Physical Therapy Korea
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Phys. Ther. Korea 2023; 30(1): 15-22
Published online February 20, 2023
https://doi.org/10.12674/ptk.2023.30.1.15
© Korean Research Society of Physical Therapy
Hip Muscle Strength and Ratio Differences in Delivery Workers With and Without Iliotibial Band Syndrome
Eun-su Lee1,3 
, PT, BPT, Ui-jae Hwang2,3 , PT, PhD, Hwa-ik Yoo1,3 , PT, BPT, Il-kyu Ahn1,3 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, 3Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea
Correspondence to: Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS.
Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS.
Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05).
Conclusion: This study’s findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.
Keywords: Hip, Iliotibial band syndrome, Muscle strength
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Original Article
Phys. Ther. Korea 2023; 30(1): 15-22
Published online February 20, 2023 https://doi.org/10.12674/ptk.2023.30.1.15
Copyright © Korean Research Society of Physical Therapy.
Hip Muscle Strength and Ratio Differences in Delivery Workers With and Without Iliotibial Band Syndrome
Eun-su Lee1,3 , PT, BPT, Ui-jae Hwang2,3 , PT, PhD, Hwa-ik Yoo1,3 , PT, BPT, Il-kyu Ahn1,3 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, 3Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea
Correspondence to:Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS.
Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS.
Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05).
Conclusion: This study’s findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.
Keywords: Hip, Iliotibial band syndrome, Muscle strength
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Table 1 . General characteristics of the subjects (N = 28).
Variable Without ITBS With ITBS p-value Age (y) 46.86 ± 7.42 39.21 ± 9.08 < 0.05 Height (cm) 174.43 ± 8.58 175.43 ± 5.45 > 0.05 Weight (kg) 76.29 ± 12.03 73.64 ± 11.62 > 0.05 Body mass index (kg/m2) 24.97 ± 2.52 23.85 ± 3.12 > 0.05 Work duration (mo) 26.43 ± 12.46 25.07 ± 19.36 > 0.05 KWOMAC (score) 40.43 ± 13.97 71.86 ± 41.42 < 0.05 Values are presented as mean ± standard deviation. ITBS, iliotibial band syndrome; KWOMAC, the Korean version of the Western Ontario and McMaster Universities Arthritis Index..
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Table 2 . Group differences in hip muscle strengths normalized to body mass.
Variable Without ITBS With ITBS p-value Adductor ( kgf ∙BW –1)19.42 ± 6.03 15.79 ± 3.97 0.071 Abductor ( kgf ∙BW –1)11.11 ± 3.51 13.59 ± 4.87 0.134 Adductor/abductor ratio 1.83 ± 0.59 1.32 ± 0.61 < 0.05 Internal rotator ( kgf ∙BW –1)9.98 ± 3.84 12.77 ± 3.72 0.062 External rotator ( kgf ∙BW –1)11.66 ± 3.21 12.26 ± 4.41 0.683 Internal/external rotator
ratio0.87 ± 0.25 1.13 ± 0.45 0.077 Values are presented as mean ± standard deviation. ITBS, iliotibial band syndrome;
kgf ∙BW –1, kilograms of force by body mass..