• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.241-245
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• 2017

Purpose: This study examined the hip and lumbopelvic movement while the hip was rotating laterally in individuals with chronic low back pain (CLBP). Methods: Sixty healthy subjects and sixty subjects with CLBP were enrolled in this study. Myomotion (Myomotion research pro, Noraxon Inc., German) was used to measure the hip lateral rotation and the lumbopelvic movement. An independent t-test was used to compare the hip lateral rotation and lumbopelvic rotation between the groups. Results: Between healthy males and females, healthy females showed a smaller hip lateral rotation angle (HLRA) than healthy males in the hip lateral rotation test (HLRT). Between the healthy females and females with CLBP, the females with CLBP showed a smaller HLRA and greater lumbopelvic motion than the healthy females in the HLRT, and their lumbopelvic motions occurred earlier during lateral rotation of the hip. Finally, between the males and females with CLBP, the females with CLBP showed a smaller HLRA and greater lumbopelvic motion in the HLRT, and their lumbopelvic motions occurred earlier during lateral rotation of the hip. Conclusion: The results of this study suggest that the CLBP affected the hip lateral rotation, and the lumbopelvic movement depended on gender. In particular, compared to the other groups, the females with CLBP showed a larger lumbopelvic rotation angle and smaller hip lateral rotation angle and lumbopelvic motion occurred early during lateral rotation of the hip.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.115-122
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• 2018

The success of the total hip arthroplasty is revealed as initial stability, range of motion, and long term pain, etc. Depending upon choice of implantation options such as femoral neck offset, diameter of the femoral head, the lateral opening tilt. Especially the impingement between femoral head component and acetabular cup limits the range of motion of the hip. In this sense, estimation or evaluation of the range of motion before and after the total hip arthroplasty is important. This study provides the details of a computer simulation technique for the hip range of motion of intact hip as well as arthroplasty. The suggested method defines the hip rotation center and rotation axes for flexion and abduction, respectively. The simulation uses CT-based reconstructed 3D models and an STL treating software. The abduction angle of the hip is defined as the superolateral rotation angle from sagittal plane. The flexion angle of the hip is defined as the superoanterior angle from the coronal plane. The maximum abduction angle is found as the maximum rotation angle by which the femoral head can rotate superolaterally about the anterior-posterior axis without impingement. The maximum flexion angle is found as the maximum rotation angle by which the femoral head can rotate superoanteriorly about the medial-lateral axis without impingement. Compared to the normal hip, the total hip replacement hip showed decreased abduction by 60 degrees and decreased flexion by 4 degrees. This measured value implies that the proposed measurement technique can make surgeons find a modification of increase in the femoral neck offset or femoral head, to secure larger range of motion.

• 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 Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.1-8
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• 2010

Purpose : This study aimed to examine the relationships among five clinical measures for functional alignment of the lower extremity. Methods : Thirty healthy subjects (15 males and 15 females) were recruited for the study. The five clinical measures of functional alignment of the lower extremity included navicular drop, quadriceps angle, internal rotation of hip, and anterior and lateral pelvic tilt angles. The level of navicular drop was calculated by the difference between the height of the navicular bone in the sitting (non-weight bearing) and standing (weight bearing) positions. The quadriceps angle and internal rotation of hip were measured using a standard goniometer with photographic markers while the subjects were lying in a prone position on a table with their knee at $90^{\circ}$ flexion. Anterior and lateral pelvic tilt angles were determined using a inclinometer. Results : Correlation and a simple linear regression analysis were used to assess relationships between the clinical measures. There were significant correlations between navicular drop and quadriceps angle (p<.05), between navicular drop and internal rotation of hip (p<.05), and between quadriceps angle and internal rotation of hip (p<.01). In simple linear regression analysis, the navicular drop appeared to be a factor affecting the quadriceps angle and internal rotation of hip (p<.05). The findings suggest that navicular drop has a great impact on lower extremity alignment. Conclusion : This study might help us to examine lower extremity function and clarify its role as a potential injury risk factor.

• Physical Therapy Korea
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• v.19 no.4
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• pp.61-69
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• 2012

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.14-22
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• 2018

Purpose: This study examined the effects of the lower limb alignment on the pelvis, hip, and knee kinematics in people with genu varum during stair walking. Methods: Forty subjects were enrolled in this study. People who had intercondylar distance ${\geq}4cm$ were classified in the genu varum group, and people who had intercondylar distance <4cm and intermalleolar distance <4cm were placed in the control group. 3D motion analysis was used to collect the pelvis, hip, and knee kinematic data while subjects were walking stairs with three steps. Results: During stair ascent, the genu varum group had decreased pelvic lateral tilt and hip adduction at the early stance phase and decreased pelvic lateral tilt at the swing phase compared to the control group. At the same time, they had decreased minimal hip adduction ROM at the early stance and decreased maximum pelvic lateral tilt ROM and minimum hip rotation ROM at the swing phase. During stair descent, the genu varum group had decreased pelvic lateral tilt at the early stance and decreased pelvic lateral tilt and pelvic rotation at the swing phase. In addition, they had decreased pelvic frontal ROM during single limb support and increased knee sagittal ROM during the whole gait cycle. Conclusion: This study suggests that a genu varum deformity could affect the pelvis, hip and knee kinematics. In addition, the biomechanical risk factors that could result in the articular impairments by the excessive loads from lower limb malalignment were identified.

• Physical Therapy Korea
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• v.15 no.2
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• pp.54-63
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• 2008

The purpose of this study was to examine the effect of the hip internal rotation on knee extensor and hip abductor electromyographic (EMG) activity during stair up and stair down mobility. Eighteen healthy subjects were recruited. All subjects performed stair up and down movements on a step of 30cm height while maintaining the hip in neutral (condition 1) and hip in internal rotation (condition 2). Surface EMG activity was recorded from five muscles (gluteus maximus, vastus lateralis (VL), vastus medialis oblique (VMO), posterior gluteus medius (Gmed), and tensor fascia latae (TFU)) and hip internal rotation angle was measured using a three dimensional motion analysis system The time period for stair up and down was normalized using the MatLab 6.5 program, and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities according to the hip rotation (neutral or internal rotation) during the entire time period of stair up and down in each phase were compared using a paired t-test. During the entire period of stair up, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). During the entire period of stair down, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). However, the EMG activities of the other muscles were not significantly different between the conditions (p>.05). These results suggest that the stair up and down maintaining hip internal rotation was could be a contributing factor on patellar lateral tracking.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.63-68
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• 2009

Purpose : The purpose of this study was to investigate the effect of tensor fasciae latae length on the rotation of pelvis during one leg stance. Methods : 41 healthy adults participated in this study. The movement of the pelvis and trunk was measured using 3-dimensional motion analyzer, during one leg stance. The movement of the pelvis and trunk was collected lateral shift, rotation, side bending, and flexion-extension. Tensor fasciae latae length of subjects was measured in sidelying positon with neutral position of hip joint and flexion $90^{\circ}$ of knee. Also, the range of motion of hip exteral and interal rotaion were measured in prone position wih lexion $90^{\circ}$ of knee. The subjects were separated 2 groups that more pelvic rotation group(n=15) and less pelvic rotation group(n=15) according to the degree of pelvic rotation. Results : The more pelvic rotation group was showed significantly higher in the ROM of hip external rotation than less pelvic rotation group(p<0.05). The difference of tensor fasciae latae length not showed significant difference between groups. During one leg stance, The movement of the shifting and flexion-extension of trunk and pelvis were not showed significant difference. But the side bending and the rotation of pelvis and trunk showed significant difference between groups. Conclusion : The difference of tensor fasciae latae length not showed significantly in more pelvic rotation group and less pelvic rotation group. But, this study suggests that the pelvis instability brings the instability of the trunk during one leg stance.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.