Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Theory & Practice II > Exercise Interventions for the Hip and Pelvis > Flashcards

Exercise Interventions for the Hip and Pelvis Flashcards

1
Q

What muscles flex the hip

A

Prime Movers: iliopsoas, rectus femoris, TFL, & sartorious
2ndry Movers: pectinous, adductor longus, adductor Magnus, & gracilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What muscles extend the hip

A

Prime Movers: glute max & hamstrings
2ndry Movers: glute med (posterior fibers), adductor Magnus, & piriformis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What muscles abduct the hip

A

Prime Movers: glute med, glute min, &TLF
2ndry Movers: piriformis, sartorius, & rectus femoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What muscles adduct the hip

A

Prime Movers: adductor Magnus, adductor longus, adductor brevis, gracilis, pectineus
2ndry Movers: biceps femoris (long head), glute max (posterior fibers), quadratus femoris, & obturator externus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What muscles externally rotate the hip

A
  • obturator internus
  • obturator externus
  • gemellus superior
  • gemellus inferior
  • quadraus femoris
  • piriformis
  • glute max
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What muscles internally rotate the hip

A

No prime movers
2ndry Movers: glute med (anterior fibers), glute min, TFL, adductor longus, adductor brevis, adductor Magnus (posterior fibers), & pectineus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe anterior pelvic tilt and posterior pelvic tilt

A

Anterior Tilt: results in hip flexion & increased lumbar spine extension
Posterior Tilt: results in hip extension & increased lumbar flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Order of events for lumbopelvic rhythm flexion

A

1) head & upper trunk initiate flexion
2) pelvis shifts posteriorly to maintain COG over BOS
3) trunk continues to forward bend until 45 degrees where posterior structures become taut resulting in passive tension
4) pelvis begins to rotate forward (anterior tilt) controlled by glute max & hamstrings
5) pelvis rotates forward until full ROM
6) final ROM in forward bending is dictated by the flexibility of the various back extensor muscles, fascia. & hip extensor muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Order of events for lumbopelvic rhythm extension

A

1) return to upright position: hip extensor muscles rotate the pelvis posteriorly resulting in posterior tilt
2) back extensor muscles extend the spine from lumbar region upward
3) variations in the normal synchronization of this activity occur because of training, faulty habits, restricted muscle or fascia length, or injury & faulty proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Functional relationships of the LE for hip flexion/extension

A
  • accompanied by knee flexion & ankle DF
  • controlled by glute max/hamstrings, quads, & gastric/soleus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Functional relationships of the LE in hip abduction/adduction

A

-unilateral WB gravity creates a ADD moment requiring glute med to activate
- weakness may create an ADD moment on the femur with increased knee valgus resulting in increased patella femoral joint stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Functional relationships of the LE in hip rotation

A
  • Hip IR = femur IR, eversion of calcaneus, & pronation of foot
  • Hip ER = femur ER, inversion of calcaneus, & supination of foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe open chain

A
  • independent joint movement
  • movement of body segments distal to joint moving
  • typically non-weight bearing
  • external rotary loading
  • external stabilization required
  • Goals: isolation of muscle groups, control of movements, & carryover to function/injury prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe closed chain

A
  • movement of adjacent joints
  • movement of distal & proximal body segments to joint moving
  • typically weight bearing
  • axial loading
  • internal stabilization by co-contraction
  • Goals: joint approximation, co-activation/dynamic stabilization, proprioception, & carryover to function/injury prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a critical cue for hip abduction exercises

A
  • avoid excessive flexion & ER of the thigh as this results in the TFL overpowering the glute med and min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Open chain therex for hip abduction

A
  • isometric hip ABD
  • supine ABD (gravity eliminated)
  • standing ABD (gravity minimized)
  • side lying ABD (against gravity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Open chain therex for hip extension

A
  • glute maximus focus
  • isometric glute squeezes
  • standing trunk flexion on supported surface with hip extension + knee flexion (donkey kick)
  • standing hip extension
  • quadruped leg lifts with hip extension + knee flexion
  • prone hip extension + knee flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What exercises activate glute med the most

A
  • side-lying hip abduction
  • single limb squat
  • lateral band walk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What exercises activate glute max the most

A
  • single limb squat
  • single limb deadlift
  • transverse lunge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Proper cue for patient performing prone isometrics for hip ER

A
  • bend knees & push your heels together
  • Clam Shell
  • Reverse Clam Shell: IR focused lifting heel up to the ceiling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Exercises for hip flexion focused on iliopsoas & rectus femoris

A
  • supine heel slides
  • SLR hip flexion
  • psoas march: no resistance, light resistance, or bridge + march
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe a 3 way and 4 way open chain hip exercise

A
  • 3 Way: ABD, flexion, and extension with a band in standing
  • 4 Way: ABD, ADD, flexion, and extension with a band in standing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Closed chain therex for the hip

A
  • alternating isometrics & rhythmic stabilization
  • single limb stance
  • hip hiking/pelvic drop
  • bridging
  • wall slides (squat)
  • partial squats or mini squats
  • body weight squats
  • single limb deadlift (hip dominant)
  • single limb squats (knee dominant)
  • step/step down
  • partial or full lunges
  • resisted side stepping or resisted side sliding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Functional progression of the hip

A
  • balance progressions (BLE full WB to unilateral, sagittal/frontal plane UE movements to transverse/diagonal planes, perturbation activities from stable/unstable surfaces)
  • ambulation progressions (uneven surfaces, turning, backward walking)
  • body mechanics: lifts, carry, lunges, squats, pushing/pulling
  • agility drills & plyometrics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Stretching interventions for the hip

A
  • Thomas test stretch (leg hangs off end of table)
  • Modified fencer stretch
  • Kneeling fencer stretch
  • Stretch to increase hip IR (cross bent leg over other leg and use elbow to help rotate trunk)
  • Standing quad stretch
  • Hamstring stretch in doorway
  • Hamstring stretch half seated on table and half standing
  • Piriformis stretch
  • Butterfly stretch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Stretches for the TFL

A
  • standing and lean hip towards wall while trunk remains in same position
  • side-lying with foot ER and try to ADD hip
  • side-lying pulling hip into extension with bent leg and try to ADD hip
27
Q

CPR for diagnosis of hip OA

A
  • equating aggregates symptoms per self report
  • active hip flexion causes lateral hip pain
  • scour test with adduction causes lateral hip or groin pain
  • pain with active hip extension
  • passive IR < or equal to 25 degrees
28
Q

Presentation of hip hypo-mobility

A
  • pain in groin, anterior thigh, and L3 dermatome
  • stiffness after rest
  • limited ROM with firm end feel
  • asymmetry in LE WB & an antalgic gait pattern
  • decreased hip extension leading to increased LBP
  • impaired balance & postural control
  • WB activités & ADLs
  • rising from a chair, walking long distances, uneven surfaces, stairs, squatting
29
Q

CPG hip OA management

A
  • patient education on activity modification, exercise, weight reduction when overweight, methods of unloading arthritic joints, and AD education
  • decrease effects of stiffness & maintain availability ROM
  • improve muscle performance in supporting muscles, balance, & aerobic capacity
  • modalities: ultrasound and hot packs
30
Q

Outcome measures for hip OA

A
  • Self report measure: WOMAC physical function sub scale
  • Physical performance measures: 6-minute walk test, 30-second chair to stand test, timed up and go test (TUG), and stair measure
31
Q

Goals of hip surgery & post operative management

A
  • pain free hip
  • stable joint for weight bearing & functional ambulation
  • adequate ROM & strength of the LE for functional activities
32
Q

What hip pathologies require arthroscopic surgeries

A
  • labral tears
  • femoroacetabular impingement (FAI)
  • capsular laxity
33
Q

What hip pathologies require joint arthroplasty and osteotomy

A
  • resurfacing procedures
  • hemiarthroplasty
  • total hip arthroplasty
34
Q

Salvage procedures for the hip

A
  • arthrodesis (fusion)
  • resection arthroplasty (girdlestone procedure)
35
Q

Post-operative management of a THA

A
  • early and often ROM
  • typically patient is WBAT: <60 years old typically cement-less and elderly with poor bone stock typically cemented
  • check with nurse to determine WB status
  • determine surgical approach and its precautions
  • early mobility can decrease risk of pulmonary embolism & deep vein thrombosis
36
Q

Different approaches for hip replacements

A
  • Posterio/Posteriorlateral: highest risk of post operative dislocation; avoid hip flexion >90 degrees, hip IR, and hip ADD
  • Direct lateral: risk of Trendelenburg gait pattern after surgery
  • Anterolateral: less risk of dislocation compared to posterior approach, selected in patients with history of muscle imbalance
  • Anterior: disability of the surgical field is more challenging, special equipment & training is required, WBAT immediately, avoid hip extension, hip ER, hip ADD, and hip flexion >90 degrees
37
Q

Which direction is a hip most commonly dislocated

A
  • posteriorly
38
Q

Describe leg length inequality

A
  • common complaint after hip replacement
  • most often due to muscle spasm, muscle weakness (glute med), and contracture of the hip muscles
  • length differences >20mm (3/4 inch) are associated with gait impairments & back pain
  • typically will resolve within the 1st operative year
39
Q

Describe max protect phase after a THA

A
  • selected exercise & functional training begins as soon as the patient is medically stable, POD 0
  • patient is typically seen as a “BID” (twice a day) until discharge from hospital
  • progressive mobility is critical
  • length of stay is 3 days
40
Q

Goals of the max protect phase after a THA

A
  • prevent vascular & pulmonary complications
  • prevent postoperative dislocation or subluxation of the operative hip
  • independent functional mobility
  • maintain strength & endurance in BUE and non-operated LE
  • prevent reflex inhibition & atrophy of musculature in the operated limb
  • regain active mobility & control of the operative LE
41
Q

How to regain active mobility & control after a THA

A
  • AAROM hip exercises in supine
  • seated knee flexion & extension with focus on terminal knee extension
  • active hip rotation within surgical approach
  • supine hip abd/add, side lying clamshells
  • active hip ROM in standing
  • bilateral, closed chain, weight shifting activities, heel raises & mini squats with symmetrical alignment & WBing
42
Q

Describe the moderate protect phase after a THA

A
  • understand the integrity of the abductor mechanism
  • standing on the sound LE perform open chain exercises within protected ROM
  • bilateral closed chain exercises: mini squats with light resistance
  • unilateral closed chain exercises
  • non impactful aerobic exercise
  • restore ROM via gravity assisted Thomas test, prone lying, consider ROM precautions
  • improve postural stability, balance, and gait
  • typically at 12 weeks patient will enter the min protect phase
43
Q

What activities are not allowed after a THA

A
  • jogging/running
  • baseball/softball
  • racquetball/squash
  • snow boarding
  • high-impact aerobics
  • contact sports (football, basketball, soccer, ect.)
44
Q

Criteria to initiate plyometric training

A
  • full, functional, pain-free ROM
  • > 80% quads, hamstrings, and hip strength compared to uninvolved leg
  • squat >150% body weight leg press
  • 10 forward & lateral step downs from 8” step with proper mechanics
45
Q

Criteria to initiate running training

A
  • full, functional, pain-free ROM
  • > 80% quads, hamstrings, and hip strength compared to uninvolved leg
  • squat >150% body weight leg press
  • 10 forward & lateral step downs from 8” step with proper mechanics
  • hop & held with proper mechanics
  • ability to tolerate 200-250 plyometric foot contacts without reactive pain/effusion
  • no gross visual asymmetry & rhythmic strike pattern with running
46
Q

Criteria to initiate return to recreational activities/discharge

A
  • physician clearance at last check-up
  • strength >90% compared to uninvolved hip
  • > 90% body weight with single leg leg press
  • demonstrate ability to simulate functional sport specific movement
  • patient reported outcome measures with a score > or equal to 90%
47
Q

Signs and symptoms of possible failure of the internal fixation mechanism

A
  • severe, persistent groin, thigh, or knee pain that increases with limb movement or weight bearing
  • progressive limb length inequality that wasn’t present immediately after surgery
  • persistent ER of the operated limb
  • positive Trendelenburg sign that is not resolved with strengthening exercises
48
Q

Describe the max protect phase for a hip fracture

A
  • prevent vascular & pulmonary complications
  • improve strength in the UE & sound LE
  • re-establish balance, postural stability, & safe independent functional mobility within WBing restrictions
  • prevent post operative reflex inhibition of the hip & knee muscles
  • restore mobility & control of the operated hip & adjacent joints
49
Q

Describe the moderate protect phase for a hip fracture

A
  • increase flexibility of any chronically shortened muscles
  • improve strength & muscular endurance in the LE for functional activities
  • improve postural stability, neuromuscular response, standing balance, & functional mobility
  • increase aerobic capacity/cardiopulmonary endurance
50
Q

Describe the protection phase of painful hip syndromes

A
  • patient education
  • control inflammation & promote healing
  • develop support in related areas
  • AD, bracing, activity modification
51
Q

Describe the controlled motion phase of painful hip syndromes

A
  • regain flexibility, develop strong mobile scar
  • develop balance in hip muscle length & strength
  • closed chain exercises as tolerated focusing on symmetry
  • stop exercise with the onset of fatigue, when substitute motions appear, or if pain develops in the weakest segment in the chain
52
Q

Describe the return to function phase for painful hip syndromes

A
  • progress closed chain & functional training to include balance, neuromuscular control, & muscular endurance
  • increase eccentric resistance & demand for controlled speed if necessary for return to work, activities, or sporting events
  • progress to patterns of motion consistent with the desired outcome
  • use acceleration/deceleration drills & plyometric training
  • return to play protocols
53
Q

Describe femoroacetabular impingement (FAI)

A
  • motion related disorder of the hip, symptomatic premature contact b/w the proximal femur & acetabular
  • primary symptom is motion related or position related pain in the hip or groin, pain may also be felt in the back, buttock, or thigh
  • patients may describe clicking, catching, stiffness, restricted ROM or giving way
  • identify cam or pincer morphologies and identify other causes of hip pain
54
Q

Order of progression for hip extension exercises

A

1) prone hip extension
2) bridging
3) bridging with alternating lifting each heel
4) quadruped hip extension
5) plank hip extension
6) windmill with Thera-Band under standing foot held in each hand
7) single leg deadlift with hand weight held in ipsilateral hand

55
Q

Order of progression for hip adduction

A

1) side-lying on affected leg and lift leg
2) bridge position with band around thigh and pull leg to midline inward
3) side bridge with good leg on step and lift
4) side plank on affected side, top leg placed on chair, keep bottom leg straight & lift it up to meet the top leg

56
Q

Order of progression for hip ER

A

1) quadruped, keep foot on ground, keep trunk stable, slide to turn foot against band
2) prone and turn foot against band

57
Q

Order of progression for trunk strength

A

1) side bridge
2) side bridge with arm lifts
3) side bridge with arm reach-under then lift (trunk rotation)
4) side plank with stability ball, keep elbow below shoulders, place 1 foot in front & 1 behind on ball

58
Q

Order of progression for functional tasks

A

1) wall slides with gluteal activation
2) squats
3) step-ups
4) single-leg squats
5) windmills
6) single-leg squat on wobble board
7) jump down off box
8) lunge jump 180 degrees
9) multidirectional jumps landing on toes first and allowing knees to bend

59
Q

What are the 3 types of muscles at risk for possible muscle strain

A
  • two joint muscles
  • muscles that function eccentrically
  • muscles with many type II fibers
60
Q

What muscles are the most common for hip muscle strains

A
  • hip adductors
  • hamstrings
61
Q

Muscle strain rehab progression

A
  • PEACE AND LOVE (Protect, Elevate, Avoid anti-inflammatories, Compress, Education & Load, Optimism, Vascularization, Exercise)
  • graded exercises & gradual increase in loading as tolerated (isometrics, full concentric AROM, & eccentric loading)
  • graded return to all activities
62
Q

Describe hip adductor strain rehab

A
  • low hip adduction strength is an important & modifiable risk factor associated with an increased risk of groin injury
  • > 20% deficit in eccentric strength of the hip adductor observed in players with groin pain
  • strengthening the hip adductors may play important role in reducing the prevalence & rate of groin injuries
63
Q

Describe the L-protocol for hamstring rehab

A
  • Extender: perform supine 90-90 leg extension, perform 3x12 2x/day
  • Diver: standing on single leg and reaching forward similar to a dive position, perform 3x6 every other day
  • Slider: drive front heel into ground and slide back foot until can’t go any farther, perform 3x4 every 3rd day

Theory & Practice II (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions