앞십자인대 재건술 후 엉덩관절 벌림근 강화운동이 근력과 보행에 미치는 영향

박병준,김중휘,Park, Byung-Joon,Kim, Joong-Hwi 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.5

Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.

Curved Periacetabular Osteotomy for the Treatment of Dysplastic Hips

Masatoshi Naito,Yoshinari Nakamura 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.2

Curved periacetabular osteotomy (CPO) was developed for the treatment of dysplastic hips in 1995. In CPO, the exposure of osteotomy sites and osteotomy of the ischium are made in the same manner as Bernese periacetabular osteotomy, and iliac and pubic osteotomies are performed in the same manner as rotational acetabular osteotomy. We studied the dynamic instabilities of 25 dysplastic hips before and after CPO using triaxial accelerometry. Overall magnitude of acceleration was significantly decreased from 2.30 ± 0.57 m/sec2 preoperatively to 1.55 ± 0.31 m/sec2 postoperatively. Pain relief and improvement of acetabular coverage resulting from acetabular reorientation seem to be related with reduction of dynamic instabilities of dysplastic hips. Isokinetic muscle strengths of 24 hips in 22 patients were measured preoperatively and after CPO. At 12 months postoperatively, the mean muscle strength exceeded the preoperative values. These results seem to be obtained due to no dissection of abductor muscles in CPO. The preoperative presence of acetabular cysts did not influence the results of CPO. An adequate rotation of the acetabular fragment induced cyst remodeling. Satisfactory results were obtained clinically and radiographically after CPO in patients aged 50 years or older. CPO alone for the treatment of severe dysplastic hips classified as subluxated hips of Severin group IV-b with preoperative CE angles of up to –20° could restore the acetabular coverage, weight-bearing area and medialization of the hip joint. CPO without any other combined procedure, as a treatment for 17 hips in 16 patients with Perthes-like deformities, produced good mid-term clinical and radiographic results. We have been performing CPO in conjunction with osteochondroplasty for the treatment of acatabular dysplasia associated with femoroacetabular impingement since 2006. The combined procedure has been providing effective correction of both acetabular dysplasia and associated femoral head-neck deformities without any increased complication rate. We have encountered an obturator artery injury in one case and two intraoperative comminuted fractures. Although serious complications such as motor nerve palsy, deep infection, necrosis of the femoral head or acetabulum, and delayed union or nonunion of the ilium were reported, such complications have never occurred in our 700 cases so far.

The Relationship Between Hip Abductor and Pelvic Drop During Lateral Step Down in the Elderly

Lee, Young-kwon,Jung, Sung-hoon,Yoo, Hwa-ik,Kwon, Oh-yun Korean Research Society of Physical Therapy 2022 한국전문물리치료학회지 Vol.29 No.4

Background: The lateral step down (LSD) is a form of stair negotiation used by the elderly because it requires less movement of the lower extremity. Although it is necessary to study the amount of pelvic drop and the strength of a hip abductor during LSD for intervention, limited studies have investigated the relationship between the amount of pelvic drop and strength of a hip abductor during LSD in elderly people. Objects: This study aimed to determine the relationship between the amount of pelvic drop on an unsupported leg and the strength of the hip abductor during LSD in the elderly. Methods: Thirty elderly people (male: 17, female: 13) were recruited. Subjects performed the LSD task, and the evaluator measured and the amount of pelvic drop on an unsupported side. Also, the isometric strength of the hip abductor was measured in a supine position. Results: We found significant relationships between the strength of the hip abductor and the amount of pelvic drop (r = -0.386). The average hip abductor strength normalized by body weight was 1.06 N/kg (max: 1.99, min: 0.52) and the average contralateral pelvic drop (CPD) angle was 4.16° (max: 15.3, min: 0). Conclusion: Our results indicated that the strength of the hip abductor had a moderate correlation with the CPD during a LSD in the elderly. Hip abductor weakness could translate into altered movement of the pelvis.

유소년기 감염성 고관절염으로 인한 골관절염의 외전근 활주를 이용한 2단계 고관절 전 치환술

윤강섭 ( Kang Sup Yoon ),강승백 ( Seung Baik Kang ) 대한고관절학회 1998 Hip and Pelvis Vol.10 No.2

Total hip arthroplasty for adults with the sequelae of pediatric hip infection presents a series of difficult problems because of soft tissue contractures, hypoplasia of acetabulum, distorted femur, suboptimal abductor function, leg-length discrepancy and recurrence of infection. During the past 5 years, two stage total hip arthroplasty using abductor slide has been performed for the twenty one patients with the sequelae of pediatric hip infection and followed up for average 29.1 months. No trochanteric osteotomy was done and the aMuctor was released subperiosteally and aUowed to slide distally over the wing of the ilium. The mean Harris hip score and the Enghs radiographic assessment score were 84.4 and 22.7 respectively. One hip, which showed migration of the acetabular cup, rated as poor and the revision of the acetabular cup seemed to be impending. The frequency of the pain was 19.0% and limping was seen in 47.6%. The average correction of leg length discrepancy was 3.3 cm and there was no sciatic and common peroneal nerve palsy except one case of temporary femoral nerve palsy which recovered completely 4 months after operation. Vascular injury, postoperative dislocation, deep infection were not detected in all cases and heterotopic ossification occurred in 1 1 hips(52.4%). Two stage total hip arthroplasty for adults with the sequelae of pediatric hip infection would be a safe technique, having many advantages such as safe, sufficient correction of leg length discrepancy, avoidance of nerve palsy and trochanteric problem, restoration of abductor function, detection of latent bone infection and measurement of true leg length in the presence of severe joint contracture and so on. Gentle tissue handling to avoid heterotopic ossfication and longer follow-up will be needed to uncover any hidden advantages or disadvantages of this technique.

Comparisons of Test-Retest Reliability of Strength Measurement of Gluteus Medius Strength between Break and Make Test in Subjects with Pelvic Drop

( In-cheol Jeon ) 대한물리치료학회 2019 대한물리치료학회지 Vol.31 No.3

Purpose: The purpose of this study was to compare the reliability of unilateral hip abductor strength assessment in side-lying with break and make test in subjects with pelvic drop. Hip abduction muscles are very important in the hip joint structures. Therefore, it is essential to evaluate their strength in a reliable way. Methods: Twenty-five subjects participated in this study. Unilateral isometric hip abductor muscle strength was measured in side-lying, with use of a specialized tensiometer using smart KEMA system for make test, of a hand held dynamometer for break test. Coefficients of variation, and intra class correlation coefficients were calculated to determine test-retest reliability of hip abductor strength. Results: In make test, maximal hip abductor strength in the side-lying position was significantly higher compared with break test (p<0.05). Additionally, Test-retest reliability of hip abductor strength measurements in terms of coefficients of variation (3.7% for make test, 16.1% for break test) was better in the side-lying position with make test. All intraclass correlation coefficients with break test were lower than make test (0.90 for make test, 0.73 for break test). Conclusion: The side-lying body position with make test offers more reliable assessment of unilateral hip abductor strength than the same position with break test. Make test in side-lying can be recommended for reliable measurement of hip abductor strength in subjects with pelvic drop.

클램 운동 시 운동범위에 따른 엉덩관절 벌림근의 활성도와 사용 비교

최용길,이상열,최수홍,윤성영,김인균 대한고유수용성신경근촉진법학회 2022 PNF and Movement Vol.20 No.3

Purpose: The purpose of this study is to compare the muscle activity of the hip abductors and the ratio between the hip abductor muscle group according to the range of hip abduction during the clam exercise. Methods: This study was conducted on 18 healthy men in their aged 20 to 29 who had not been diagnosed with spine-related diseases. The subjects performed a clam exercise without rotation of the pelvis in a state of 60° hip flexion and 90° knee joint flexion in the side-lying position. Using Myomotion equipment and EMG, the muscle activity of the hip abductor muscles and the activity ratio between the hip abductor muscle group were measured during the clam exercise by dividing the range into initial, mid-range, and terminal sections. Repeated measures analysis of variants was employed to compare the activity and use of hip abductor muscles according to range of motion during the clam exercise. Results: Gluteus medius muscle activation was significantly increased in the comparison of muscle activity in the initial, mid-range, and terminal sections of hip abduction. Tensor fasciae latae muscle activation was significantly increased in the comparison of muscle activity in all range of motion sections as well. The gluteus medius–tensor fasciae latae muscle activation ratio was significantly increased in the terminal section compared to the initial section. Conclusion: The gluteus medius and tensor fasciae latae had higher muscle activities as they approached the terminal section during the clam exercise, and the hip abduction activity ratio of the gluteus medius and tensor fasciae lataewas higher as the range of motion approached the terminal section.

고관절 내ㆍ외전근 수축을 이용한 교각 운동에서의 내ㆍ외전근과 복부 및 하지근육과의 상관관계 연구

이상열 ( Sang Yeol Lee ) 대한물리의학회 2012 대한물리의학회지 Vol.7 No.2

Purpose Bridging exercise was used most frequently of lumbar stabilization exercise. There has been no reserch regarding the bridging exercise according to hip abductor activation or hip adductor activation. The purpose of this study is to determine correlation of hip abductor, adductor and abdominal muscles, lower limb muscle. Methods Participants who met the criteria for this study (n=45). Participants performs bridging exercise on three types (normal bridging exercise, bridging exercise with hip abductor contraction, bridging exercise with hip adductor contraction) for evaluate correlation of each muscles. Results There was a significant negative correlation between adductor magnus and gluteus medius, adductor magnus and rectus femoris. And there was a positive correlation between gluteus medius and rectus femoris on normal bridging exercise (p<0.05). There was a significant positive correlation between adductor magnus and gluteus medius, transverse abdominis, and between gulteus medius and transverse abdominis on bridging exercise with adductor magnus activation (p<0.05). There was a significant positive correlation between adductor magnus and gluteus medius, rectus femoris, and between gulteus medius and rectus femoris on bridging exercise with gluteus medius activation (p<0.05). Conclusion When we perform bridging exercise for transverse abdominis activation and increase pressure in the abdmen, bridging exercise with hip adductor contraction is more effective than normal bridging exercise and bridging exercise with hip abductor contraction.

Comparisons of Test- Retest Reliability of Strength Measurement of Gluteus Medius Strength between Break and Make Test in Subjects with Pelvic Drop

전인철 대한물리치료학회 2019 대한물리치료학회지 Vol.31 No.3

Purpose: The purpose of this study was to compare the reliability of unilateral hip abductor strength assessment in side-lying with break and make test in subjects with pelvic drop. Hip abduction muscles are very important in the hip joint structures. Therefore, it is essential to evaluate their strength in a reliable way. Methods: Twenty-five subjects participated in this study. Unilateral isometric hip abductor muscle strength was measured in side-lying, with use of a specialized tensiometer using smart KEMA system for make test, of a hand held dynamometer for break test. Coefficients of variation, and intra class correlation coefficients were calculated to determine test-retest reliability of hip abductor strength. Results: In make test, maximal hip abductor strength in the side-lying position was significantly higher compared with break test (p<0.05). Additionally, Test-retest reliability of hip abductor strength measurements in terms of coefficients of variation (3.7% for make test, 16.1% for break test) was better in the side-lying position with make test. All intraclass correlation coefficients with break test were lower than make test (0.90 for make test, 0.73 for break test). Conclusion: The side-lying body position with make test offers more reliable assessment of unilateral hip abductor strength than the same position with break test. Make test in side-lying can be recommended for reliable measurement of hip abductor strength in subjects with pelvic drop.

Comparisons of Test-Retest Reliability of Strength Measurement of Gluteus Medius Strength between Break and Make Test in Subjects with Pelvic Drop

Jeon, In-Cheol The Korean Society of Physical Therapy 2019 대한물리치료학회지 Vol.31 No.3

Purpose: The purpose of this study was to compare the reliability of unilateral hip abductor strength assessment in side-lying with break and make test in subjects with pelvic drop. Hip abduction muscles are very important in the hip joint structures. Therefore, it is essential to evaluate their strength in a reliable way. Methods: Twenty-five subjects participated in this study. Unilateral isometric hip abductor muscle strength was measured in side-lying, with use of a specialized tensiometer using smart KEMA system for make test, of a hand held dynamometer for break test. Coefficients of variation, and intra class correlation coefficients were calculated to determine test-retest reliability of hip abductor strength. Results: In make test, maximal hip abductor strength in the side-lying position was significantly higher compared with break test (p<0.05). Additionally, Test-retest reliability of hip abductor strength measurements in terms of coefficients of variation (3.7% for make test, 16.1% for break test) was better in the side-lying position with make test. All intraclass correlation coefficients with break test were lower than make test (0.90 for make test, 0.73 for break test). Conclusion: The side-lying body position with make test offers more reliable assessment of unilateral hip abductor strength than the same position with break test. Make test in side-lying can be recommended for reliable measurement of hip abductor strength in subjects with pelvic drop.

심부 안정성이 부족한 대상자에게 외부적 지지가 엉덩관절 벌림근의 근력과 근활성도에 미치는 영향

전인철(In-Cheol Jeon) 한국전문물리치료학회 2022 한국전문물리치료학회지 Vol.29 No.1

Background: Gluteus medius muscle is important for the stability of hip joint. The sufficient core stability can be contributed to the performance of gluteus medius muscle in standing position. In addition, the external support may affect core stability in standing position. Objects: The purpose of this study was to investigated the effectiveness of the external sup-port on the strength and muscle activity of hip abductor muscle during hip abduction in standing position in subjects without core stability. Methods: Fifteen subjects participated in this study. The subjects were evaluated by us-ing the double-leg lowering with bent knees to measure the core stability. The strength and muscle activity of hip abductors was measured in standing position with the condition with and without external support using the tensiometer sensor and the surface electromyography. The paired t-test was used to investigate the difference between hip abductor strength and activity according to external support. The level of statistical significance was set at α = 0.05. Results: The hip abductor strength and muscle activity of gluteus medius muscle with exter-nal support were significantly greater than those without external support during hip abduc-tion in standing position (p < 0.05). Conclusion: During hip abduction in standing position, the external support may be contrib-uted to the improvement of the hip abductor strength and muscle activity of gluteus medius especially in the subjects without core stability.