• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.23-29
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• 2023

Background: There is still controversy as to whether hip external rotation and dorsiflexion selectively activate the vastus medialis obliquus (VMO) during straight leg raise exercise. Due to the anatomical characteristics, hip adduction must be preceded to activate the VMO. In this study, the activities of the rectus femoris (RF), vastus lateralis (VL), VMO were measured by adding the hip adduction movement to the straight leg raise exercise with hip 45° external rotation and straight leg raise exercise with hip 45° external rotation and dorsiflexion. Through this, we want to find out whether the VMO is selectively activated. Methods: Thirteen healthy participants performed straight leg raise exercise with hip 45° external rotation, straight leg raise exercise with hip 45° external rotation and dorsiflexion, straight leg raise exercise with hip 45° external rotation and adduction, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion was randomly performed. Through this, EMG data of the RF, VL, VMO were collected. Results: During the straight leg raise exercise, hip adduction increased the activity of the VMO and VL, no significant difference was found(p>.05). However, in the VMO/VL ratio, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion activated the VMO and the VL at a ratio of about 1:1, It showed a significantly higher rate than straight leg raise exercise with hip 45° external rotation(p<.05). Conclusion: During the straight leg raise exercise, hip adduction is considered to be an important movement that can selectively induce the activity of the VMO. Therefore, follow-up studies on this should be conducted.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.99-105
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• 2018

PURPOSE: The aim of this study was to evaluate the concurrent validity and clinical usefulness of the universal plastic goniometer to measure the range of motion of the internal and external rotation of the hip joint using the three dimensional motion analysis which can analyze the joints and segment movements in the most objective and quantitative method. METHODS: Clinical and kinematic data were collected from thirty individuals using a universal plastic goniometer and a ten camera motion analysis system. Passive hip rotation range was obtained three trials for left and right hip joints using two measure methods simultaneously. RESULTS: There were significant differences between all matching measures of the two measures of internal and external rotation of the hip joint (p<.05). The relationship between the two tests for all measurements of the internal and external rotation of the hip was statistically significant with correlation coefficient form r=.87 to .96. (p<.01). CONCLUSION: Clinical measurement of the internal and external rotation of the hip using a universal plastic goniometer is effective to assess the hip condition. However, application of universal plastic goniometer requires careful attention in more accurate evaluation and research verification of the internal and external rotation of hip joint.

• Journal of Korean Physical Therapy Science
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• v.8 no.1
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• pp.893-906
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• 2001

The purposes of this study were to compare pelvic tilt. range of motion(ROM) of hip rotation, and leg length difference before and after manipulation and to investigate correlation between changes of each variables after manipulation of sacroiliac pint in 31 low back pain patients(11 males, 20 females) with sacroiliac pint dysfunction. The sacroiliac pint of patients was manipulated on the side of anterior pelvic tilt, using the technique described by Stoddard(1962) and Greenmann (1996). I used this technique because it usually eliminated sacroiliac Pint dysfunction in one treatment session. SPSS for window computer system was used to analyze the data. Also t-test was performed for comparison of the variables before and after manipulation, and Pearson product-moment correlation analysis and regression analysis were performed for changes of each variables after manipulation. The result were as follows: 1. The pelvic tilt after manipulation was significantly decreased(mean=$2.79^{\circ}$) compared with the pelvic tilt before manipulation(p=.001). 2. The PROM of hip internal rotation ipsilateral to anterior pelvic tilt after manipulation significantly decreased (mean = $1.88^{\circ}$) compared with hip internal rotation before manipulation (p=.008). The PROM of hip internal rotation ipsilateral to posterior pelvic tilt after manipulation significantly increased(mean = $1.29^{\circ}$) compared with hip internal rotation before manipulation (p=.029). 3. The PROM of hip external rotation ipsilateral to anterior pelvic tilt after manipulation significantly increased(mean=$2.42^{\circ}$) compared with the hip external rotation before manipulation(p=$2.42^{\circ}$) compared with the hip external rotation ipsilateral to posterior pelvic tilt after manipulation significantly decreased(mean = $1.84^{\circ}$) compared with the hip external rotation before manipulation (p=.008). 4. Leg length difference after manipulation significantly decreased(mean=2.15 mm) compared with leg length difference before manipulation (p=.008). Regression analysis revealed that a fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(p=.009). 5. Pearson product-moment correlation coefficient was used to assess differences of the variables after manipulation. A fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(r=.462, p<.01). A fair correlation was found between change in anterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.397, p<.05) and between change in anterior pelvic tilt and change in hip external rotation ipsilateral to anterior pelvic tilt(r=.516, p<.01). A fair correlation was found between change in posterior pelvic tilt and changes in hip internal rotation ipsilateral to posterior pelvic tilt (r=.441, p<.05) and between change in posterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.361, p<.05). A fair correlation was found between change in hip internal rotation ipsilateral to anterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.388, p<.05) and between change in hip internal rotation ipsilateral to posterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.426. p<.05).

• Physical Therapy Korea
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• v.21 no.3
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• pp.1-10
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• 2014

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles ($0^{\circ}$, $20^{\circ}$, $40^{\circ}$) with a $30^{\circ}$ hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both $40^{\circ}$ (p=.006) and $20^{\circ}$ (p=.010) compared to a $0^{\circ}$ hip external rotation angle. G Med muscle activity increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. The G Max/HAM activity ratio increased significantly at both $40^{\circ}$ (p=.004) and $20^{\circ}$ (p=.014) compared to a $0^{\circ}$ hip external rotation angle. The G Med/HAM activity ratio increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. In conclusion, $40^{\circ}$ and $20^{\circ}$ hip external rotation angles are recommended to increase G Max activity, and $20^{\circ}$ hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and $30^{\circ}$ hip abduction in healthy subjects.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.43-49
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• 2017

PURPOSE: This study investigated the relationship among hip adduction angle, tibial rotation, and ITB length during an Ober test to determine the most appropriate position for performing the test. METHODS: The study included thirty-nine asymptomatic participants (23 males, 16 females). Their hip adduction angles were measured using the Ober test during three tibial rotation conditions (internal tibial rotation, external rotation, and neutral position). ITB length was calculated by measuring the position of the patella to lateral femoral condyle using ultrasonography (patella-condyle distance; PCD). RESULTS: The relationship among hip adduction angle, tibial rotation, and ITB length was analyzed under the three conditions using the Pearson correlation. The hip adduction angle of the internal tibial rotation, the external rotation, and the neutral position were significantly related to ITB length. Moreover, the hip adduction angle measured during the internal tibial rotation had the highest correlation with ITB length among the three conditions (r=.58, p<.001). CONCLUSION: Internal tibial rotation caused by the Ober test led to increased iliotibial band (ITB) tension and a decreased adduction angle. These findings support that tibial rotation influences the flexibility of ITB. Therefore, therapists should consider the position of the internal tibial rotation when taking measurements using an Ober test.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.41-48
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• 2017

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

• The Journal of Korean Physical Therapy
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• v.3 no.1
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• pp.97-108
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• 1991

The purpose of this article is to know the standard figures of joint range of motion, in conjuction with age and sen, for normal adults. The results of assessment and analysis io shoulder and hip joint range of motion are as follows : 1) The average shoulder joint range of motion in normal adults are $160.5^{\circ}$ in flexion, $53.5^{\circ}$ in extension, $159.3^{\circ}$ in adduction, $62.3^{\circ}$ in internal rotation, $83.9^{\circ}$ in external rotation, The average hip joint range of motions are $116.8^{\circ}$ in flexion, $16.1^{\circ}$ in extension, $41.1^{\circ}$ in abduction, $33.8^{\circ}$ in abduction, $40.0^{\circ}$ in interne rotation, $41.2^{\circ}$ in external rotation. 2) There is no significant difference in shoulder and hip joint range of motion between male and female (p>0.05). 3) As to the inter-relation in age and range of motion, the left flexion and extension, internal rotation and right extension in shoulder joint is decreased gradually with increasing age, and left flexion (knee flexion, knee extension) and right flexion (knee extension) in hip joint is decreased with increasing age (p<0.01). 4) Relating to age and sex, the twenties male shows highest range of motion in shoulder and hip joint, with .the fifties female shows, lowest range of motion.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.177-185
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• 2022

Purpose : The purpose of this study was to compare the effect of additional isometric contraction of trunk, shoulder, and hip muscles during abdominal crunch exercise on abdominal muscle thickness and to identify the most effective intervention for core muscle activation. Methods : This study was conducted on 22 healthy male adults. Subjects performed three types of crunch exercises (abdominal crunches accompanied by internal and external isometric rotation of the hip, horizontal shoulder adduction and abduction, and rotation of the trunk). The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) were evaluated using ultrasonography. The collected data used one-way repeated ANOVA statistics. Wilcoxon signed-rank test of nonparametric statistics was used for post-test analysis. Results : The IO thickness was significantly lower than general abdominal crunch when shoulder adduction was added (p<.05). The crunch with shoulder abduction, hip external rotation, and ipsilateral trunk rotation was significantly higher than the abdominal crunch (p<.05). The EO thickness was significantly greater in the crunch with hip external rotation than in the abdominal crunch (p<.05). Conclusion : The level of contraction in abdominal muscles appears to vary when isometric contractions of the trunk, shoulder, and hip muscles are added to the abdominal crunch exercise. Therefore, the use of isometric contractions of other joints to selectively induce contraction of the abdominal muscles may be considered.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.210-217
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• 2014

This study is to present objective data for the approaches of therapeutic exercise for the correction of genu varum by making an analysis and a comparison of the hip joints' ROM and isokinetic muscles of the female college students with straight legs with those of a female college student with idiopathic genu varum. Additionally, the state of the adductor muscle's thighs and the deep muscles of the subjects with bowed legs were experimented and the equipment's effect and applicability was reviewed through the process of the movement of newly developed exercise equipment, Balloa(2013, Balloa/Adonia/Korea). As a result, a person with genu varum needs the height increasing method for increasing external rotation ROM of a hip joint and requires the exercise techniques to strengthen external rotator muscles and to inhibit the activity of internal rotator muscles of a hip joint. Balloa increases the external rotation ROM of a hip joint and strengthens gluteal muscles, deep muscles, and adductor muscles, and the equipment's function of muscle strengthening shows that the equipment is an effective corrective exercise for the patients of genu varum.