中級 股関節捻挫・挫傷リハビリテーション

Pain at rest less than 3/10 on VAS scale, Able to ambulate with assistive device (if prescribed) without increased pain, Hip flexion range of motion within 15 degrees of contralateral side, No exacerbation of symptoms with gentle passive range of motion, Tolerates prone lying position without increased hip/groin pain, Ability to perform isometric contractions of hip abductors and adductors without increased pain

→ 次の段階へ： Phase 2: Early Mobility

Pain with activities of daily living less than 4/10, Hip flexion Range of Motion greater than 90 degrees, Hip internal rotation greater than 15 degrees, No pain with passive hip distraction or FABER position, Tolerates stationary cycling with minimal resistance, Single leg stance for 10 seconds with minimal compensation

→ 次の段階へ： Phase 3: Early Strengthening

Hip abduction strength greater than 4/5 on manual muscle testing, Hip adduction strength greater than 4/5, Active hip flexion Range of Motion greater than 110 degrees, No pain with resisted hip flexion in neutral rotation, Tolerates progressions to walking program without exacerbation, Hip internal rotation greater than 20 degrees without pain

→ 次の段階へ： Phase 4: Intermediate Strengthening

Hip external rotation strength greater than 4/5, Single leg squat to 45 degrees knee flexion without compensatory Trendelenburg, Hip flexion strength greater than 4/5, Standing hip abduction with resistance without pain, Tolerance of hip capsule mobilization (if indicated), No pain with functional activities lasting 20+ minutes

→ 次の段階へ： Phase 5: Advanced Strengthening

Hip extension strength greater than 4/5, Single leg stance for 30 seconds without compensation, Full hip Range of Motion equal to contralateral side (flexion, extension, abduction, adduction, internal/external rotation), Tolerates bridging progressions without pain, Can perform step-ups onto 8-inch step without pain, Hip Outcome Score sports subscale improvement of 10+ points

→ 次の段階へ： Phase 6: Power Development

Hip abduction power greater than 75% of contralateral side, Hip adduction power greater than 75% of contralateral side, No pain with resisted hip external rotation in prone, Tolerates agility drills at 50% speed without increased symptoms, Single leg hop for distance greater than 50% of body height, Functional movement screen score greater than 14

→ 次の段階へ： Phase 7: Sport-Specific Training

Full pain-free hip Range of Motion during sport-specific movements, Hip flexion with greater than 90 degrees in functional positions, Tolerates cutting and pivoting activities at 75% speed, Single leg hop for time less than 110% of contralateral side, No hip pain with resisted side-lying hip external rotation, Modified Harris Hip Score greater than 80

→ 次の段階へ： Phase 8: Return to Activity Preparation

Hip muscle endurance within 90% of contralateral side, Tolerance of high-intensity interval training without flare-up, Full sport-specific movement patterns without compensation, No pain with maximal hip muscle contractions, iHOT-12 score improvement of 15+ points from baseline, Confidence in hip stability during dynamic activities

→ 次の段階へ： Phase 9: Graduated Return to Sport

Complete full-speed sport-specific drills without pain, Hip range of motion equal to contralateral side in all planes, Single leg vertical hop greater than 90% of contralateral side, No apprehension with hip flexion and internal rotation (impingement tests negative), Tolerates contact or collision scenarios in practice, Patient subjective readiness to return to sport

→ 次の段階へ： Phase 10: Full Sport Participation

Return to full competitive training, No hip symptoms during or after activity, Maintenance of hip strength greater than 90% of contralateral side, Full participation in team practices, No loss of hip Range of Motion post-activity, Hip Outcome Score activities of daily living subscale greater than 90%

→ 次の段階へ： Phase 11: Performance Optimization

Increased training load without symptom recurrence, Hip power metrics within 95% of pre-injury levels, Tolerance of repeated sprint efforts, No hip fatigue-related performance decrement, Maintenance program compliance documented, Subjective hip function rating of good to excellent

→ 次の段階へ： Phase 12: Maintenance and Prevention

Three consecutive weeks without hip symptoms during sport, Hip abduction to adduction strength ratio greater than 70%, Core endurance tests within normal limits, No hip pain with activities requiring hip flexion greater than 90 degrees, Continued progression of maintenance program, Patient education on injury prevention completed

→ 次の段階へ： Phase 13: Discharge and Long-Term Management

Discharge criteria met: full return to pre-injury activity level, No restrictions from medical clearance, Independent home exercise program management, Understanding of warning signs requiring follow-up, Hip Outcome Score greater than 90% on both subscales, Patient discharged with written home maintenance protocol