• Physical Therapy Korea
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• v.26 no.1
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• pp.75-83
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• 2019

Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

• PNF and Movement
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• v.22 no.1
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• pp.71-80
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• 2024

Purpose: The purpose of this study is to compare the effects of proprioceptive neuromuscular facilitation (PNF) stretching, based on ballistic stretching and the contract-relax technique, on hip joint flexibility and muscle tone in adults with shortened rectus femoris muscles. Methods: The study involved 40 adults with shortened rectus femoris muscles, identified using the modified Thomas test. Participants were randomly divided into two groups: PNF stretching, employing the contract-relax technique, and ballistic stretching. Measurements included muscle tension, hip joint range of motion, and muscle characteristics. The rectus femoris muscle shortening effect was confirmed by the modified Thomas test, while the flexibility effect was assessed through hip joint motion range. The muscle tension effect was determined using Myoton-PRO. Results: Both stretching methods resulted in significant improvements in modified Thomas test angles and frequency, with the PNF stretching group showing notably greater changes. However, neither stretching method significantly affected decrement or stiffness measurements. These findings suggest that PNF stretching may be more effective for certain outcomes compared to ballistic stretching. Conclusion: In summary, both stretching methods positively influenced flexibility and muscle tension, with PNF stretching showing a greater impact. These findings highlight the importance of selecting the appropriate stretching technique for achieving functional improvements in muscles, which could serve as valuable indicators for preventing and treating muscle injuries in both sports and daily activities.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.49-59
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• 2023

PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

• Physical Therapy Korea
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• v.23 no.4
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• pp.1-8
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• 2016

Background: Various methods are used for recovery of knee flexion range of motion (ROM) due to a tightened rectus femoris muscle (RFM) or limited inferior glide of the patella. Stretching methods are common interventions for restoring the tightened RFM length. Also patellar inferior gliding (PIG) technique can recover tightened RFM length too. However, effect of applying the PIG to passive knee flexion (PKF) has not been studied. Objects: The purpose of this study was to investigate the effect of combining PIG with RFM stretching for improving knee flexion ROM in subjects with RFM tightness. Methods: Twenty-six subjects with RFM tightness were recruited. Two different methods of knee stretching were tested: 1) PKF during modified Thomas test (MTT) and 2) PKF with PIG during MTT. The passive stretching forces was controlled by hand-held dynamometer. The knee flexion ROM angle was measured by a MTT with ImageJ software. Differences between the conditions with and without PIG were identified with a paired t-test. Results: The knee flexion ROM was significantly greater for PKF with PIG ($114.44{\pm}9.33$) than for PKF alone ($108.97{\pm}9.42$) (p<.001). Conclusion: A combination of passive knee flexion exercise and PIG can be more effective than PKF in increasing knee flexion ROM in individuals with RFM tightness.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.225-234
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• 2021

Objective: We aimed to identify the effects of proprioceptive neuromuscular facilitation (PNF) stretching on pain, hip range of motion, and functional disability in patients with chronic low back pain. Design: Randomized controlled trial Methods: In total, 45 patients with chronic low back pain were randomly divided into a conventional stretching group (n=22) and a PNF stretching group (n=23). Both interventions were performed three times per week for 6 weeks. Assessments were made using the visual analog scale, Flexion-Abduction-External Rotation test, modified Thomas test, prone hip extension test, and Oswestry disability index before and after the 6-week intervention period. We conducted a paired t-test to compare the within-group findings before and after the intervention. An independent t-test was used to compare the between-group differences. The statistical significance level was set at α=0.05, for all variables. Results: Both groups showed significant improvements in pain, hip range of motion, and functional disability after the intervention (p<0.05). A significant difference was observed in pain, hip range of motion, and functional disability in patients belonging to the PNF stretching group (p<0.05). Conclusions: This study provides evidence that the application of PNF stretching can effectively reduce pain and improve hip range of motion and functional disability in patients with chronic low back pain.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.21-27
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• 2020

Purpose : The purpose of this paper is to compare the immediate effects of tensor fascia latae (TFL) stretching with weight bearing (standing position) or non-weight bearing (side-lying position). Methods : The study was conducted on 30 adults (12 men, 18 women) in their 20s. Modified Thomas's test was conducted to find out if the TFL muscle has a tightness for current study. This study randomly divided the subjects into two groups and set the standing stretching group (n=15) or the side-lying stretching group (n=15). Both groups applied self-stretching under the therapist's supervision. TFL stretching in each positions was performed 30 seconds per set, 3 times, and 30 seconds per set could rest. The Ober test were conducted to investigate the effect of TFL stretching in each positions. Results : For the Ober test measurements within each group, both groups significantly increased after intervention compared to before (p<.05). There was no significant difference between the groups (p>.05). Conclusion : TFL stretching in standing position and side-lying position increased the range of motion of the TFL muscle. Therefore, if it is difficult to apply TFL stretching in standing position (weight bearing) due to pain or other reasons, it will be able to TFL stretching in side-lying position (non-weight bearing).

• Geomechanics and Engineering
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• v.20 no.6
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• pp.505-516
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• 2020

In recent years, Nano-technology significantly invaded the field of Geotechnical engineering, particularly in soil stabilisation techniques. Stabilisation of weak soil is envisioned to modify various soil characteristics by the addition of natural or synthetic materials into the virgin soil. In the present study, laboratory experiments were executed to investigate the influence of nano-silica particles in the consistency limits, compressive strength of the soft clay blended with cement. The results revealed that the high compressibility behaviour of soft clay modified to medium-stiff condition with fewer dosages of cement and nano-silica. The mechanism behind the strength development is verified with the previous researches as well as from Fourier Transform Infrared spectroscopy (FTIR), X-ray diffraction test (XRD) and Scanning Electron Microscopy (SEM) analysis. Based on the results, the presence of nano-silica in soft clay blended with cement has a positive effect on the behaviour of soil. This technique proves to be very economical and less detrimental to the environment.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.23-28
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• 2018

Purpose: This study examined the effectiveness of iliopsoas self-stretching on the hip extension angle, gluteus maximus (GM) activity, and pelvic compensated angle during prone hip extension (PHE) in subjects with iliopsoas shortness. Methods: Twenty-healthy subjects with iliopsoas shortness were recruited. Electromyography (EMG) was used to examine erector spinae (ES), multifidus (MF), GM, and biceps femoris (BF) while performing PHE. An electromagnetic tracking motion analysis device was used to measure the pelvic compensations. The pelvic compensations while performing PHE were considered to be anterior tilting and rotation. A modified Thomas test was used to monitor the hip extension angle before and after iliopsoas self-stretching. A paired t-test was used to investigate the significant difference after iliopsoas self-stretching during PHE. The level of statistical significance was set to ${\alpha}=0.05$. Results: Muscle activity of GM and hip extension angle were significantly greater after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). BF and pelvic rotation angle were significantly lower after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). The muscle activity of ES was not significantly different between PHE before and after iliopsoas self-stretching (p>0.05). Conclusion: Iliopsoas self-stretching can be effective in selectively strengthening the GM muscles with minimized pelvic compensation in subjects with iliopsoas shortness.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.79-86
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• 2022

PURPOSE: By virtue of its location, the iliopsoas muscle has the potential to affect the function of the diaphragm. Therefore, the purpose of this study was to investigate the effects of passive stretching of the iliopsoas muscles on pulmonary function. METHODS: Twenty male university students participated in this study. Subjects with low back pain, negative results on the modified Thomas test, and chest breathing patterns not directly related to the function of the iliopsoas muscles were excluded from this study. A digital pulmonary function measuring device (Pony FX, COSMED Inc, Italy) was used to test pulmonary function. The test was performed three times: the first test before passive stretching, the second test 10 minutes after the first test, and the third after passive stretching. Passive stretching was performed 5 times for each of the left and right iliopsoas muscles. Passive stretching was carried out for 20 seconds followed by a 10-second break. The SPSSWIN (ver. 27.0) statistics program was used for data analysis, and the significance level was α =.05. RESULTS: Among slow vital capacity (SVC) parameters, tidal volume (VT), inspiratory reserve volume (IRV), inspiratory capacity (IC) and vital capacity (VC) improved significantly after passive stretching. Also, among the maximal effort vital capacity (MEVC) parameters, forced vital capacity(FVC) and forced expiratory volume in one second(FEV1) improved significantly after passive stretching. CONCLUSION: The results showed that among the various pulmonary function parameters measured, passive stretching of the iliopsoas muscles can improve the SVC and MEVC. Therefore, passive stretching of the iliopsoas muscles may be considered for use as a treatment method to improve pulmonary function.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.11-20
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• 2006

Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.