biomekanik hip joint

7/23/2019 Biomekanik Hip Joint

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BIOMEKANIK HIP JOINTDAN PELVIC

OLEH

SUKADI,SST,MM.Kes.


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INTRODUKSI

Hip joint e!"p#$#n t!i#%i#& joint, $#!en# e'i&i$i ( )i*#n+ +e!#$.

Hip joint j"+# e!"p#$#n ")"n+#n p!o$si#&

*#!i e%t!eit#s in-e!io!. Di)#n*in+$#n *en+#n so"&*e! joint #n+

$onst!"$sin# "nt"$ o)i&it#s, ip joint s#n+#tst#)i& #n+ $onst!"$sin# "nt"$ en"p" )e'

!#t )#*#n.

Se# )e!j#n, +## *#!i e%t!eit#s in-e!io!*it!#nsisi$#n $e#t#s e&"i ip $e pe&/is 0

t!"n$, *#n #$ti/it#s e%t!eit#s in-e!io! inn#.


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D# s"#t" +e!#$ -"n+sion#&, te!j#*i ")"'n+#n #nt#!# pe&/i1 +i!*&e *#n ip joint

pe&/i1 +i!*&e #$#n en+#i ti&tin+ *#n !ot#si

se# +e!#$#n -e"!.

H")"n+#n te!se)"t #pi! s## *en+#n ")"'

n+#n s1#p" *en+#n so"&*e! joint,

pe!)e*##n'n# #*# s1#p" $i!i 0 $#n#n

*#p#t )e!+e!#$ )e)#s se*#n+$#n pe&/i1 #n#

*#p#t )e!+e!#$ se)#+#i s#t" "nit.


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BIOMEKANIK HIP JOINT DAN PELVIC

HIP JOINT

PELVIC

HUBUN2AN 3UN2SIONAL HIP, PELVIS

DAN LUMBAL SPINE DALAM RAN2'

KAIAN KINEMATIK.


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A. St!"$t"! An#toi Hip

Hip joint *i)ent"$ o&e 1#p"t -e"! #n+ $on'/e$s )e!sen*i *en+#n #1et#)"&" #n+ $on$#-.

Hip joint #*# )#&& #n* so1$et 4spe!oi*#&5

t!i#%i#& joint. A1et#)"&" te!)ent"$ *#!i pen#t"#n os i&i",

is1i", *#n p")is.

Se&"!" #1et#)"&" *ipisi o&e 1#!ti+o#&ine, 0 p"s#t #1et#)"&" te!isi o&e s"#t"

#ss# j#!in+#n &e#$ #n+ te!t"t"p o&e

e)!#n sno/i#&.


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J#!in+#n -i)!o$#!ti+o #n+ e&in+$#! *#t#! *i#1et#)"&" *ise)"t *en+#n )!" #1et#)"!,

#n+ e&e$#t *ise$e&i&in+ #!+o #1et#)"&".

L#)!" #1et#)"! en"t"p 1#!ti+o #&ine0 s#n+#t te)#& p#*# se$e&i&in+ #1et#)"&"

*#!i'p#*# p"s#tn# #& ini en#)#

$e*##n #1et#)"&".

A1et#)"&" te!&et#$ *i )#+i#n te!#& pe&/is,

en+#*#p $e te!#&, #nte!io! 0 in-e!io!.


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C#p"t -e"! se1#!# sep"!n# *it"t"p o&e1#!ti+o #&ine.

P#*# p"s#t 1#p"t -e"! te!*#p#t &")#n+ $e1i&

#n+ *in##$#n *en+#n -o/e# 1#pitis ti*#$

*it"t"p o&e 1#!ti+o #&ine.

C#p"t -e"! e)ent"$ se$it#! 67( *#!i s"#t"

)o.

C#p"t -e"! )e!)ent"$ spe!i1#& *#n en+#'*#p $e#!# #nte!io!, e*i#& *#n s"pe!io!.


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Hip joint *ipe!$"#t o&e $#ps"& sen*i #n+$"#t, &i+#en i&io-eo!#&, p")o-eo!#&, *#nis1io-eo!#&.

Hip joint j"+# *ipe!$"#t o&e &i+#en t!#ns/e!'

se #1et#)"! #n+ $"#t 0 )e!s#)"n+ *en+#n)!" #1et#)"!.

Li+#en te!es -eo!is e!"p#$#n &i+#en

t!i#n+"! #n+ $e1i&, e&e$#t p#*# #pe% -o/e#1#pitis *e$#t p"s#t 1#p"t -e"! $e tepi &i+#en#1et#)"!.


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Li+#en te!es -eo!is )e!-"n+si se)#+#i pe'n+i$#t 1#p"t -e"! $e )#+i#n )#8# #1et#)"'&" *#n e)e!i$#n st#)i&is#to! #n+ $"#t*i*# sen*i 4int!##!ti$"!5.

St#)i&is#to! )#+i#n &"#! *i#si&$#n o&e ( &i+#'en #n+ e&e$#t p#*# 1o&&"7ne1$ -e"!#it" 9 &i+#en i&io-eo!#&, p")o-eo!#& 0 is'

1io-eo!#&. Li+#en i&io-eo!#& *ise)"t j"+# &i+#en :;


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Li+#en i&io-eo!#& epe!$"#t $#ps"&sen*i )#+i#n #nte!io!.

Li+#en p")o-eo!#& te!*i!i *#!i i$#t#n se'!#)"t #n+ $e1i& p#*# $#ps"& sen*i )#+i#ne*i#& #nte!io! *#n )#8#.

Li+#en is1io-eo!#& e!"p#$#n &i+#ent!i#n+"! #n+ $"#t p#*# )#+i#n )e$#n+

$#ps"&.


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B. Otot'otot Re+io Hip

Hip joint *ipe!$"#t o&e otot'otot p#n++"& *#n p##.

Otot'otot p#n++"& *#n p## te!*i!i #t#s otot one'joint *#nt8o joint

2!o"p Otot One'Joint T8o'Joint

Ante!io! I&iopso#s Re1t"s -eo!isS#!to!i"s

Me*i#& Pe1tine"s

A**"1to! #+n"sA**"1to! &on+"s

A**"1to! )!e/is

2!#1i&is

Poste!io! 2&"te"s #%i"sDeep !ot#to!

Seie)!#nos"sSeiten*inos"sBi1eps -eo!is

L#te!#& 2&"te"s e*i"s2&"te"s ini"s

Tenso! -#s1i# t#e


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C. S"*"t P#*# Hip Joint

S"*"t in$&in#si #*# s"*"t #n+ *i)ent"$#nt#!# #%is ne1$ -e"! *#n s#-t -e"! 4no!'

#&n# =6>o5.

Ji$# s"*"t in$&in#si &e)i )es#! *#!i no!#&*ise)"t *en+#n 1o%# /#&+#, ji$# &e)i $e1i& *#!i

no!#& *ise)"t *en+#n 1o%# /#!#.

To!sion #*# s"*"t + *i)ent"$ o&e #%ist!#ns/e!s#& 1on*&"s -e"! *#n #%is ne1$

-e"! 4no!#&n# ? @ 6>o#t#" =6o5.


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Penin+$#t#n s"*"t to!sion *ise)"t *en+#n #nte'/e!sion 4s#-t -e"! )e!ot#si $e e*i#&5.

Pen"!"n#n s"*"t to!sion *ise)"t *en+#n !et!o'

/e!sion 4s#-t -e"! )e!ot#si $e te!#&5.


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D. 2e!#$#n p#*# Hip

K#!en# ip joint e!"p#$#n t!i#%i#& joint #$#te!*#p#t ( p#s#n+ +e!#$#n #n+ te!j#*i p#*#

ip joint.

2e!#$#n te!se)"t #*# -&e$si @ e$stensi, #)'*"$si @ #**"$si, e%te!n#& !ot#si @ inte!n#& !ot#si

2e!#$#n #n+ p#&in+ &"#s #*# -&e$si ip *#n

#n+ p#&in+ te!)#t#s #*# e$stensi7ipe!e$s'tensi ip.


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=. 3&e$si Hip

3&e$si ip #*# +e!#$#n -e"! $e *ep#n *#' )i*#n+ s#+it#&.

Ji$# $nee &"!"s, #$# +e!#$#n -&e$si ip *i)#'

t#si o&e $ete+#n+#n otot #st!in+. P#*# +e!#$ -&e$si #n+ &"#s, pe&/is #$#n )#1$'

8#!* ti&t "nt"$ e&en+$#pi7enep"!n#$#n

+e!#$#n p#*# ip joint.


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6. E$stensi7ipe!e$stensi Hip

E%tensi #*# +e!#$#n $e)#&i *#!i -&e$si. Hipe!e$stensi #*# +e!#$#n -e"! $e )e'

$#n+ *# )i*#n+ s#+it#&.

2e!#$#n ini s#n+#t te!)#t#s, $e1"#&i p#!# *#n'1e! *#n #$!o)#t #n+ e"n+$in$#n te!j#*i

!ot#si -e"! $e&"#! sein++# +e!#$#nn# 1"$"p

&"#s. 3#$to! pen+#)#t ipe!e$stensi ip #*#

$ete+#n+#n &i+#en i&io-eo!#& p#*# )#+i#n

*ep#n sen*i.


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Ke"nt"n+#n *#!i $ete!)#t#s#n +e!#$ ini #*#sen*i enj#*i s#n+#t st#)i& "nt"$ 8ei+t

)e#!in+ 4en"p" )e!#t )#*#n5 t#np# e'

)"t"$#n $ont!#$si otot #n+ $"#t.


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(. A)*"$si

A)*"$si #*# +e!#$#n -e"! $e s#pin+ *#' )i*#n+ -!ont#& sein++# p## )e!+e!#$

j#" *#!i i*&ine t")".

ROM A)*"$si #n+ &e)i )es#! *#p#t te!j#*iji$# -e"! )e!ot#si $e&"#!.

A)*"$si *i)#t#si o&e otot'otot #**"$to! *#n

&i'+#en p")o-eo!#&.


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. A**"$si

A**"$si #*# +e!#$#n $e)#&i *#!i #)*"$si. Hipe!#**"$si #n# *#p#t te!j#*i ji$# t"n+$#i

sisi $ont!#te!#& *i+e!#$$#n $e&"#!.

P#*# ipe!#**"$si #n+ &"#s, &i+#en te!es-eo!is enj#*i te+#n+.


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>. E%te!n#&7L#te!#& Rot#si

E%te!n#& !ot#si #*# s"#t" !ot#si -e"!*ise$it#! #%is &on+it"*in#& sein++# $nee

te!p"t#! $e&"#!.

E%te!n#& !ot#si j"+# e!"p#$#n s"#t" !ot#si-e"! *ise$it#! #%is s#+it#& sein++# $nee te!'

p"t#! $e*#.

ROM e%te!n#& !ot#si )i#s#n# &e)i )es#! *#!i'p#*# inte!n#& !ot#si.


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. Inte!n#&7Me*i#& Rot#si

Inte!n#& !ot#si #*# +e!#$ !ot#si -e"! *ise'$it#! #%is &on+it"*in#& sein++# $nee te!p"t#!

$e*#.

Inte!n#& !ot#si j"+# e!"p#$#n +e!#$ !ot#si

-e"! *ise$it#! #%is s#+it#& sein++# $nee te!'

p"t#! $e&"#!.

ROM inte!n#& *#n e%te!n#& !ot#si *ipen+#!"i

o&e *e!#j#t to!si -eo!#& 4te!p"t#!n# -e"!

p#*# #%is &on+it"*in#& sein++# s# s#t"

"j"n+n# )e!ot#si $e*# te!#*#p "j"n+

inn#5.


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. Di#+on#& A**"$si7A)*"$si

Di#+on#& #**"$si #*#s"#t" +e!#$#n $e *ep#n

*#!i posisi #)*"$si p##

*# )i*#n+ o!iont#&,

#n+ *ii$"ti o&e pen"'!"n#n e%te!n#& !ot#si.

Di#+on#& #)*"$si #*#s"#t" +e!#$#n $e s#pin+

*#!i posisi -&e$si ip *#

)i*#n+ o!iont#&, #n+

*ii$"ti o&e e%te!n#& !ot#si.


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D. A!t!o$ine#ti$#

C#p"t -e"! )e!)ent"$ $on/e$s #$#n )e!+e!#$ s&i*e*# #!# #n+ )e!#n#n *en+#n +e!#$ -isio&o+is

-e"!.

No. 2e!#$ -isio&o+is 2e!#$ A!t!o$ine#ti$#

=. 3&e$si S&i*e $e posteio!

6. E$stensi S&i*e $e #nte!io!

(. A)*"$si S&i*e $e in-e!io!

. A**"$si S&i*e $e s"pe!io!>. Inte!n#& Rot#si Poste!io!

. E%te!n#& Rot#si Ante!io!


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A. St!"$t"! An#toi Pe&/i1

Pe&/i1 e!"p#$#n s"#t" t"n+ #n+ $#$",)e!pe!#n se)#+#i !#n+$#i#n ")"n+#n #n+

)es#! #nt#!# t!"n$ *#n e%t!eit#s in-e!io!.

Seti#p t"n+ pe&/i1 *i)ent"$ o&e ( t"n+ 9 osi&i", is1i" *#n p")is.

Ke*"# t"n+ pe&/i1 4$i!i *#n $#n#n5 )e!s#'

)"n+ e)ent"$ pe&/i1 +i!*&e. Ke*"# t"n+ pe&/i1 se1#!# $"#t e&e$#t p#*#

s#1!" e&"i s#1!oi&i#1# joint.


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S#1!" *ii$#t *en+#n $"#t o&e 6 t"n+ i&i#1#*#n &i+#en s#1!oi&i#1# #nte!io!, poste!io! *#n&i+#en s#1!oi&i#1# inte!osse"s #n+ epe!'$"#t s#1!oi&i#1# joint.

S#1!oi&i#1# joint j"+# *ipe!$"#t o&e &i+#eni&io&")#!, s#1!ot")e!o"s, *#n &i+#en s#1!o'spino"s se!t# )#+i#n )#8# o&e otot e!e1to!

spine. K#!en# pe!&e$#t#nn#, #$# s#1!" *i#n++#p

se)#+#i )#+i#n *#!i pe&/i1 +i!*&e.


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Pe!")##n posisi pe&/i1 se)en#!n# *i#si&$#no&e +e!#$#n &")#& spine *#n ip joint.

2e!#$#n p#*# &")#& spine *#n ip joint *#p#ten+#si&$#n pe&/i1 )e!+e!#$ ti&tin+ $e *ep#n,$e )e$#n+, $e s#pin+, *#n !ot#si se1#!# o'!iont#&.

2e!#$#n #n+ te!j#*i p#*# pe&/i1 te!*i!i *#!i 9

-o!8#!* ti&t 4in$&in#si enin+$#t5, )#1$8#!*ti&t 4in$&in#si en"!"n5, te!#& ti&t, !ot#si 4te'!#& t8ist7e"t#!5

B. 2e!#$#n Pe&/i1


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=. 3o!8#!* Ti&t

3o!8#!* ti&t #*# +e!#$#n pe&/i1 p#*# )i*#n+s#+it#& *ise$it#! #%is -!ont#&'o!iont#& sein+'

+# spisis p")is )e!p"t#! $e)#8# *#n pe!'

"$##n poste!io! s#1!" )e!p"t#! $e#t#s. D# -o!8#!* ti&t, penin+$#t#n s"*"t *i)ent"$

o&e p"n1#$ os p")is *#n penin+$#t#n *e/i#si

s#1!" se!t# pe&/is )#+i#n poste!io! enj#"

*#!i /e!ti$#&.


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6. B#1$8#!* ti&t

B#1$8#!* ti&t #*# s"#t" +e!#$ !ot#si pe&/is*# )i*#n+ s#+it#& se$it#! #%is -!ont#&'

o!iont#& sein++# spisis p")is )e!+e!#$

$e *ep#n @ #t#s *#n pe!"$##n poste!io!s#1!" )e!p"t#! se*i$it $e )#8#.

D# )#1$8#!* ti&t, s"*"t *i)ent"$ o&e p"n'

1#$ os p")is *#n pen"!"n#n o!iont#& se!t#

te!j#*i pen"!"n#n in$&in#si o!iont#& s#1!"

*#n poste!io! pe&/is.


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(. L#te!#& ti&t

L#te!#& ti&t #*# s"#t" +e!#$ !ot#si pe&/is *#' )i*#n+ -!ont#& se$it#! #%is s#+it#&'o!ion'

t#& sein++# s# s#t" 1!ist# i&i#1# t"!"n *#n

#n+ inn# n#i$. P#*# te!#& ti&t $e $i!i, 1!ist# i&i#1# sisi $i!i

#$#n t"!"n *#n sisi $#n#n #$#n n#i$


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. Rot#si 4te!#& t8ist5

Rot#si 4te!#& t8ist5 #*# s"#t" +e!#$ !ot#sipe&/is *# )i*#n+ o!iont#& se$it#! #%is

/e!ti$#&7&on+it"*in#&.

D# !ot#si, pe&/is )#+i#n *ep#n )e!p"t#! $e#!# )e$#n+.

HUBUN2AN 3UN2SIONAL HIP PELVIS


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HUBUN2AN 3UN2SIONAL HIP, PELVIS

DAN SPINE

Se1#!# #!site$t"!, pe&/is te!&et#$ st!#te+is $#!e'n# e!"p#$#n pen+")"n+ t!"n$ *en+#n e%t!e'

it#s in-e!io! sein++# #!"s s#&in+ )e$e!j#'

s## p#*# seti#p +e!#$#n &")#& *#n ip. Keti$# t")" *# posisi )e!*i!i te+#$, pe&/is

ene!i# )e!#t $ep#, t!"n$, *#n "ppe! e%t!e'

it#s, $e"*i#n ent!#nsisi$#n )e)#n te!se'

)"t $e 6 &o8e! e%t!eit#s.


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K#!en# +e!#$ pe&/is )e!+#nt"n+ p#*# sen*i'

sen*i *i &")#& spine *#n ip #$# +e!#$ pe&'

/is *#p#t )e!si-#t se$"n*e! #t#" p!ie!.

Unt"$ en+##ti +e!#$ pe&/is s#n+#t s"&it

$#!en# p#nt#t #n+ enonjo& *en+#n pis#n

&e#$ #n+ te)#& *#n $on/e$s s#1!" #n+

ti*#$ "*# *io)se!/#si.

Den+#n )#nt"#n '!# #$# *#p#t *i&i#t #n#'

&isis +e!#$#n p!ie! *#n se$"n*e! *#!i pe&/is

te!#*#p &")#& spine *#n ip.

T ) & 6 2 $ P i * i P & i


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T#)e& 6. 2e!#$#n P!ie! *#!i Pe&/isAn#&isis +e!#$#n p!ie! pe&/is s##t posisi )e!*i!i

Pe&/is L")#& spine Hip joint

3o!8#!* ti&t Hipe!e$stensi Se*i$it 3&e$si

B#1$8#!* ti&t Se*i$it 3&e$si E$stensi pen"

L#te!#& ti&t $e$i!i Se*i$it te!#& -&e$si $e$#n#n K#n#n 9 se*i$it #**"$siKi!i 9 se*i$it #)*"$si

Rot#si $e $i!i4t#np# $ep#

)e!p"t#! #t#"$#$i )e!+e!#$

Rot#si $e $#n#n K#n#n 9 se*i$it e%te!n#&!ot#si.

Ki!i 9 se*i$it inte!n#&!ot#si.

T ) & ( 2 $ S $ * * i P & i


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T#)e& (. 2e!#$#n Se$"n*e! *#!i Pe&/isAn#&isis +e!#$#n se$"n*e! pe&/is te!#*#p &")#& spine

L")#& spine Pe&/is

3&e$si B#1$8#!* ti&t

E$stensi7ipe!e$stensi 3o!8#!* ti&tL#te!#& -&e$si $e $i!i L#te!#& ti&t $e $i!i

Rot#si $e $i!i Rot#si $e $i!i


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2e!#$ se$"n*e! pe&/is te!#*#p ip7&o8e! e%t!eit#s

S## ")"n+#nn# #nt#!# so"&*e! +i!*&e *#n"ppe! e%t!eit#s, *i#n# pe&/is )e!+e!#$"nt"$ enep"!n#$#n7e&en+$#pi +e!#$#np#*# ip.

A*# ( tipe +e!#$#n #n+ e&i)#t$#n +e!#$#nse$"n*e! pe&/is 9@2e!#$#n $e*"# t"n+$#i se1#!# )e!s###n $e *ep#n

#t#" $e )e$#n+ *# s"spension.

@2e!#$#n $e*"# t"n+$#i #n+ )e!#n#n #!#, se'pe!ti )e!j#n, )e!!i.

@2e!#$#n s# s#t" t"n+$#i, sepe!ti enen*#n+ $e

*ep#n #t#" $e s#pin+.


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P#*# +e!#$#n $e*"# t"n+$#i en+#"n $e

*ep#n #t#" $e )e$#n+, pe&/is #$#n )#1$8#!*ti&t $eti$# ip -&e$si *#n pe&/is #$#n -o!8#!*

ti&t $eti$# ip e%tensi7ipe!e%tensi.

P#*# +e!#$#n $e*"# t"n+$#i #n+ )e!#n#n4)e!j#n5, pe&/is #$#n )e!ot#si *# )i*#n+

o!iont#& *ise$it#! #%is /e!ti$#&. o!ient#si

pe&/is te!se)"t ene)#)$#n s#t" t"n+$#i -&e$'si ip *en+#n se*i$it e%te!n#& !ot#si 0 t"n+$#i

inn# e$stensi ip *en+#n se*i$it inte!n#& !o'

t#si.


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P#*# +e!#$#n s#t" t"n+$#i $e s#pin+ 4#)*"$si

ip5, pe&/is #$#n te!#& ti&t.

P#*# +e!#$#n s#t" t"n+$#i $e *ep#n 4-&e$si

ip5, pe&/is #$#n )#1$8#!* ti&t, )e+it"p" se'

)#&i$n#.

A*#n# pe!")##n posisi pe&/is p#*# seti#p

+e!#$#n ip )e!t"j"#n "nt"$ enep"!n#$#n

#t#" en+"nt"n+$#n +e!#$#n ip joint.


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L")ope&/i1 Rt

S"#t" +e!#$#n $oo!*in#si #nt#!# &")#& spine*#n pe&/is te!j#*i se# -&e$si t!"n$ s#p#i

j#!i'j#!i t#n+#n en1#p#i nt#i7t#n#. ini

*ise)"t &")ope&/i1 !t. P#*# s##t $ep# *#n "ppe! t!"n$ 4p"n++"n+

#t#s5 "i -&e$si, #$# pe&/is #$#n )e!+ese!

$e poste!io! 4)#1$8#!* ti&t5 "nt"$ epe!t#'

#n$#n p"s#t +!#/it#si sei)#n+ *i#t#s *#s#!

t"p"#n


51/54

Keti$# t!"n$ )e!nj"t $e -&e$si, #$# *i$on'

t!o& o&e otot e$stenso! spine s#p#i se$it#!

>o.

Ke"*i#n &i+#en'&i+#en )#+i#n poste!io!

#$#n te+#n+ *#n o!ient#si -#1et *# )i*#n+

-!ont#&, sein++# e)e!i$#n st#)i&it#s p#*#

/e!te)!# 0 otot !e%.

P#*# #$i! ROM, se&"!" se+en /e!te)!# *i'

st#)i&is#si o&e &i+#en'&i+#en poste!io! *#n

-#1et joint.


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P#*# #$i! ROM, pe&/is "i )e!ot#si $e *e'p#n 4-o!8#!* ti&t5 #n+ *i$ont!o& o&e otot +&"'

te"s #%i"s *#n #st!in+.

Ke"*i#n pe&/is enj"t$#n !ot#si $e *ep#n

s#p#i pe#nj#n+#n pen" otot e$stenso!

spine *#n #st!in+ te!1#p#i. #$i! ROM

*ipen+#!"i o&e -&e$si)i&it#s otot e$stenso!

spine *#n -#s1i# se!t# otot e$stenso! ip 4#s'

t!in+5.


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P#*# s##t t!"n$ $e)#&i $e posisi te+#$, *i#8#&+e!#$#n otot e$stenso! ip e!ot#si$#n pe&/is

$e#!# poste!io! 4)#1$8#!* ti&t5.

Ke"*i#n otot e$stenso! spine e#nj#n+$#n

spine 4e$stensi t!"n$5 *#!i posisi -&e$si.

L")ope&/i1 !t *#p#t te!+#n++" #$i)#t

$e)i#s##n post"! #n+ je&e$, $ete!)#t#s#n p#n'

j#n+ otot #t#" -#s1i#, #t#" inj"! *#n +#n++"#n

p!op!iosepsi.


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biomekanik hip joint

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