A patient is lying supine with hips and knees extended and hands behind the head. The patient can raise the head, shoulders, and thorax but cannot reach a long-sitting position. Which muscle should be targeted for strengthening?

A patient is lying supine with hips and knees extended and hands behind the head. The patient can raise the head, shoulders, and thorax but cannot reach a long-sitting position. Which muscle should be targeted for strengthening?

• A. Iliopsoas
• B. External abdominal oblique
• C. Quadratus lumborum
• D. Upper rectus abdominis

Answer: (A)

The movement required to go from lying on the back with the legs straight to a long-sitting position relies on bending the hip with the knee extended. While the ability to lift the head and shoulders shows the trunk flexors are functioning, reaching long-sitting depends on a strong hip flexor to bring the thigh up toward the chest. The iliopsoas is the primary hip flexor and provides the force needed to flex the hip when the leg is straight. If this muscle is weak, trunk flexion may occur, but the legs won’t clear the thighs to achieve long-sitting. The other muscles listed mainly influence the trunk rather than the hip. External abdominal oblique and upper rectus abdominis contribute to trunk flexion, stabilization, or rotation, and quadratus lumborum helps with lateral stabilization and pelvic control. They don’t provide the key hip flexion needed to reach long-sitting, which is why strengthening the iliopsoas is the best target.

The movement required to go from lying on the back with the legs straight to a long-sitting position relies on bending the hip with the knee extended. While the ability to lift the head and shoulders shows the trunk flexors are functioning, reaching long-sitting depends on a strong hip flexor to bring the thigh up toward the chest. The iliopsoas is the primary hip flexor and provides the force needed to flex the hip when the leg is straight. If this muscle is weak, trunk flexion may occur, but the legs won’t clear the thighs to achieve long-sitting.

The other muscles listed mainly influence the trunk rather than the hip. External abdominal oblique and upper rectus abdominis contribute to trunk flexion, stabilization, or rotation, and quadratus lumborum helps with lateral stabilization and pelvic control. They don’t provide the key hip flexion needed to reach long-sitting, which is why strengthening the iliopsoas is the best target.