• 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).

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.1
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• pp.39-47
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• 2013

Objectives : The purpose of this study is to find out the relationship between hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD) in single-segment. Methods : We investigated 314 patients (158 male, 156 female) who were diagnosed as herniation of lumbar intervertebral disc(HIVD) in single-segment. We measured 314 patients' hip internal rotation angle and analysed the relationship between the hip internal rotation angle and the level of herniation of lumbar intervertebral disc(HIVD). Results : 1. Among 314 cases, the hip internal rotation angle was different between male and female. Hip internal rotation angle of male was mainly limited and that of female was mainly excessive. 2. Among 314 cases, the normal group, defined as patients who have specific range of hip internal rotation angle(male : $35^{\circ}{\pm}10^{\circ}$, female : $45^{\circ}{\pm}10^{\circ}$), tends to be occurred HIVD at L4/5 level. The limited group, defined as patients who have less angle than normal group, the excessive group, defined as patients who have more angle than normal group, and the complex group, defined as patients who have more angle of one leg and less angle of the other leg than normal group, tend to be occurred HIVD at L5/S1 level(p<0.05). Conclusions : In single-segment lumbar HIVD patients, The normal hip internal rotation angle mainly leads to L4/5 HIVD, while the limited and excessive hip internal rotation angle mainly lead to L5/S1 HIVD.

• 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 the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.39-45
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• 2019

PURPOSE: We investigated the most effective way to activate the posterior oblique sling muscles by performing prone hip extension exercises. METHODS: An electromyography system was used to measure the activation of the posterior oblique sling muscles (latissimus dorsi, gluteus maximus, multifidus, and biceps femoris) in three different prone hip extension exercises of in 12 healthy individuals (6 men and 6 women): 1) prone hip extension, 2) prone hip extension with internal rotation and extension of the arm, and 3) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell. RESULTS: The overall muscular activation of the posterior oblique sling muscles was more increased when performing 1) prone hip extension with internal rotation and 2) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell as compared with that during prone hip extension except for the biceps femoris activation. There was a statistically significant difference in the activities of the contralateral multifidi among all three exercises; of the ipsilateral multifidi in PHE1) prone hip extension alone, PHE2) prone hip extension with internal rotation and extension of the arm and PHE3) prone hip extension with internal rotation and extension of the arm with 1-Ib dumbbell; and of the ipsilateral gluteus maximus among all the prone hip extension exercises. There was no significant difference in the activity of the biceps femoris among the three exercises. CONCLUSION: Prone hip extension with internal rotation and with internal rotation and extension of the arm with 1-Ib dumbbell can activate the posterior oblique sling muscles and so prevent back pain in healthy people.

• 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.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.9-16
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• 2010

Objectives : This study is planned to classify different biomechanics of men and women, from the comparison of normal range and hip internal rotation angle in chronic low back pain patients. Methods : We measured the hip internal rotation angle of the 30 men and 30 women patients with low back pain that has been over 3 months in BuCheon Jaseng Hospital of Oriental medicine. We set 35-45 degrees as normal range, and found the patients with exceeding normal range, the patients with normal range, and the patients with under normal range. Results : Men appeared to have less hip internal rotation angle than women. Especially, the men's left hip internal rotation angle was less than normal range. On the other hand, women's right hip internal rotation angle was often larger than normal range which was stastically significant. Conclusions : Contraction of hip external rotation muscle including gluteus maxius muscle and piriformis muscle in men, or relaxation of posterior gluteus medius, gluteus maxius and piriformis muscle with contraction of tensor fasciae latae, a part of hip internal rotation muscle, in women seems to be the basis for biomechanics of chronic low back pain.

• Physical Therapy Korea
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• v.13 no.1
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• pp.24-31
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• 2006

The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.2
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• pp.41-48
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• 2011

Background: Patellofemoral pain syndrome is very common knee problem and altered hip rotation may play a role in patellofemoral pain. The purpose of this case study is to describe the manual therapy of and the therapeutic exercise for a patient with asymmetrical hip rotation and patellofemoral pain. Method: The patient was a 29 years old woman with an 3 month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the VAS was Max 6 to Min 4. Left hip internal rotation was less than right hip internal rotation, and manual muscle testing showed weakness of the left hip internal rotator and abductor muscles. The intervention consisted of manual therapy and therapeutic exercise for three times a weeks, two weeks for increasing right hip medial rotation, improving left hip muscle strength, and eliminating anterior right knee pain. Result: After intervention for 2weeks, passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her VAS score was Max 2 to Min 0. Conclusion: Manual therapy and therapeutic exercise is effective in improving for patient had patellofemoral pain with pattern of asymmetrical hip rotation.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.117-127
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• 2014

Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.

• 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.