significantly different among three conditions (PTHEA vs. PTHEAF vs. PTHEAFA)(p<0.01). The GM muscle activity and onset time were significantly greater and reduced during the PTHEAFA compared to PTHEA and PTHEAF (p<0.01). However, The HAM muscle activity and onset time were significantly smaller and delayed during the PTHEAFA compared to PTHEA and PTHEAF (p<0.01). Conclusions: PTHEAFA exercise can be recommended to facilitate the muscle activity and efficient muscle firing time of GM without HAM dominance.

• Physical Therapy Korea
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• v.30 no.3
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• pp.245-252
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• 2023

Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting-side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.

• Physical Therapy Korea
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• v.24 no.2
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• pp.19-26
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• 2017

Background: To improve lumbo-pelvic stability, passive support devices (i.e., a pelvic belt) are recommended clinically. Nevertheless, to understand the influence of passive support on lumbo-pelvic stability, it is necessary to examine the influence of a pelvic belt on the abdominal and hip abductor muscles. Objects: To examine the effects of a pelvic belt on the forces of the hip adductor and abductor muscles and activity of the abdominal muscles during isometric hip adduction and abduction. Methods: This study recruited 14 healthy men. All subjects performed isometric hip adduction and abduction with and without a pelvic belt in a neutral hip position. Load cells, wrapped with a non-elastic belt, were placed above the medial and lateral malleoli of the dominant leg to measure the muscle forces of the hip adductors and abductors, respectively. The forces of the hip adductors and abductors were measured using a load cell during isometric hip adduction and abduction, while the electromyographic activities of the bilateral rectus abdominis, internal oblique, and external oblique muscles were measured. Results: The forces generated by the hip adductors and abductors were significantly greater with the pelvic belt than without (p<.05). No significant differences in abdominal muscle activities between the two conditions were found (p>.05). Conclusion: These findings suggest that use of a pelvic belt could lead to effective strengthening exercise of hip muscles in individuals with sacroiliac joint pain.

• Physical Therapy Korea
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• v.28 no.1
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• pp.84-91
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• 2021

Background: A hip fracture may occur spontaneously prior to the hip impact, due to the muscle pulling force exceeding the strength of the femur. Objects: We conducted falling experiments with humans to measure the activity of the hip muscles, and to examine how this was affected by the fall type. Methods: Eighteen individuals fell and landed sideways on a mat, by mimicking video-captured real-life older adults' falls. Falling trials were acquired with three fall directions: forward, backward, or sideways, and with three knee positions at the time of hip impact, where the landing side knee was free of constraint, or contacted the mat or the contralateral knee. During falls, the activities of the iliopsoas (Ilio), gluteus medius (Gmed), gluteus maximus (Gmax) and adductor longus (ADDL) muscles were recorded. Outcome variables included the time to onset, activity at the time of hip impact, and timing of the peak activity with respect to the time of hip impact. Results: For Ilio, Gmed, Gmax, and ADDL, respectively, EMG onset averaged 292, 304, 350, and 248 ms after fall initiation. Timing of the peak activity averaged 106, 96, 84, and 180 ms prior to the hip impact, and activity at the time of hip impact averaged 72.3, 45.2, 64.3, and 63.4% of the peak activity. Furthermore, the outcome variables were associated with fall direction and/or knee position in all but the iliopsoas muscle. Conclusion: Our results provide insights on the hip muscle activation during a fall, which may help to understand the potential injury mechanism of the spontaneous hip fracture.

• PNF and Movement
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• v.21 no.3
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• pp.281-289
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• 2023

Purpose: This study investigated the effects of the non-elastic taping method for controlling internal hip joint rotation on internal and external hip rotator muscle activity in healthy people. Methods: In this study, 18 healthy volunteers were instructed to perform the small knee bending (SKB) test. All participants completed the test following two methods (using non-elastic taping and not using taping). Muscle activation during the two methods was measured using a surface electromyography (EMG) device. Surface EMG data were collected from the gluteus medius, gluteus maximus, and tensor fasciae femoris muscles while performing the SKB test with and without non-elastic taping. Results: Muscle activity in the gluteus maximus was significantly higher during the SKB test with non-elastic taping than during the conventional SKB test with taping (p < 0.05). Tensor fasciae latae muscle activity was lower during the SKB test with non-elastic taping than during the conventional SKB test (p < 0.05). Conclusion: The findings suggest that the non-elastic taping method for controlling internal hip joint rotation effectively activates the hip's external rotator muscles and minimizes unwanted internal rotator muscle use during the SKB test. Therefore, the non-elastic taping method for controlling internal hip joint rotation could be an effective intervention for those who cannot control the internal rotation of their hips.