Background: Hip flexor muscles are very important in the hip joint structure as a mover and stabilizer. In addition, isometric hip flexor strength in the supine position needs to be considered with isometric core strength (WICS) to measure a precise strength in a clinical way. Objects: We compared isometric hip flexor strength in the supine position in subjects with and without WICS (between factors) and conditions with and without an external support (within factors). Methods: A total of 34 subjects (16 with WICS, 18 without WICS) participated in this study. We used the double-bent leg-lowering test to divide the subjects in two groups according to the presence of WICS. Isometric hip flexor strength was evaluated in the supine position both with and without an external support condition. The two-way mixed analysis of variance was applied to identify significant differences between groups (with vs. without WICS: between factors) and conditions (with vs. without an external support: within factors). Statistical significance was set at α = 0.05. Results: In subjects with WICS, isometric hip flexor strength was greater with an external support than without it (p = 0.0064). In subjects without WICS, there were no significant differences in isometric hip flexor strength in the presence or absence of an external support (p = 0.075). The isometric hip flexor strength was significantly greater with an external support condition in particular in subjects with WICS. Conclusion: The findings of this study reported that an external support condition in individuals with WICS may contribute to the improvement of isometric hip flexion strength in the supine position. Therefore, isometric core strength should be evaluated to distinguish the weakness between core region and hip flexors.

The purpose of this study was to assess the intra-rater test-retest reliability of tibial external rotation angle measurement using a smartphone-based photographic goniometer, DrGoniometer (DrG) compared to a three-dimensional motion analysis system (Vicon). The current study showed an interchangeable method using DrG to measure the tibial external rotation angle in standing knee flexion at . Twelve healthy subjects participated in this study. A rest session was conducted 30 minutes later for within-day reliability and five days later for between-day intra-rater test-retest reliability. To assess the validity of the measurement using DrG, we used a three dimensional motion analysis system as a gold standard to measure the angle of tibial external rotation. Intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) values were used to determine the within- and between- day intra-rater test-retest reliability of using DrG and a three dimensional motion analysis system. To assess validity, Pearson correlation coefficients were used for two measurement techniques. The measurement for tibial external rotation had high intra-rater test-retest reliability of within-day (ICC=.88) and between-day (ICC=.83) reliability using DrG and of within-day (ICC=.93) and between-day (ICC=.77) reliability using a three-dimentional motion analysis system. Tibial external rotation angle measurement using DrG was highly correlated with those of the three-dimensional motion analysis system (r=.86). These results represented that the tibial external rotation angle measurement using DrG showed acceptable reliability and validity compared with the use of three-dimensional motion analysis system.