Iliotibial Band Stretching in the Modified Thomas Test Position Changes Hip Abduction Angle and Vastus Medialis Activity in Individuals With Tight Iliotibial Band원문보기
Baik, Seung-min
(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
,
Jeong, Hyo-jung
(Movement Science Program, Program in Physical Therapy, Washington University School of Medicine)
,
Lee, Ji-hyun
(Department of Physical Therapy, Division of Health Science, Baekseok University)
,
Park, Dong-hwan
(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
,
Cynn, Heon-seock
(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
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 mana...
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.
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.
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문제 정의
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 QS in individuals with tight ITB. We hypothesized hip adduction would increase in the modified Ober test, hip abduction would decrease in the modified Thomas test, and lateral patellar translation would decrease.
The purpose of this study was to investigate whether ITB flexibility, patellar translation, and muscle activities of the VMO and VL during QS would be different after ITB stretching in the modified Thomas test position in individuals with tight ITB. We hypothesized that hip adduction would increase in the modified Ober test, hip abduction would decrease in the modified Thomas test and lateral patellar translation would decrease.
가설 설정
The purpose of this study was to investigate whether ITB flexibility, patellar translation, and muscle activities of the VMO and VL during QS would be different after ITB stretching in the modified Thomas test position in individuals with tight ITB. We hypothesized that hip adduction would increase in the modified Ober test, hip abduction would decrease in the modified Thomas test and lateral patellar translation would decrease. VMO muscle activity would increase, and VL muscle activity would decrease during QS.
제안 방법
This study has several limitations. First, it was designed as a cross-sectional study; thus, the long-term effects of ITB stretching cannot be determined. Future research must consider a longitudinal study to investigate the long-term effects of ITB stretching.
Future research must consider a longitudinal study to investigate the long-term effects of ITB stretching. Second, this study had a one-sample pretest-posttest design. We only considered the modified Thomas test position to stretch the ITB.
To provide static compression, the examiner placed the transducer at the marked point with constant pressure in a vertical direction without horizontal shift (Thomas et al, 2006). The hip adduction position was performed with the participant adducting hip by 20˚ by determining the degree with a universal goniometer. The axis, stationary arm, and movable arm were the same as those in the hip abduction angle measurement during the modified Thomas test.
The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, lateral patellar translation, and VMO and VL muscle activities during QS. The results demonstrated that ITB stretching in the modified Thomas position improved hip range of motion by increasing and decreasing the adduction angle in modified Ober test and modified Thomas test, respectively.
데이터처리
05). A paired t-test was used to determine the statistical significance between pretest and posttest. The statistical significance was set at α level of .
The range of hip adduction in the modified Ober test, hip abduction in the modified Thomas test, and lateral patellar translation were measured twice. The VMO and VL muscle activities during QS were measured three times before and after ITB stretching in the modified Thomas test position with the average and intra-class correlation coefficients (ICC) calculated for the data analysis. The participants performed tests in random order using randomization sequence created with Microsoft Excel (Microsoft corp.
The VMO and VL muscle activities during QS were measured three times before and after ITB stretching in the modified Thomas test position with the average and intra-class correlation coefficients (ICC) calculated for the data analysis. The participants performed tests in random order using randomization sequence created with Microsoft Excel (Microsoft corp., Roselle, IL, USA). A 2-min rest time was provided between the trials in all the measurements.
이론/모형
The Ober test and modified Ober test are known to be assessment tools for ITB tightness in the side-lying position (Ferber et al, 2010; Harvey, 1998; Herrington and Payton, 1997). The Ober test and modified Ober test positions are also used as ITB stretching methods (Wang et al, 2006). ITB tightness can also be confirmed using the modified Thomas test; in addition, the modified Thomas test position can be utilized as a stretching position.
The range of hip abduction was measured using a universal goniometer (Baseline, Pakistan) during the modified Thomas test. The participant was instructed to sit at the end of the treatment table and then to roll back on to the table while holding both knees to the chest to flatten the lumbar spine by posteriorly tilting the pelvis.
성능/효과
80. As a result, total 21 (9 males, 12 females, the results were compared according to gender, and there was no significant difference, we proceeded to one group regardless of gender) participants with tight ITB were recruited (Table. 1). Tight ITB was assessed using the modified Ober test.
The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, lateral patellar translation, and VMO and VL muscle activities during QS. The results demonstrated that ITB stretching in the modified Thomas position improved hip range of motion by increasing and decreasing the adduction angle in modified Ober test and modified Thomas test, respectively. The VMO muscle activity during QS also increased after ITB stretching.
후속연구
First, it was designed as a cross-sectional study; thus, the long-term effects of ITB stretching cannot be determined. Future research must consider a longitudinal study to investigate the long-term effects of ITB stretching. Second, this study had a one-sample pretest-posttest design.
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