初級 股関節神経損傷リハビリテーション

Pain level reduced to ≤3/10 at rest with verbal descriptor scale,Hip flexion to 70 degrees without increased neuropathic symptoms,Ability to perform stationary standing with equal weight bearing,No exacerbation of symptoms with gentle passive hip rotation,Demonstrates understanding of nerve gliding precautions,Sensory examination shows no worsening of deficits in femoral, obturator, or lateral femoral cutaneous nerve distributions

→ 次の段階へ： Early Mobilization

Hip flexion improved to 90 degrees with tolerance,Able to perform supine knee flexion with hip neutral without radiating pain,Standing tolerance increased to 10 minutes without symptom provocation,Gentle active hip abduction in sidelying initiated without neuropathic flare,Demonstrates 2/5 hip flexion strength against gravity,No worsening of patting or Tinel's sign over affected nerve pathway

→ 次の段階へ： Nerve Gliding Phase

Hip flexion to 100 degrees with pain ≤2/10,Completes supine nerve glides for femoral nerve without symptom exacerbation,Active hip external rotation against gravity achieved,Single leg stance on unaffected limb for 30 seconds,Demonstrates 3/5 hip abduction strength,Tolerates 15 minutes of gentle walking with normalized gait pattern

→ 次の段階へ： Strength Building

Hip flexion to 110 degrees with functional range,Performs seated hip flexion against resistance without neuropathic symptoms,Hip abduction strength 3/5 or greater,Able to perform clamshells with proper gluteal activation,Single leg stance on affected limb for 10 seconds,Pain-free active hip internal and external rotation through full range

→ 次の段階へ： Progressive Strengthening

Hip flexion to 115 degrees without compensation,Hip abduction strength improved to 4/5,Completes 10 repetitions of sidelying hip abduction without fatigue,Standing hip extension against resistance tolerated,Demonstrates proper pelvic control during single limb activities,Tolerates 20 minutes of continuous ambulation at comfortable pace

→ 次の段階へ： Advanced Strengthening

Full hip flexion range of motion achieved,Hip extension strength 4/5 or greater,Performs 15 repetitions of monster walks with resistance band,Single leg squat on affected limb to 45 degrees knee flexion without valgus,Hip external rotation strength 4/5,No recurrent neuropathic symptoms following exercise session

→ 次の段階へ： Functional Integration

Completes 3 sets of 12 repetitions hip strengthening without increased symptoms,Single leg stance on affected limb for 30 seconds with eyes closed,Able to perform step-up onto 4-inch step with control,Hip adduction strength 4/5 or greater,Tolerates 25 minutes of varied pace walking,Demonstrates normalized gait mechanics during stair negotiation

→ 次の段階へ： Dynamic Movement

Completes lateral step-downs from 4-inch step with proper alignment,Able to perform mini squats on balance board,Hip flexion strength 5/5 or within 1 grade of contralateral side,Single leg hop in place for 10 repetitions without compensation,Tolerates 30 minutes of functional activity,No provocation of neural symptoms with high-velocity movements

→ 次の段階へ： Power Development

Performs single leg squat to 70 degrees knee flexion with control,Hip abduction and adduction power symmetrical within 10%,Completes forward lunges with proper knee-over-toe alignment,Single leg stance reach forward 12 inches without loss of balance,Tolerates 35 minutes of community ambulation,Pain and neuropathic symptoms absent during and after activity

→ 次の段階へ： Sport-Specific Preparation

Hip external rotation power within 15% of contralateral side,Completes agility ladder drills at 50% speed,Able to perform single leg RDL with 5 lb weight,Tolerates 40 minutes of intermittent high-intensity activity,No recurrence of nerve-related symptoms with explosive movements,Demonstrates proper hip hinge mechanics during deadlift pattern

→ 次の段階へ： Return to Activity Initiation

Full strength symmetrical across all hip muscle groups,Completes 20-minute jog at moderate pace without compensation,Single leg hop for distance within 80% of contralateral side,Tolerates plyometric double leg jumps without neural symptoms,Hip range of motion symmetrical in all planes,Patient-reported outcome scores improved by 20% from baseline

→ 次の段階へ： Return to Activity Progression

Completes 30 minutes of continuous running at 70% effort,Single leg hop test within 90% of contralateral side,Able to perform cutting maneuvers at 50% speed,Hip abduction and extension power within 85% of contralateral side,No provoked neuropathic symptoms during sport-specific drills,Patient reports return to 75% of pre-injury functional capacity

→ 次の段階へ： Advanced Return to Activity

Jogging at 80% effort for 30 minutes without symptom recurrence,Single leg vertical hop within 85% of contralateral side,Completes reactive agility drills without hesitation,Tolerates repeated sprint intervals with adequate recovery,Hip muscle endurance index greater than 90% of contralateral side,No night pain or morning stiffness

→ 次の段階へ： Near Full Return

Full-speed running and cutting drills tolerated,Single leg hop for time within 80% of contralateral side,Completes sport-specific drills at 90% intensity,Hip flexion and extension power within 92% of contralateral side,No sensory deficits in nerve distribution patterns,Patient reports 90% return to pre-injury function

→ 次の段階へ： Full Return to Activity

Returned to full sport-specific training without restrictions,Single leg hop battery scores within 95% of contralateral side,Hip strength and power metrics meet sport-specific requirements,No provoked neural symptoms with maximal effort activities,Patient-reported outcome scores at 85% or greater of pre-injury baseline,Demonstrates proper movement patterns under fatigue

→ 次の段階へ： Maintenance and Discharge

Completed 2 weeks of full sport participation without setbacks,Hip muscle girth within 1 cm of contralateral side,All hip special tests negative for pathology,Sensory examination normal in all nerve distributions,Patient confident in return to all activities,Home exercise program independently managed

→ 次の段階へ： Long-term Monitoring

Full return to competitive activities sustained for 1 week,Patient-reported outcome scores at 90% or greater of pre-injury baseline,Hip range of motion and strength maintained at discharge levels,No recurrence of neuropathic symptoms at 3-month follow-up,Patient demonstrates understanding of maintenance program,Discharge criteria met for outpatient rehabilitation

→ 次の段階へ： Discharge