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        Iliotibial Band Stretching in the Modified Thomas Test Position Changes Hip Abduction Angle and Vastus Medialis Activity in Individuals With Tight Iliotibial Band

        Seung-min Baik,Hyo-jung Jeong,Ji-hyun Lee,Dong-hwan Park,Heon-seock Cynn 한국전문물리치료학회 2019 한국전문물리치료학회지 Vol.26 No.1

        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.

      • KCI등재

        만성 허리통증 환자의 엉덩허리근 단축과 허리 불안정성 검사 간에 관련성 연구

        유창현 ( Chang-hyun You ),김선엽 ( Suhn-yeop Kim ) 대한물리의학회 2023 대한물리의학회지 Vol.18 No.2

        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.

      • KCI등재

        The Effect of Patellar Inferior Gliding on Knee Flexion Range of Motion in Individuals With Rectus Femoris Tightness

        Jun-hee Kim,Moon-hwan Kim,In-cheol Jeon,Ui-jae Hwang,Oh-yun Kwon 한국전문물리치료학회 2016 한국전문물리치료학회지 Vol.23 No.4

        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±9.33) than for PKF alone (108.97±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.

      • KCI등재

        다리 절단장애인의 엉덩관절 굽힘 구축각도를 반영한 의지 소켓 정렬 후 보행분석

        성우성 ( Seong Woo-sung ),김장환 ( Kim Jang-hwan ),정동훈 ( Jeong Dong-hoon ) 대구대학교 특수교육재활과학연구소 2021 특수교육재활과학연구 Vol.60 No.1

        본 연구는 엉덩관절 굽힘 구축이 있는 다리 절단장애인 8명을 대상으로 엉덩관절 굽힘 구축을 반영한 소켓의 정렬기준을 확인하기 위하여 현재 소켓 굽힘 정렬 각도를 측정하여 기준으로 하였고, 토머스 검사를 통해 측정한 엉덩관절 굽힘 구축 각도에 5° 를 더하여 소켓 기울기 정렬을 수정한 후 3차원 동작분석기를 통해 보행의 변화를 비교 하였다. 단일집단 사전·사후 검사설계를 이용 하였고, 엉덩관절 굽힘 구축 정렬적용 전과 후에 따른 보행주기 동안의 시·공간적, 운동 형상학적, 그리고 운동역학적변수는 대응표본 t-검정을 이용하여 차이를 알아보았다. 본 연구 결과 엉덩관절 굽힘 구축을 반영한 소켓 정렬이 보행의 시간-거리 변수와 무릎 안정성을 위한 운동형상학적 변수에서 개선되었음을 보여주었다. 본 연구를 통해 의지 제작과정 동안 정렬의 중요성을 확인하였으며, 특히 엉덩관절이 굽힘 구축된 넙다리 절단장애인의 소켓 기울기 정렬 기준을 확인하는데 기초자료를 제공한다. 이를 통해 넙다리 절단장애인이 보다 안전한 의지 착용에 도움이 될 것으로 판단되며 향후 수평이동 정렬과 무릎관절장치의 종류에 따른 정렬 변화에 대하여 추가적인 연구가 필요하다고 사료된다. In this study, the current socket flexion alignment angle was measured and used as a reference to confirm the socket alignment criteria reflecting of 8 trans-femoral amputees with hip flexion contractures, and the hip flexion contracture measured through the Thomas test and correcting the socket inclination alignment by adding 5° to the socket angle, gait was compared through a 3D motion analyzer. As a result, the socket alignment reflecting hip joint flexion contracture improved the time-distance variable of walking and the kinematic variable for knee stability, confirming the importance of alignment, and in particular as judged that it will be provided as basic data for confirming the socket tilt alignment criteria. Through this, it is thought that it will be helpful for the trans-femoral amputee’s prosthetic fitting.

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