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Unuvar E, Guney-Deniz H, Akinoglu B, Kocahan T, Nyland J. Frontal plane lower extremity alignment in adolescent athletes with chronic hip adductor-related groin injury symptoms: A case-control study. Phys Ther Sport 2022; 57:53-60. [PMID: 35921782 DOI: 10.1016/j.ptsp.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare trunk and lower extremity frontal plane projection angles (FPPA) during single leg squat (SLS) performance, perceived hip and groin function and symptoms, and isometric hip strength of adolescent athletes with chronic hip adductor-related groin injury (HARGI) symptoms and age, gender, and sport-matched healthy subjects. DESIGN Case-control study. SETTING Junior Olympic Development Training Centre. PARTICIPANTS Twenty-six athletes at 59.1 ± 60 weeks (range = 12-208 weeks) post-index grade II HARGI injury who had continued sport training (injury group) and 26 control group subjects. MAIN OUTCOME MEASURES SLS trunk, hip, and knee FPPA, isometric hip strength standardized to bodyweight, and Copenhagen Hip and Groin Outcome Scores (HAGOS). RESULTS The injury group had greater bilateral knee FPPA, and greater injury side hip FPPA during maximum SLS. Injury group HAGOS subscale scores were lower than control group scores. Hip abductor, adductor, external rotator, and internal rotator strength was lower at the injury side of the injury group compared to the matched control group limb. Forward stepwise multiple regression analysis of the injury group found that 50% of injury side knee FPPA was predicted by hip internal rotator strength and time post-index HARGI; and 47% of injury side hip FPPA was predicted by other side hip flexor strength and the HAGOS function, sport and recreation subscale score (p = 0.002). CONCLUSIONS Greater injury side hip and bilateral knee FPPA during maximum SLS, lower self-reported hip symptom and function scores, and less injury side hip abductor, adductor, external rotator and internal rotator strength suggests that adolescent athletes with chronic HARGI symptoms are at an increased risk for sustaining a non-contact knee injury. Impaired hip internal rotator strength at the side of the chronic HARGI was related to increased knee FPPA, and impaired hip flexor strength at the other side of the HARGI was related to increased hip FPPA. Findings support using SLS performance testing in this athlete group to help determine safe return to sport training readiness.
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Affiliation(s)
- Ezgi Unuvar
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, 06100, Ankara, Turkey
| | - Hande Guney-Deniz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, 06100, Ankara, Turkey
| | - Bihter Akinoglu
- Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Etlik, Ankara, Turkey
| | - Tugba Kocahan
- University of Health Sciences, Gulhane Faculty of Medicine, Sports Medicine Department, Ankara, Turkey
| | - John Nyland
- Spalding University, Kosair Charities College of Health and Natural Sciences, Louisville, KY, USA.
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Dunne C, Callaway AJ, Thurston J, Williams JM. Validity, reliability, minimal detectable change, and methodological considerations for HHD and portable fixed frame isometric hip and groin strength testing: A comparison of unilateral and bilateral testing methods. Phys Ther Sport 2022; 57:46-52. [PMID: 35921781 DOI: 10.1016/j.ptsp.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Comparative assessment of bilateral (KangaTech) and unilateral (HHD) testing modalities through concurrent validity and test-retest reliability. Methodological considerations explored include minimum repetitions and comparison of average and maximum values. DESIGN Experimental, observational. SETTING Biomechanics laboratory. PARTICIPANTS Thirty-three participants. MAIN OUTCOME MEASURES Concurrent validity using peak force. Test-retest reliability used Abduction and Adduction using 2 trials, randomised between devices. Maximum peak force and average of both trials were used. RESULTS HHD and KT360 are concurrently valid (r = 0.996); with no significant difference (z = -0.681). Excellent HHD reliability (ICC:0.92-0.96) and KT360 (ICC:0.89-0.97). Significant difference between max peak force and average peak force but within the calculated MDC(%). No significant differences between max peak force between trials. Spearman-Brown prophecy predicted excellent reliability for one trial (ICC:0.81-0.95). Bilateral facilitation was demonstrated using the KT360 with 94.6-101.2% increase in force compared to HHD. CONCLUSIONS With no significant difference between first and second max effort, and excellent prophesised reliability, one rep max effort should be acceptable to use. Body positioning within the KT360 seems to elicit bilateral facilitation rather than deficit, therefore unilateral and bilateral force values are not interchangeable.
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Affiliation(s)
- Cian Dunne
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
| | - Andrew J Callaway
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK.
| | - Joanna Thurston
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
| | - Jonathan M Williams
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
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Pacheco-Brousseau L, Dobransky J, Jane A, Beaulé PE, Poitras S. Feasibility of a preoperative strengthening exercise program on postoperative function in patients undergoing hip or knee arthroplasty: a pilot randomized controlled trial. Pilot Feasibility Stud 2022; 8:162. [PMID: 35908037 PMCID: PMC9338629 DOI: 10.1186/s40814-022-01126-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are conflicting results on the effect of preoperative exercise programs on long-term function and little evidence on short-term function. The aim is to assess the feasibility of a preoperative strengthening exercise program in patients undergoing hip or knee joint arthroplasty in terms of trial design, recruitment, and follow-up rates. METHODS A randomized controlled feasibility study with patients undergoing hip or knee joint arthroplasty. Patients were randomized to a preoperative strengthening exercise program or standard of care. Feasibility outcome measures were recruitment rate (≥ 50%) and loss to follow-up (≤ 15%). RESULTS Of the 129 eligible participants, 63 participants consented to participate in the study (49%), and 27 were successfully randomized prior to surgery (43%). All 27 participants completed the baseline assessment. Of these, 6 (22%) had surgery during the exercise period. Of the remaining 21 participants, 20 (95%) completed the pre-surgery assessment. The study was terminated before five participants could be eligible for the 6-month assessment. Sixteen (76%) participants completed the 6-week post-surgery assessment. Twelve participants completed the 6-month assessment (75%). CONCLUSION Given the recruitment rate, randomization barriers, and study participant loss to follow-up, the study was discontinued since it was not considered feasible in this current form at our clinical site despite modifications made to the protocol. Future investigations into a modified intervention via telerehabilitation should be explored. TRIAL REGISTRATION ClinicalTrials.gov, NCT03483519 . Retrospectively registered in March 2018.
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Affiliation(s)
- Lissa Pacheco-Brousseau
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.,Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Johanna Dobransky
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Alanna Jane
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Paul E Beaulé
- Faculty of Medicine, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Stéphane Poitras
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.
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Is the Side Bridge Test Valid and Reliable for Assessing Trunk Lateral Flexor Endurance in Recreational Female Athletes? BIOLOGY 2022; 11:biology11071043. [PMID: 36101422 PMCID: PMC9312545 DOI: 10.3390/biology11071043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Although the side bridge test has been widely used for assessing trunk lateral flexor endurance in sport, clinical, and scientific settings, to the best of the authors’ knowledge, no study has analyzed its validity and reliability in an only female population. The surface electromyography of eight abdominal, back, shoulder and hip muscles was measured during the test to analyze its validity. A one-week test-retest design was performed to evaluate its reliability. No significant differences were found between the trunk lateral flexors and the deltoids. The study data showed that the test performance could be significantly predicted by external oblique and deltoid normalized median frequency slopes and by body mass and trunk height. Based on the results of this study, the shoulder muscle activation and fatigue and the individuals’ anthropometric characteristics, especially the mass, played an important role in the side bridge test performance, which questions the validity of this multi-joint test to specifically assess trunk lateral flexor endurance. In addition, although the side bridge test showed a good data consistency, its intra-subject variability was high, which reduces its utility when small intra-subject changes in muscle endurance are important (e.g., elite sport). Abstract The side bridge test (SBT) is one of the most popular tests to assess isometric trunk lateral flexor endurance. The aim of this study was to assess the validity and reliability of the SBT in healthy females. Twenty-four (24.58 ± 3.92 years) physically active (1–2 h of moderate physical activity, 2–3 times a week) females voluntarily participated in this study. The surface electromyography (EMG) of eight abdominal, back, shoulder and hip muscles was measured during the SBT. Normalized median frequency slopes (NMFslope) were calculated to analyze the muscle fatigue. The EMG amplitudes were normalized to maximum EMG values to assess muscle activity intensity. A one-week test-retest design was performed to evaluate the SBT reliability through the ICC3,1 and typical error. Higher NMFslopes and normalized EMG amplitudes were found in deltoids, abdominal obliques, rectus abdominis, and erector spinae in comparison to latissimus dorsi, gluteus medius, and rectus femoris. However, no significant differences were found between the trunk lateral flexors and the deltoids. Linear regression analysis showed that SBT performance could be significantly predicted by external oblique and deltoid NMFslope (adjusted R2 = 0.673) and by body mass and trunk height (adjusted R2 = 0.223). Consistency analysis showed a high intraclass correlation coefficient (0.81) and a relatively high typical error (10.95 s). Despite the good relative reliability of the SBT, its absolute reliability was low and its validity questionable, as the shoulder muscle activation and fatigue and the individuals’ anthropometric characteristics played an important role in SBT performance.
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Fernandez-Fernandez J, Granacher U, Martinez-Martin I, Garcia-Tormo V, Herrero-Molleda A, Barbado D, Garcia-Lopez J. Physical fitness and throwing speed in U13 versus U15 male handball players. BMC Sports Sci Med Rehabil 2022; 14:113. [PMID: 35725495 PMCID: PMC9210574 DOI: 10.1186/s13102-022-00507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022]
Abstract
Background The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed. Methods One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study. The participating athletes had a mean background of sytematic handball training of 5.5 ± 2.8 years and they exercised on average 540 ± 10.1 min per week including sport-specific team handball training and strength and conditioning programs. Players were tested for passive shoulder range-of-motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, overhead medicine ball throw (OMB), hip isometric abductor (ABD) and adductor (ADD) strength, hip ROM, jumps (countermovement jump [CMJ] and triple leg-hop [3H] for distance), linear sprint test, modified 505 change-of-direction (COD) test and handball throwing speed (7 m [HT7] and 9 m [HT9]). Results U15 players outperformed U13 in upper (i.e., HT7 and HT9 speed, OMB, absolute IR and ER strength of the dominant and non-dominant sides; Cohen’s d: 0.76–2.13) and lower body (i.e., CMJ, 3H, 20-m sprint and COD, hip ABD and ADD; d: 0.70–2.33) performance measures. Regarding shoulder ROM outcomes, a lower IR ROM was found of the dominant side in the U15 group compared to the U13 and a higher ER ROM on both sides in U15 (d: 0.76–1.04). It seems that primarily anthropometric characteristics (i.e., body height, body mass) and upper body strength/power (OMB distance) are the most important factors that explain the throw speed variance in male handball players, particularly in U13. Conclusions Findings from this study imply that regular performance monitoring is important for performance development and for minimizing injury risk of the shoulder in both age categories of young male handball players. Besides measures of physical fitness, anthropometric data should be recorded because handball throwing performance is related to these measures.
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Affiliation(s)
- Jaime Fernandez-Fernandez
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain.,AMRED, Human Movement and Sports Performance Analysis, Universidad de León, León, Spain
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, Faculty of Human Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany.
| | - Isidoro Martinez-Martin
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain.,AMRED, Human Movement and Sports Performance Analysis, Universidad de León, León, Spain
| | - Vicente Garcia-Tormo
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain.,AMRED, Human Movement and Sports Performance Analysis, Universidad de León, León, Spain
| | - Alba Herrero-Molleda
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain.,AMRED, Human Movement and Sports Performance Analysis, Universidad de León, León, Spain
| | - David Barbado
- Department of Sport Science, Sport Research Centre, Miguel Hernandez University of Elche, Elche, Spain
| | - Juan Garcia-Lopez
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain.,AMRED, Human Movement and Sports Performance Analysis, Universidad de León, León, Spain
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Seth M, Pohlig RT, Beisheim-Ryan EH, Stauffer SJ, Horne JR, Hicks GE, Sions JM. Residual and sound limb hip strength distinguish between sedentary and nonsedentary adults with transtibial amputation. Int J Rehabil Res 2022; 45:137-145. [PMID: 35131977 PMCID: PMC9086098 DOI: 10.1097/mrr.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Following a transtibial amputation (TTA), physical activity has known benefits for health and quality of life. Adults post-TTA, however, demonstrate reduced physical activity, predisposing them to adverse health outcomes. Identifying adults at the risk of sedentarism post-TTA via commonly used, objective clinical measures may enhance clinical decisions, including prosthesis prescription. The study's purpose was to determine whether residual and sound limb hip strength distinguishes between sedentary and nonsedentary adults post-TTA. A secondary analysis of a cross-sectional dataset (n = 44) was conducted. Participant residual and sound limb hip flexion, extension, abduction and adduction strength were assessed via handheld dynamometry. Physical activity was monitored for 7 days and participants were classified as sedentary (<5000 steps/day; n = 13) or nonsedentary (≥5000 steps/day; n = 31). Receiver operating curves revealed that residual and sound limb hip extension, abduction and adduction strength distinguished between sedentary and nonsedentary adults post-TTA (P < 0.050). Preliminary cut-points for hip strength measures to classify adults at the risk of sedentarism were determined. A hip strength composite score (0-6) estimates a 2.2× increased odds of being sedentary with each additional hip strength deficit. Post-TTA, residual and sound limb hip strength can help identify adults at risk of sedentarism to aid clinical decision making, including prosthesis prescription.
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Affiliation(s)
- Mayank Seth
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Ryan T Pohlig
- Biostatistics Core, University of Delaware, Newark, DE, USA
| | - Emma H Beisheim-Ryan
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Samantha J Stauffer
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
- Independence Prosthetics-Orthotics, Inc., Newark, DE, USA
| | - John R Horne
- Independence Prosthetics-Orthotics, Inc., Newark, DE, USA
| | - Gregory E Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Jaclyn Megan Sions
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
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Clinical Measures of Adolescent Softball Players With and Without Upper-Extremity Pain: A Preliminary Study. J Sport Rehabil 2022; 31:971-977. [PMID: 35523422 DOI: 10.1123/jsr.2021-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Upper-extremity (UE) pain is a concern among softball adolescent athletes. However, research on preseason screening of demographic characteristics and clinical measures among those with and without UE pain among adolescent softball athletes is underreported. This study sought to present functional outcomes and clinical measures of shoulder and hip complex flexibility, range of motion (ROM), and strength in adolescent softball athletes with and without UE pain. DESIGN Cross-sectional study. METHODS Sixty-seven athletes were assessed at the start of the spring season. The Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Questionnaire was administered to determine UE function. UE measurements included shoulder ROM, flexibility, and strength; lower-extremity measurements included hip ROM and strength. These variables were reported for players with and without UE pain as mean and SD. Independent samples t tests were performed to analyze differences between the groups. RESULTS Thirteen (19.4%) athletes reported UE pain during preseason screening. Mean Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Questionnaire score among athletes with UE pain was 58.0 (17.6) compared with 97.1 (6.9) for athletes reporting no UE pain (P < .001). Athletes with UE pain presented with significantly less dominant side external rotation ROM (UE pain: 106.5 [10.4], no UE pain: 114.6 [11.3]) and total ROM (UE pain: 163.7 [14.5], no UE Pain: 174.8 [14.3]). CONCLUSION These findings inform clinicians on function and preseason clinical measures in adolescent softball athletes who present with or without UE pain. Athletes with UE pain demonstrated lower outcome scores indicating likely impact on overall UE function. These athletes also appeared to demonstrate UE ROM differences compared with athletes without UE pain. Further research is needed to investigate larger sample sizes and positional differences at baseline and throughout the season to determine if clinical measures used in the current study are risk factors for pain and injury.
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Thomas RJ, Timmins RG, Tofari PJ, Williams MD, Opar DA. Assessing isometric kicking force and post-match responses using the Kicker test. J Sports Sci 2022; 40:1275-1281. [PMID: 35502468 DOI: 10.1080/02640414.2022.2065772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined the inter-session reliability of force output from a novel isometric strength assessment protocol (the Kicker); and its suitability to monitor soccer player's combined hip flexion and knee extension force capacity over 72-h post-competitive matches. Reliability (Part-A) testing was completed over three sessions on 20 individuals participating in various sports at a recreational level or higher. Post-match strength response (Part-B) data were collected for 72-h after a game (24-h (+24), 48-h (+48) and 72-h (+72) post-match) in 17 male academy soccer players. After familiarisation, Kicker force for each limb showed high inter-session reliability (ICC >0.95; typical error <14 N, CV <6%); minimum detectable change at a 95% confidence interval <40 N). Across the 72-h post-match period, Kicker force for each limb was suppressed compared to baseline (force loss range = -5.8% to -12.5%; effect sizes range = -0.26 to -0.43) at all time points. The Kicker assessment protocol measures combined isometric hip flexor and knee extensor force capacity with high inter-session reliability. The proof of concept that the protocol can be used as a monitoring tool was evidenced by sustained suppression of baseline force capacity in both kicking limbs for 72-h post soccer matches.
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Affiliation(s)
- Rees J Thomas
- Melbourne Victory Football Club, Melbourne, Vic, Australia.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Vic, Australia.,College of Health and Biomedicine, Victoria University, Melbourne, Vic, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Vic, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, Vic, Australia
| | - Paul J Tofari
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Vic, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, Vic, Australia
| | - Morgan D Williams
- School of Health, Sport and Professional Practice, Faculty of Life Sciences and Education, University of South Wales, Treforest, UK
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Vic, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, Vic, Australia
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Sancho I, Morrissey D, Willy RW, Tayfur A, Lascurain-Aguirrebeña I, Barton C, Malliaras P. Recreational runners with Achilles tendinopathy have clinically detectable impairments: A case-control study. Phys Ther Sport 2022; 55:241-247. [DOI: 10.1016/j.ptsp.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 10/24/2022]
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Abstract
We analyzed the Smart Groin Trainer device's validity and reliability to measure the isometric hip adduction strength during the adductor squeeze strength test. Fifteen professional soccer players (25.33±4.06 years) and fifteen university students (21.60±1.76 years) participated in this study. All participants performed the squeeze strength test using two portable dynamometers: Smart Groin Trainer and Globus Ergometer. Three maximal isometric hip adduction contractions lasting 5s, interspersed by 3min rest intervals, were performed. Reliability was analyzed with intraclass correlation coefficients, standard error of measurements, and minimal detectable change. The absolute percent error and inter-device accuracy were also analyzed. Correlation analysis assessed the inter-device concurrent validity. The results found no significant differences (p>0.05) between devices in the squeeze strength test values in soccer players and university students. Inter-device comparisons revealed excellent levels of reliability and accuracy in soccer players. Concurrent validity measures revealed strong inter-device relationships in soccer players (r=0.89) and very strong relationships in university students (r=0.99). Intra-device analysis using the Smart Groin Trainer showed excellent relative and absolute reliability in tested soccer players. Our data demonstrated excellent levels of agreement between both dynamometers during the squeeze strength test, suggesting the Smart Groin Trainer as a valid, reliable, and accurate device to measure isometric hip adduction strength.
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Mohammad WS, Elsais WM. Comparison of hip abductor and adductor muscle performance between healthy and osteitis pubis professional footballers. Ir J Med Sci 2022; 192:685-691. [PMID: 35426013 DOI: 10.1007/s11845-022-03010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study aimed to compare the concentric and eccentric muscle performance of the hip abductor and adductor muscles at a high angular velocity in football players with osteitis pubis and healthy players. METHODS A total number of 32 male football players with osteitis pubis and 20 healthy footballers were tested using an isokinetic dynamometer at a speed of 180°/s. Hip abductor and adductor peak torque/body weight, time to peak torque, acceleration, and deceleration times produced during concentric and eccentric muscle contraction modes were measured using a Biodex dynamometer. RESULTS Football players with osteitis pubis demonstrated a significantly higher time to peak torque, acceleration, and deceleration times (p < 0.05); however, when compared to healthy athletes, there was no significant change in muscle strength. CONCLUSION The present study showed that football players with osteitis pubis had a reduction in neuromuscular reaction. Therefore, the reaction time of these muscles is critical, and the reduction could result in magnified stresses and/or poorly distributed loads across the musculotendinous structure of the anterior pelvis, which presumably could lead to the development of osteitis pubis. Incorporate findings of the current study in clinical practice could afford critical information when evaluating the hip muscles in football players with osteitis pubis, for pre-screening, enhancing the rehabilitation programs, and guiding the decision of returning to sports after injury.
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Affiliation(s)
- Walaa S Mohammad
- Department of Physical Therapy, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia.
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
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Yang Y, Liu S, Ling M, Ye C. Prevalence and Potential Risk Factors for Occupational Low Back Pain Among Male Military Pilots: A Study Based on Questionnaire and Physical Function Assessment. Front Public Health 2022; 9:744601. [PMID: 35059371 PMCID: PMC8764305 DOI: 10.3389/fpubh.2021.744601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/13/2021] [Indexed: 01/09/2023] Open
Abstract
Objectives: Low back pain (LBP) has negative implications for the military's combat effectiveness. This study was conducted to determine the prevalence and risk factors of LBP among pilots through a questionnaire and physical function assessments. Methods: Data on the demographic and occupational characteristics, health habits, physical activity, and musculoskeletal injuries of 217 male pilots (114 fighter, 48 helicopter, and 55 transport pilots) were collected using a self-reported questionnaire and physical function assessments. Results: LBP prevalence was 37.8% in the total cohort and 36.0, 45.8, and 34.5% among fighter, helicopter, and transport pilots, respectively. Multivariate regression analysis revealed that the risk factors significantly associated with LBP were neck pain [odds ratio (OR): 3.559, 95% confidence interval (CI): 1.827–6.934], transversus abdominis activation (OR: 0.346, 95% CI: 0.172–0.698), and hip external rotator strength (OR: 0.001, 95% CI: 0.000–0.563) in the total cohort; neck pain (OR: 3.586, 95% CI: 1.365–9.418), transversus abdominis activation (OR: 0.268, 95% CI: 0.094–0.765), hip external rotator strength (OR: 0.000, 95% CI: 0.000–0.949), and weekly flying hours (OR: 3.889, 95% CI: 1.490–10.149) in fighter pilots; irregular strength training (OR: 0.036, 95% CI: 0.003–0.507) and hip external rotator strength (OR: 0.000, 95% CI: 0.000–0.042) in helicopter pilots; and neck pain (OR: 6.417, 95% CI: 1.424–28.909) in transport pilots. Conclusions: High volume flight schedules and weak core muscle functions have significant negative effects on pilots' back health. LBP is commonly associated with high weekly flying hours, worsening neck pain, transversus abdominis insufficient activation, and reduced hip extensor/rotator strength. Risk factors vary among pilots of different aircraft. Thus, specific core muscle training would be especially important for military pilots.
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Affiliation(s)
- Yizhuo Yang
- Department of Rehabilitation Medicine, Air Force Medical Center, PLA, Beijing, China
| | - Shuai Liu
- Department of Rehabilitation Medicine, Air Force Medical Center, PLA, Beijing, China
| | - Mengyu Ling
- Department of Rehabilitation Medicine, Air Force Medical Center, PLA, Beijing, China.,Department of Rehabilitation Medicine and Physiotherapy, Anhui Medical University, Hefei, China
| | - Chaoqun Ye
- Department of Rehabilitation Medicine, Air Force Medical Center, PLA, Beijing, China
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Lu J, Wu Z, Adams R, Han J, Cai B. Sex differences in the relationship of hip strength and functional performance to chronic ankle instability scores. J Orthop Surg Res 2022; 17:173. [PMID: 35313904 PMCID: PMC8935730 DOI: 10.1186/s13018-022-03061-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/09/2022] [Indexed: 12/26/2022] Open
Abstract
Background While decreased hip abductor strength, functional performance, and self-reported instability scores have all been shown in association with CAI, any sex difference in the relationship between these indicators is unclear. This study was to determine whether sex differences are present in the relationship between these indicators in individuals with CAI. Methods Thirty-two women and twenty-nine men with unilateral CAI took part. Hip abductor strength and functional performance were respectively assessed using a hand-held dynamometer and the figure-8-hop test. All 61 participants scored the Cumberland Ankle Instability Tool (CAIT) for self-reported ankle instability. Independent sample t-tests and correlation analysis were conducted. Results Normalized hip abductor strength and functional performance measures for females were lower than for males. The self-reported ankle instability CAIT score, where higher values represent less instability, was significantly and positively correlated with both normalized hip abductor strength (p = 0.003) and functional performance (p = 0.001) on the affected side in females, but not in males (p = 0.361 and p = 0.192 respectively). Conclusions Sex differences were observed in that there were significant relationships between normalized hip abductor strength, functional performance, and CAIT scores in female CAI participants, but not males, suggesting that CAI evaluation and rehabilitation strategies should be sex-specific. Highlights In females with CAI, hip abductor strength and functional performance showed significant relationships with self-reported instability scores. Correspondingly, in clinical practice with individuals with CAI, evaluation criteria may be formulated according to these observed sex differences. Sex differences should be factored into the evaluation and treatment of CAI individuals. Hip strength assessment should be employed with CAI individuals. Hip strengthening and functional hopping may be recommended for the rehabilitation of CAI, especially in female patients.
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Affiliation(s)
- Junlan Lu
- Children's Rehabilitation Center, Division of Pediatric Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhigang Wu
- Department of Rehabilitation Medicine, Hainan Western Central Hospital, Danzhou, Hainan, China
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway,Pudong New Area, Shanghai, 201318, China. .,Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT, Australia.
| | - Bin Cai
- Department of Rehabilitation Medicine, Hainan Western Central Hospital, Danzhou, Hainan, China. .,Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
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64
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Farley JB, Keogh JWL, Woods CT, Milne N. Physical fitness profiles of female Australian football players across five competition levels. SCI MED FOOTBALL 2022; 6:105-126. [PMID: 35236230 DOI: 10.1080/24733938.2021.1877335] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine physical fitness profiles of female Australian football players and investigate differences according to competition level. METHODS A testing battery of 28 physical fitness assessments was undertaken with 240 players across five competition levels: elite senior (≥18 years), non-elite senior (≥18 years), high-level junior (<18 years), non-elite junior (14-17 years), and non-elite junior (10-13 years). Physical fitness profiles were examined and competition level differences were investigated using multivariate analyses of variance. RESULTS Significant differences (p<0.001) were observed between competition levels in body composition (η2p=0.225), flexibility (η2p=0.071), muscular strength and endurance (η2p=0.238), balance (η2p=0.093), reaction time (η2p=0.103), and whole-body locomotor performance (η2p=0.200). Elite seniors and high-level juniors were stronger (p<0.001-0.043), faster (p=0.001-0.022), more responsive (p<0.001-0.048), and had better cardiorespiratory fitness (p<0.001) compared to the non-elite groups. Additionally, body composition and muscular strength and endurance differences were common between the senior and non-elite junior groups. CONCLUSIONS This is the first study to comprehensively profile physical characteristics of female Australian footballers across a broader development pathway. These preliminary findings may assist sport practitioners to better understand athlete development, provide insight on talent identification and development programs, and injury management in this population.
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Affiliation(s)
- Jessica B Farley
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of Sunshine Coast, Sunshine Coast, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Carl T Woods
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Nikki Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
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65
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Moreno-Pérez V, Rodas G, Peñaranda-Moraga M, López-Samanes Á, Romero-Rodríguez D, Aagaard P, Del Coso J. Effects of Football Training and Match-Play on Hamstring Muscle Strength and Passive Hip and Ankle Range of Motion during the Competitive Season. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052897. [PMID: 35270589 PMCID: PMC8909953 DOI: 10.3390/ijerph19052897] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Deficits in hamstring muscle strength and in hip range of motion (ROM) have been considered risk factors for hamstring muscle injuries. However, there is a lack of information on how chronic exposure to regular football training affects hamstring muscle strength and hip ROM. The aim of this study was to examine the longitudinal effect of football training and competition during a complete season on hamstring muscle strength and hip ROM in football players. A total of 26 semi-professional football players underwent measurements of isometric hamstring muscle strength and passive hip flexion/extension, and internal/external hip rotation (IR/ER) ROM during the football season (pre-season, mid-season, end-season). Compared to pre-season, hamstring muscle strength increased in the dominant (+11.1%, p = 0.002) and non-dominant (+10.5%, p = 0.014) limbs in the mid-season. Compared to mid-season, hamstring strength decreased in the dominant (−9.3%, p = 0.034) limb at end-season. Compared to the pre-season, hip extension ROM decreased in mid-season in the dominant (−31.7%, p = 0.007) and non-dominant (−44.1%, p = 0.004) limbs, and further decreased at end-season (−49.0%, p = 0.006 and −68.0%, p < 0.001) for the dominant and non-dominant limbs. Interlimb asymmetry for hip IR ROM increased by 57.8% (p < 0.002) from pre-season to mid-season. In summary, while hamstring muscle strength increased during the first half of the football season in football players, a progressive reduction in hip extension ROM was observed throughout the season. The reduced hip extension ROM suggests a reduced mobility of the hip flexors, e.g., iliopsoas, produced by the continuous practice of football. Consequently, hip-specific stretching and conditioning exercises programs should be implemented during the football season.
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Affiliation(s)
- Víctor Moreno-Pérez
- Sports Research Centre, Miguel Hernandez University of Elche, 03202 Elche, Spain;
| | - Gil Rodas
- Medical Department, Futbol Club Barcelona, 08028 Barcelona, Spain;
| | | | - Álvaro López-Samanes
- Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain;
| | | | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Spain
- Correspondence:
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66
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Knox PJ, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Aberrant Lumbopelvic Movements Predict Prospective Functional Decline in Older Adults with Chronic Low Back Pain. Arch Phys Med Rehabil 2022; 103:473-480.e1. [PMID: 34547273 PMCID: PMC8901446 DOI: 10.1016/j.apmr.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate if clinically observable aberrant lumbopelvic movements are associated with physical function at 12-month follow-up in older adults with chronic low back pain (CLBP), both directly and indirectly through baseline physical function. DESIGN Secondary analysis of a yearlong prospective cohort study. SETTING Clinical Research Laboratory. PARTICIPANTS Community-dwelling older adults with CLBP (N=250). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Data from 239 participants were analyzed. Participants were screened at baseline for aberrant lumbopelvic movements during active trunk flexion; total observable aberrant movements were recorded and summed (range 0-4). Latent constructs of physical function were developed from an array of perception-based and performance-based outcome measures at baseline and 12 months, respectively. Structural Equation Modeling was used to assess the direct effect of baseline aberrant movement score on the latent construct of 12-month physical function, and its indirect effect through baseline physical function. RESULTS Aberrant movements were present in most participants (64.7%) and had a significant negative total effect on 12-month physical function (γ= -0.278, P<.001). Aberrant movement score's direct effect and indirect effect, through baseline functioning, were significantly negatively associated with physical function at 12-months, after adjusting for covariates (γ=-0.068, P=.038; γ= -0.210, P<.001, respectively). CONCLUSIONS Aberrant lumbopelvic movements are associated with decreased physical function at 12-month follow-up in older adults with CLBP, independent of baseline physical function and covariates. Future studies should evaluate if screening for aberrant movements may inform prognostic and interventional efforts in this patient population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE.,Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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67
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Nielsen MF, Thorborg K, Krommes K, Thornton KB, Hölmich P, Penalver JJ, Ishøi L. Hip adduction strength and provoked groin pain: A comparison of long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test. Phys Ther Sport 2022; 55:28-36. [DOI: 10.1016/j.ptsp.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/25/2022]
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68
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Mentiplay BF, Kemp JL, Crossley KM, Scholes MJ, Coburn SL, Jones DM, de Oliveira Silva D, Johnston RTR, Pazzinatto MF, King MG. Relationship between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome. Clin Biomech (Bristol, Avon) 2022; 92:105587. [PMID: 35123104 DOI: 10.1016/j.clinbiomech.2022.105587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hip muscle weakness and altered hip biomechanics during walking are often observed in people with femoroacetabular impingement syndrome, although little is known about biomechanics during higher impact tasks. The aim of our study was to explore relationships between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome, including exploring sex as an effect-modifier of this relationship. METHODS Forty-two adults with unilateral femoroacetabular impingement syndrome (20 females; age 18-50 years; alpha angle ≥60°) completed assessments of hip muscle strength and hip biomechanics during running. Strength was assessed using a hand-held dynamometer for the hip flexors, extensors, abductors, adductors, internal rotators, and external rotators. Hip biomechanics were assessed during overground running (3-3.5 m/s) using three-dimensional motion capture and a force plate. Linear models assessed the relationships between hip strength and hip biomechanics of the symptomatic limb, controlling for body mass and running velocity along with an interaction term (strength*sex). FINDINGS A significant negative relationship was observed between hip external rotator strength and hip frontal plane range of motion (i.e., excursion), independent of sex (estimate = -0.039, 95%CI -0.071 to -0.008, P = 0.02). Four sex-specific interactions were observed, with a significant positive relationship between hip external rotator strength and peak hip extension moment in women (estimate = -0.413, 95%CI -0.713 to -0.114, P = 0.01) but not in men. INTERPRETATION We found significant relationships between hip external rotator strength and stance phase running biomechanics, providing further understanding on two impaired physical measures that may inform exercise-based management strategies in femoroacetabular impingement syndrome.
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Affiliation(s)
- Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Mark J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Sally L Coburn
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Denise M Jones
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Danilo de Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Richard T R Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Marcella F Pazzinatto
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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69
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Mendonça LDM, Bittencourt NFN, Freire RL, Campos VC, Ferreira TV, Silva PL. Hip external rotation isometric torque for soccer, basketball, and volleyball athletes: normative data and asymmetry index. Braz J Phys Ther 2022; 26:100391. [PMID: 35121388 DOI: 10.1016/j.bjpt.2022.100391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/29/2021] [Accepted: 01/05/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Deficits in strength of the hip external rotators (ER) affect trunk, hip, and knee movement patterns, potentially contributing to injury in athletes. OBJECTIVES To provide normative data on isometric torque for hip ER in athletes of three distinct sports and to determine if isometric torque for the hip ER and torque asymmetry between legs differ among sports and between sexes. METHODS Basketball, soccer, and volleyball athletes (n=451) were evaluated. Hip ER torque was quantified bilaterally with athletes in prone and 90° of knee flexion using a hand-held dynamometer. RESULTS Data are expressed as mean and 95% confidence interval. Hip ER torque values in Nm/kg for the dominant and non-dominant limbs were, respectively, 0.46 (0.44, 0.48) and 0.42 (0.40, 0.44) for male soccer athletes; 0.35 (0.32, 0.37) and 0.27 (0.25, 0.29) for male basketball athletes; and 0.37 (0.34, 0.39) and 0.35 (0.32, 0.37) for male volleyball athletes. Hip ER torque in Nm/kg for the female volleyball athletes was 0.29 (0.26, 0.33) for the dominant and 0.29 (0.25, 0.32) for the non-dominant limb. The Limb Symmetry Index for male soccer, basketball, and volleyball players was, respectively, 94% (91, 97), 81% (75, 87), and 95% (91, 99). For female volleyball players the Limb Asymmetry Index was 102% (95, 108). Male volleyball athletes showed higher torque values than female volleyball athletes. CONCLUSIONS This study reported normative values for hip ER isometric torque of youth athletes. Clinicians can use the reported data as reference to identify torque deficits in athletes of the three reported sports.
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Affiliation(s)
- Luciana De Michelis Mendonça
- Physical Therapy Department, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Diamantina, MG, Brazil; Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | | | - Roberta Lima Freire
- Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Thiago Vinícius Ferreira
- Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Paula Lanna Silva
- Department of Psychology, Center for the Ecological Study of Perception and Action, University of Connecticut, Storrs, Connecticut, United States
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Sánchez-Migallón V, López-Samanes Á, Del Coso J, Navandar A, Aagaard P, Moreno-Pérez V. Effects of consecutive days of matchplay on maximal hip abductor and adductor strength in female field hockey players. BMC Sports Sci Med Rehabil 2022; 14:3. [PMID: 34980243 PMCID: PMC8725242 DOI: 10.1186/s13102-021-00394-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 12/04/2022] Open
Abstract
Background The purpose of this study was to examine the effects of two competitive field hockey matches, played on consecutive days, on maximal isometric hip adductor and abductor strength, wellness and fatigue.
Methods Fourteen professional female field hockey players (age: 20.4 ± 5.4 years; body mass: 60.7 ± 7.2 kg; height: 167.0 ± 1.0 cm) volunteered to participate in this investigation. Maximal isometric hip adductor and abductor strength were obtained before (pre-match 1) and after the first match (post-match 1), after the second match (post-match 2), and 48 h after the second match. Locomotion patterns during the matches were obtained with portable Global Positioning System (GPS) and perceived exertion (RPE) was assessed after each match. In addition, Wellness Questionnaire (5-WQ) and the Total Quality Recovery Scale (TQR) were employed before the matches and 48 h after the second match. Results For the non-dominant limb, the maximal isometric hip adductor and abductor strength were lower after post-match 2 when compared to pre-match 1 (p = 0.011). Hip abductor strength in the non-dominant limb remained reduced 48 h after post-match 2 (p < 0.001). There were no differences in the total distance covered when comparing match 1 and match 2. Players reported more acute fatigue (5-WQ, p = 0.009) and increased muscle soreness on pre-match 2 compared to pre-match 1 (p = 0.015), while fatigue returned to pre-competition levels 48 h after post-match 2 (p = 0.027). No changes were observed in the TQR. Conclusion The assessment of maximal adductor and abductor strength before and after competitive matches, in addition to evaluating self-perceived fatigue by a wellness questionnaire can help to identify field hockey players with excessive fatigue responses during tournaments with a congested match program.
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Affiliation(s)
- Violeta Sánchez-Migallón
- Exercise Physiology Group, School of Physiotherapy, School of Health Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain
| | - Álvaro López-Samanes
- Exercise Physiology Group, School of Physiotherapy, School of Health Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223, Madrid, Spain.
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Archit Navandar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Per Aagaard
- Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Víctor Moreno-Pérez
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Universidad Miguel Hernández, Elche, San Juan, Spain
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71
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Gencer B, Doğan Ö, Çalışkan E, İğdir V, Biçimoğlu A. Single versus double plating for bicondylar tibia plateau fractures: Comparison of range of motion, muscle strength, clinical outcomes and accelerometer-measured physical activity levels. Knee 2022; 34:187-194. [PMID: 34959135 DOI: 10.1016/j.knee.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 10/30/2021] [Accepted: 12/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Optimal treatment of bicondylar plateau fractures is still a matter of debate. Accelerometer-measured physical activity levels may help us to obtain objective information regarding the quality of life of patients. The aim of this study was to compare the physical activity levels, objective and subjective functional results and stabilities of fixations of patients with treated bicondylar plateau fractures. METHODS In this cross-sectional study of 23 patients, accelerometer-measured physical activity levels, daily energy consumption and measurements of knee joint range of motion (ROM) and muscle strength were measured. While Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as a patient-reported outcome measurement, Rasmussen Radiological Score was used for radiological evaluation. RESULTS There was no significant difference between the groups in terms of physical activity levels and daily energy consumption (P = 0.667). While Total KOOS, Symptom and Stiffness and Sports Activities scores were higher in patients with a single plate (P = 0.034, P = 0.003 and P = 0.014, respectively), knee flexion and extension ROM and flexor and extensor muscle strength were similar between groups (P = 0.405, P = 0.095, P = 0.982 and P = 0.988, respectively). CONCLUSIONS While patient-reported outcome measurements were better with single plating, there was no difference between the groups in terms of physical activity levels, ROM, muscle strength and radiological results. Although it should be kept in mind that the choice of the primary surgeon, the condition of the soft tissue and the fracture geometry are also effective in the decision-making process, single plating seems to be a valid surgical option in the treatment of bicondylar plateau fractures.
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Affiliation(s)
- Batuhan Gencer
- Ankara City Hospital, Orthopaedics and Traumatology Clinic, Ankara, Turkey.
| | - Özgür Doğan
- Ankara City Hospital, Orthopaedics and Traumatology Clinic, Ankara, Turkey
| | - Emrah Çalışkan
- Koç University Medical Faculty, Orthopaedics and Traumatology Department, İstanbul, Turkey
| | - Volkan İğdir
- Ankara City Hospital, Orthopaedics and Traumatology Clinic, Ankara, Turkey
| | - Ali Biçimoğlu
- Ankara City Hospital, Orthopaedics and Traumatology Clinic, Ankara, Turkey
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van Melick N, Pronk Y, Nijhuis-van der Sanden M, Rutten S, van Tienen T, Hoogeboom T. Meeting movement quantity or quality return to sport criteria is associated with reduced second ACL injury rate. J Orthop Res 2022; 40:117-128. [PMID: 33650704 DOI: 10.1002/jor.25017] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/09/2021] [Accepted: 02/21/2021] [Indexed: 02/04/2023]
Abstract
The purposes of this prospective cohort study were (1) to assess if second anterior cruciate ligament (ACL) injury rate 2 years after ACL reconstruction (ACLR) in those who returned to pivoting sport was associated with meeting (a) quantitative return to sport (RTS) criteria, (b) qualitative RTS criteria, and (c) combined quantitative and qualitative RTS criteria, and (2) to determine why athletes did not return to their preinjury (level of) sport. Athletes after ACLR performed RTS tests immediately before RTS: seven movement quantity (strength and hop test battery) and two movement quality (countermovement jump with LESS score and hop-and-hold test) tests. A 2-year postoperative questionnaire asked for RTS, reasons for not returning to the same (level of) sport and second ACL injuries. One hundred and forty-four athletes (82%) completed the questionnaire and 97 of them returned to a pivoting sport. Seven of these athletes had a second ACL injury. Meeting the hop test battery RTS criterion (absolute risk reduction 11%; p = .047) and hop-and-hold test RTS criterion (absolute risk reduction 15%; p = .031) were both significantly associated with a reduced second ACL injury rate. Meeting combined RTS criteria were not significantly associated with second ACL injury rate. Therefore, RTS tests after ACLR should at least comprise a hop test battery or the hop-and-hold test to reduce second ACL injury risk after return to pivoting sport. Also, one-third of all athletes mentioned fear of reinjury as the main reason for not returning to their preinjury (level of) sport. This psychological component should be taken seriously and discussed during rehabilitation.
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Affiliation(s)
- Nicky van Melick
- Research Department, Kliniek ViaSana, Mill, The Netherlands.,KneeSearch, Heesch, The Netherlands
| | - Yvette Pronk
- Research Department, Kliniek ViaSana, Mill, The Netherlands
| | - Maria Nijhuis-van der Sanden
- Research Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sebastiaan Rutten
- Department of Orthopedic Surgery, Kliniek ViaSana, Mill, The Netherlands
| | - Tony van Tienen
- Department of Orthopedic Surgery, Laurentius Hospital, Roermond, The Netherlands
| | - Thomas Hoogeboom
- Research Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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Comparing Functional Motor Control Exercises With Therapeutic Exercise in Wrestlers With Iliotibial Band Syndrome. J Sport Rehabil 2022; 31:1006-1015. [DOI: 10.1123/jsr.2020-0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
Context: Iliotibial band syndrome (ITBS) is a common overuse injury in runners with parallels to our findings of overuse in Greco Roman wrestlers. Despite research indicating coordination and movement-based factors about the hip, no studies were found using functional motor control (FMC) in runners or wrestlers with ITBS. Thus, we compared FMC exercises and therapeutic exercises (TEs) on pain, function, muscle strength, and range of motion (ROM) in national-level Greco Roman wrestlers with ITBS. Design: Controlled laboratory study. Methods: Sixty national-level Greco Roman wrestlers diagnosed with ITBS were randomly assigned to 8 weeks of FMC exercises, TE, and a control group (20 individuals for each group). Pain (visual analog scale), function (triple hop test for distance, single-leg vertical jump test, and agility T test), muscle strength (handheld dynamometer), and ROM (goniometer) were measured at baseline and 8 weeks after intervention as posttest. Results: Although both interventions significantly reduced pain (P < .001, η2 = .87), improved function (triple hop test P = .004, η2 = .94; single-leg vertical jump P = .002, η2 = .93; and T test P < .001, η2 = .93) and strength (hip abduction (P < .001, η2 = .52), hip external rotation (P = .02, η2 = .95), knee flexion (P ≤ .001, η2 = .94), and knee extension (P < .001, η2 = .91) compared with the control group, FMC showed more significant improvements in comparison with TE. Significant differences (P = .001) were observed between FMC and TE compared with the control group in ROM outcome. However, TE was more effective than FMC in improving ROM hip abduction (P < .001, η2 = .93), hip adduction (P = .000, η2 = .92), hip internal rotation (P < .001, η2 = .92), and hip external rotation (P < .001, η2 = .93). Conclusion: FMC exercises were superior to TE in terms of pain, function, and muscle strength, whereas TE was more effective for improving ROM. FMC exercise is suggested as an effective intervention for improvement of the outcomes related to ITBS in national-level Greco Roman wrestlers.
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74
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First-time anterior cruciate ligament injury in adolescent female elite athletes: a prospective cohort study to identify modifiable risk factors. Knee Surg Sports Traumatol Arthrosc 2022; 30:1341-1351. [PMID: 33961066 PMCID: PMC9007777 DOI: 10.1007/s00167-021-06595-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/26/2021] [Indexed: 12/04/2022]
Abstract
PURPOSE To identify modifiable biomechanical and neuromuscular anterior cruciate ligament (ACL) injury risk factors for first-time ACL injury in adolescent female elite football and team handball players. METHODS Adolescent female elite football and handball players with no previous ACL injury participated in the present study. At baseline, players were tested during side-cutting manoeuvres performed in a 3-dimensional motion analysis laboratory with concomitant electromyography (EMG) measurements. Maximal isometric lower limb muscle strength was assessed by handheld dynamometry. Players were prospectively followed for 2 years after baseline testing, and all magnetic resonance imaging (MRI) verified ACL injuries were registered. The effect of 16 risk factor candidates on the relative risk (RR) of ACL injury was estimated using Poisson regression analysis. RESULTS Ninety players (age 16.9 ± 1.2 years) were included in the analyses. Nine first-time ACL injuries (injury incidence 10.0% (95% confidence interval (CI) 5.4-18.6%)) were registered during the 2-year follow-up period. Four risk factor candidates were significantly associated with the risk of ACL injury: (1) hip flexion angle at initial contact (IC) [RR 0.56, 95% confidence interval (CI) 0.34-0.92], (2) internal knee rotation angle at IC [RR 1.13, 95% CI 1.08-1.19], (3) semitendinosus EMG activity 50 ms prior to IC [RR: 0.62, 95% CI 0.43-0.89], and (4) external hip rotator strength [RR: 0.77, 95% CI 0.66-0.89]. CONCLUSION Four distinct ACL injury risk factors related to the side-cutting manoeuvre were identified in a population of adolescent female elite football and team handball players with no previous ACL injury. As ACL injury typically occur during side-cutting, intervention programmes to modify these risk factors pose a promising strategy for ACL injury prevention in adolescent female elite football and team handball. LEVEL OF EVIDENCE II.
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75
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Schoffl J, Dooley K, Miller P, Miller J, Snodgrass SJ. Factors Associated with Hip and Groin Pain in Elite Youth Football Players: A Cohort Study. SPORTS MEDICINE - OPEN 2021; 7:97. [PMID: 34923614 PMCID: PMC8685189 DOI: 10.1186/s40798-021-00392-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite hip and groin pain being commonly reported in elite youth football players, little evidence on risk factors exists. Risk factors in adult football players include reduced hip adductor strength and hip adductor/abductor strength ratios, and lower Copenhagen Hip and Groin Outcome Score (HAGOS) subscale scores. It is unknown if these factors are also predictive of pain development in youth football players. OBJECTIVE To identify whether preseason hip adductor and abductor strength and HAGOS subscale scores of male and female elite youth football players are associated with in-season or historical (lifetime) hip and groin pain. METHODS Preseason hip adductor and abductor strength testing and the HAGOS were undertaken by 105 elite male (n = 58) and female (n = 47) football players aged 11-15 years. Medical staff documented both players' self-reported historical and in-season hip and groin pain. Univariate and multivariate logistic regression models were undertaken with main outcome measures in-season hip and groin pain and historical hip and groin pain and independent variables of hip muscle strength, hip muscle torque and HAGOS subscale scores. RESULTS Twenty-three players (21.9%) self-reported in-season hip and groin pain, while 19 players (18.1%) self-reported historical hip and groin pain. Pre-season hip adductor and abductor variables and HAGOS subscale scores failed to predict in-season hip and groin pain. However, a higher body mass index (odds ratio [OR] = 1.32; 95% CI 1.01, 1.73, p = .043) and being male (OR 5.71; 95% CI 1.65, 19.7) were associated with having in-season hip and groin pain (R2 = 0.211). There was also an association between historical hip and groin pain (R2 = 0.579) and both HAGOS subscale Quality of Life (odds ratio [OR] = 0.84; 95% CI 0.77, 0.91, p < .001) and mean abductor torque (OR = 11.85; 95% CI 1.52, 91.97; p = .018). CONCLUSION Pre-season hip adductor and abductor strength and HAGOS subscale scores did not predict subsequent in-season hip and groin pain in elite youth football players. However, pre-season higher hip abductor strength and lower HAGOS scores were retrospectively associated with historical hip and groin pain.
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Affiliation(s)
- Jacob Schoffl
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Katherine Dooley
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Leeds Parade, Orange, NSW, 2800, Australia
| | - Peter Miller
- NUmoves Physiotherapy, Ring Road, Callaghan, NSW, 2308, Australia
| | - Jess Miller
- NUmoves Physiotherapy, Ring Road, Callaghan, NSW, 2308, Australia
| | - Suzanne J Snodgrass
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
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76
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Balius R, Pujol M, Pérez-Cuenca D, Morros C, Susín A, Corominas H, Sala-Blanch X. Sciatic nerve movement in the deep gluteal space during hip rotations maneuvers. Clin Anat 2021; 35:482-491. [PMID: 34913517 DOI: 10.1002/ca.23828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/15/2021] [Accepted: 12/10/2021] [Indexed: 11/08/2022]
Abstract
We hypothesize that the sciatic nerve in the subgluteal space has a specific behavior during internal and external coxofemoral rotation and during isometric contraction of the internal and external rotator muscles of the hip. In 58 healthy volunteers, sciatic nerve behavior was studied by ultrasound during passive internal and external hip rotation movements and during isometric contraction of internal and external rotators. Using MATLAB software, changes in nerve curvature at the beginning and end of each exercise were evaluated for longitudinal catches and axial movement for transverse catches. In the long axis, it was observed that during the passive internal rotation and during the isometric contraction of external rotators, the shape of the curve increased significantly while during the passive external rotation and the isometric contraction of the internal rotators the curvature flattened out. During passive movements in internal rotation, on the short axis, the nerve tended to move laterally and forward, while during external rotation the tendency of the nerve was to move toward a medial and backward position. During the isometric exercises, this displacement was less in the passive movements. Passive movements of hip rotation and isometric contraction of the muscles affect the sciatic nerve in the subgluteal space. Retrotrochanteric pain may be related to both the shear effect of the subgluteus muscles and the endoneural and mechanosensitive aggression to which the sciatic nerve is subjected.
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Affiliation(s)
- Ramon Balius
- Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain.,Sports Medicine Department, Clínica Diagonal, Barcelona, Spain
| | - Montse Pujol
- Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain.,Facultad de Fisioteràpia, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Spain
| | - Dolores Pérez-Cuenca
- Anesthesiology, Reanimation and Pain Therapy, Clínica Diagonal, Barcelona, Spain
| | - Carles Morros
- Anesthesiology, Reanimation and Pain Therapy, Clínica Diagonal, Barcelona, Spain.,Anatomy and Embryology Unit, Faculty of Medicine, Universitat of Barcelona, Barcelona, Spain
| | - Antonio Susín
- Math Department, UPC-BarcelonaTech, Barcelona, Spain
| | - Hèctor Corominas
- Rheumatology Department, Hospital of the Holy Cross and Saint Paul, Barcelona, Spain
| | - Xavier Sala-Blanch
- Anatomy and Embryology Unit, Faculty of Medicine, Universitat of Barcelona, Barcelona, Spain.,Department of Anesthesiology, Hospital Clínic, Barcelona, Spain
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Julie Sandell J, Stig Storgaard J, Kjeld S, Per H, Kristian T, Zhong M, Zhu W. Correspondence: Isometric hip strength impairments in patients with hip dysplasia are improved but not normalized 1 year after periacetabular osteotomy: a cohort study of 82 patients. Acta Orthop 2021; 92:760-762. [PMID: 34607507 PMCID: PMC8635595 DOI: 10.1080/17453674.2021.1982480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Jacobsen Julie Sandell
- Research Centre for Health and Welfare Technology,
Programme for Rehabilitation, VIA University College, Aarhus,Research Unit for General Practice in Aarhus, Aarhus
| | | | - Søballe Kjeld
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus.,Department of Clinical Medicine, Aarhus University, Aarhus
| | - Hölmich Per
- Sports Orthopaedic Research Center-Copenhagen (SORCC), Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre
| | - Thorborg Kristian
- Sports Orthopaedic Research Center-Copenhagen (SORCC), Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark
| | - Mingjin Zhong
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China,
| | - Weimin Zhu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China,
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Diniz KMA, Resende RA, Mascarenhas RDO, Silva HDJ, Filho RGT, Mendonça LDM. Hip passive stiffness is associated with hip kinematics during single-leg squat. J Bodyw Mov Ther 2021; 28:68-74. [PMID: 34776202 DOI: 10.1016/j.jbmt.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/16/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Single-leg squat (SLS) is a test commonly used to assess lower limb function in rehabilitation. Increased hip adduction and internal rotation (IR) is associated with dynamic knee valgus, which is related to hip and knee overload. Proximal and distal factors, such as hip passive stiffness, poor hip muscle strength and excessive foot misalignment may influence hip movement. However, previous studies focus on how proximal and distal factors affected knee joint movement and did not reported the influence on hip joint. OBJECTIVE This study investigated the association of hip external rotators (ER) strength, hip passive stiffness and shank-forefoot alignment (SFA) with hip adduction and IR during SLS. DESIGN Cross-sectional study. METHOD Forty-six health participants of both sexes (23.47 ± 4.29 years, 60.40 ± 11.28 kg, 1.67 ± 8.9 m) had SFA, hip ER torque, hip passive stiffness and hip kinematics assessed. Multiple linear regressions were performed to identify the factors which associated with mean and peak hip adduction and IR movement during SLS. RESULTS Only hip passive stiffness was associated with mean (R2 = 0.164; Confidence Interval (CI) 95% = [-0.250, -0.048]; p = 0.005) and peak (R2 = 0.116; CI 95% = [-0.223, -0.210]; p = 0.019) hip IR movement. CONCLUSION Hip passive stiffness was associated with mean and peak hip IR movement during the SLS. These results suggest that individuals with reduced hip passive stiffness may demonstrate increased hip IR movement during SLS.
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Affiliation(s)
- Karen Marina Alves Diniz
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab) of Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil; Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil
| | - Renan Alves Resende
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab) of Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil; Department of Physical Therapy, Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rodrigo de Oliveira Mascarenhas
- Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil
| | - Hytalo de Jesus Silva
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab) of Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil; Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil
| | - Renato Guilherme Trede Filho
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab) of Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil; Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil
| | - Luciana De Michelis Mendonça
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab) of Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil; Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Rodovia MGT 367 - Km 583, n° 5000 Alto da Jacuba, CEP 39100-000, Diamantina, Minas Gerais, Brazil.
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Influence of Football Match-Play on Isometric Knee Flexion Strength and Passive Hip Flexion Range of Motion in Football Referees and Assistant Referees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211941. [PMID: 34831696 PMCID: PMC8625078 DOI: 10.3390/ijerph182211941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/24/2021] [Accepted: 11/10/2021] [Indexed: 12/04/2022]
Abstract
The aim of this study was to examine the acute effect of officiating a football (soccer) match on isometric knee flexion strength and passive hip flexion range-of-motion (ROM) in referees and assistant football referees. Twelve referees (25.3 ± 3.3 years) and twenty-three assistant referees (25.1 ± 4.8 years) underwent measurements on isometric knee flexion strength and passive hip flexion ROM before and after officiating an official football match. Referees’ and assistant referees’ running patterns were monitored during the match using GPS technology. In comparison to pre-match values, referees reduced their isometric knee flexion strength (−12.36%, p = 0.046, Effect size [ES] = −0.36) in the non-dominant limb, while no significant differences were reported in the dominant limb (−0.75%, p = 0.833, ES = −0.02). No effect of the match was found in hip flexion ROM values in dominant (−4.78%, p = 0.102, ES = −0.15) and non-dominant limb (5.54%, p = 0.544, ES = 0.19). In assistant referees, the pre-to-post-match changes in isometric knee flexion strength (dominant limb −3.10%, p = 0.323, ES = −0.13; non-dominant limb −2.18%, p = 0.980, ES= 0.00) and hip flexion ROM (dominant limb 1.90% p = −0.816, ES = 0.13; non-dominant limb 3.22% p = 0.051, ES = 0.23) did not reach statistical significance. Officiating a match provoked a reduction in isometric knee flexion strength in the non-dominant limb of football referees, while no differences were reported in assistant referees.
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80
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Randelli F, Fioruzzi A, Magnani M, Mazzoleni M, Elhiny M, Via AG, Ayeni OR, Di Benedetto P. Endoscopic gluteus maximus tendon release for external snapping hip syndrome: a functional assessment. J Orthop Traumatol 2021; 22:45. [PMID: 34757530 PMCID: PMC8581119 DOI: 10.1186/s10195-021-00610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/31/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose The aim of this retrospective study was to investigate the clinical follow-up of patients with external snapping hip syndrome (ESHS) treated with endoscopic gluteus maximus tendon release and to compare the residual muscular strength and thigh circumference as an indirect outcome measure. Methods Patients of all ages with external snapping hip syndrome were treated with endoscopic gluteus maximus tendon release. Outcome measures evaluated included: visual analog scale (VAS), modified Harris Hip Score (mHHS), and Non-Arthritic Hip Score (NAHS). The gluteus maximus strength and the circumference of the thigh were also evaluated. Results Among 25 patients, 23 fulfilled the inclusion criteria and one patient was lost to follow-up. The series included 22 patients, 6 males and 16 females with a mean age of 27.9 ± 13.4 years (range 16–76 years). All patients had resolution of the snapping symptoms after the procedure. The mean follow-up was 18 ± 9.3 months. All outcomes improved in a statistically significant manner: VAS value decreased from 6.8 (range 6–8) to 0.6 (range 0–4) (p < 0.001), mHHS increased from 48.6 (range 17.6–67) to 88.2 (range 67–94.6) (p < 0.001), NAHS increased from 49.0 (range 21.5–66) to 90.8 (range 66–98.75) (p < 0.001). A statistically significant reduction of operated limb thigh circumference compared to the contralateral side (3.7%) was also found, while there were no statistical differences regarding the strength of gluteus maximus muscles. Conclusions Endoscopic gluteus maximus tendon release is an excellent surgical option to treat snapping hip syndrome. The evaluated muscle strength revealed no functional impairment. The significance of the limb circumference reduction has yet to be determined. Level of evidence IV: retrospective comparative trial.
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Affiliation(s)
- Filippo Randelli
- Hip Department (CAD), Gaetano Pini-CTO Orthopaedic Institute, University of Milan, Piazza Cardinale Andrea Ferrari 1, 20122, Milan, Italy
| | - Alberto Fioruzzi
- Hip Department (CAD), Gaetano Pini-CTO Orthopaedic Institute, University of Milan, Piazza Cardinale Andrea Ferrari 1, 20122, Milan, Italy.
| | - Mauro Magnani
- Hip Department (CAD), Gaetano Pini-CTO Orthopaedic Institute, University of Milan, Piazza Cardinale Andrea Ferrari 1, 20122, Milan, Italy
| | - Manuel Mazzoleni
- Department of Life Health & Environmental Sciences, Unit of Orthopaedics and Traumatology, University of L'Aquila, L'Aquila, Italy
| | - Mohammad Elhiny
- Department of Orthopaedic Surgery and Traumatology, Minya University Hospital, Minya, Egypt
| | - Alessio Giai Via
- Department of Orthopaedic Surgery and Traumatology, San Camillo-Forlanini Hospital, Rome, Italy
| | - Olufemi R Ayeni
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Canada
| | - Paolo Di Benedetto
- Division of Orthopaedic Surgery, DAME University of Udine, ASUFC, Udine, Italy
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81
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Pugliese JM, Coyle PC, Knox PJ, Sions JM, Patterson CG, Pohlig RT, Simon CB, Weiner DK, George SZ, Piva S, Hicks GE. The Manual Therapy and Strengthening for the Hip (MASH) Trial: Protocol for a Multisite Randomized Trial of a Subgroup of Older Adults With Chronic Back and Hip Pain. Phys Ther 2021; 102:6420898. [PMID: 34751784 PMCID: PMC8831280 DOI: 10.1093/ptj/pzab255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/14/2021] [Accepted: 10/11/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic low back pain (CLBP) is a disabling and costly condition for older adults that is difficult to properly classify and treat. In a cohort study, a subgroup of older adults with CLBP who had elevated hip pain and hip muscle weakness was identified; this subgroup differentiated itself by being at higher risk for future mobility decline. The primary purpose of this clinical trial is to evaluate whether a hip-focused low back pain (LBP) treatment provides better disability and physical performance outcomes for this at-risk group compared with a spine-focused LBP treatment. METHODS This study is a multisite, single-blinded, randomized controlled, parallel arm, Phase II trial conducted across 3 clinical research sites. A total of 180 people aged between 60 and 85 years with CLBP and hip pain are being recruited. Participants undergo a comprehensive baseline assessment and are randomized into 1 of 2 intervention arms: hip-focused or spine-focused. They are treated twice weekly by a licensed physical therapist for 8 weeks and undergo follow-up assessments at 8 weeks and 6 months after randomization. Primary outcome measures include the Quebec Low Back Disability Scale and the 10-Meter Walk Test, which are measures of self-report and performance-based physical function, respectively. IMPACT This multicenter, randomized clinical trial will determine whether a hip-focused or spine-focused physical therapist intervention results in improved disability and physical performance for a subgroup of older adults with CLBP and hip pain who are at increased risk of mobility decline. This trial will help further the development of effective interventions for this subgroup of older adults with CLBP.
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Affiliation(s)
- Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Patrick J Knox
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - J Megan Sions
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Charity G Patterson
- Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, Delaware, USA
| | - Corey B Simon
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Debra K Weiner
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Steven Z George
- Department of Orthopedic Surgery, Duke School of Medicine, Durham, North Carolina, USA
| | - Sara Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Mizuno F, Koganemaru S, Irisawa H, Saito A, Mizushima T. Knee Valgus during Jump Landing Is Related to the Inaccuracy of Knee Position Recognition in Healthy Young Women. Prog Rehabil Med 2021; 6:20210041. [PMID: 34722947 PMCID: PMC8530781 DOI: 10.2490/prm.20210041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/29/2021] [Indexed: 11/19/2022] Open
Abstract
Objective: Knee valgus during jump landing is a cause of knee injuries during sports activities. Body recognition is important for maintaining the knees and other body parts in their proper positions. The aim of this study was to investigate whether knee valgus during jump landing in healthy young women is related to the inaccuracy of recognition of bilateral knee positions in the squatting position. Methods: In 39 healthy young women, the degree of knee valgus was evaluated during the drop vertical jump test using the ratio of the knee separation distance to the ankle separation distance. The accuracy of recognition of bilateral knee positions in the squatting position was evaluated by having the blindfolded subjects indicate with their index fingers the subjective positions of their bilateral patellae by placing their fingers on a horizontal bar positioned in front of them 3 cm below the navel. The difference ratio of the recognized distance to the actual distance between the bilateral patellae was measured as an inaccuracy index. Results: The degree of knee valgus during the drop vertical jump test was positively correlated with the degree of inaccuracy of the recognized knee position with the knees in the neutral position (r=0.358, P=0.025). Conclusions: In healthy young women, knee valgus during jump landing was significantly correlated with the inaccuracy in knee position recognition in the squatting posture. This finding suggests that the assessment of knee position recognition in the squatting position could be useful as a screening tool for preventing knee injuries on jump landing during sports activities.
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Affiliation(s)
- Fumiya Mizuno
- Division of Rehabilitation Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Satoko Koganemaru
- Department of Regenerative Systems Neuroscience, Human Brain Research Center, Kyoto University, Graduate school of Medicine, Kyoto, Japan
| | - Hiroshi Irisawa
- Department of Rehabilitation Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Akira Saito
- Department of Physical Therapy, Akita University, Graduate School of Health Sciences, Akita, Japan
| | - Takashi Mizushima
- Department of Rehabilitation Medicine, Dokkyo Medical University, Tochigi, Japan
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83
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Frydendal T, Christensen R, Mechlenburg I, Mikkelsen LR, Overgaard S, Ingwersen KG. Total hip arthroplasty versus progressive resistance training in patients with severe hip osteoarthritis: protocol for a multicentre, parallel-group, randomised controlled superiority trial. BMJ Open 2021; 11:e051392. [PMID: 34686555 PMCID: PMC8543646 DOI: 10.1136/bmjopen-2021-051392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Hip osteoarthritis (OA) is the leading cause for total hip arthroplasty (THA). Although, being considered as the surgery of the century up to 23% of the patients report long-term pain, and deficits in physical function and muscle strength may persist after THA. Progressive resistance training (PRT) appears to improve multiple outcomes moderately in patients with hip OA. Current treatment selection is based on low-level evidence as no randomised controlled trials have compared THA to non-surgical treatment. The primary aim of this trial is to investigate whether THA followed by standard care is superior to 12 weeks of supervised PRT followed by 12 weeks of optional unsupervised PRT for improving hip pain and function in patients with severe hip OA. METHODS AND ANALYSIS This is a protocol for a multicentre, parallel-group, assessor-blinded, randomised controlled superiority trial conducted at four hospitals across three healthcare regions in Denmark. 120 patients aged ≥50 years with clinical and radiographic hip OA found eligible for THA by an orthopaedic surgeon will be randomised to THA followed by standard care, or 12 weeks of PRT (allocation 1:1). The primary outcome will be change in patient-reported hip pain and function, measured using the Oxford Hip Score, from baseline to 6 months after initiating the treatment. Key secondary outcomes will be change in the Hip disability and Osteoarthritis Outcome Score subscales, University of California Los Angeles Activity Score, 40 m fast-paced walk test, 30 s chair stand test and occurrence of serious adverse events. Patients declining participation in the trial will be invited into a prospective observational cohort study. ETHICS AND DISSEMINATION The trial has been approved by The Regional Committees on Health Research Ethics for Southern Denmark (Project-ID: S-20180158). All results will be presented in peer-reviewed scientific journals and international conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04070027).
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Affiliation(s)
- Thomas Frydendal
- Department of Physio- and Occupational Therapy, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, Odense, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lone Ramer Mikkelsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Gordon Ingwersen
- Department of Physio- and Occupational Therapy, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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84
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Pålsson A, Kostogiannis I, Ageberg E. Physical impairments in longstanding hip and groin pain: Cross-sectional comparison of patients with hip-related pain or non-hip-related groin pain and healthy controls. Phys Ther Sport 2021; 52:224-233. [PMID: 34628337 DOI: 10.1016/j.ptsp.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare physical impairments between patients with hip-related pain and those with non-hip-related groin pain, and to compare both patient groups with healthy controls. DESIGN Cross-sectional. PARTICIPANTS Eighty-one hip and groin pain patients were consecutively included and categorized into having hip-related pain or non-hip-related groin pain. Twenty-eight healthy controls were recruited. SETTINGS Tertiary care. MAIN OUTCOME MEASURES All participants performed physical impairment testing including hip ROM, muscle function, and functional tasks. An analysis of covariates was used for analysis between patients groups and controls. RESULTS Patients with hip-related pain showed reduced hip ROM in internal rotation compared to patients with non-hip-related groin pain and controls (p ≤ 0.026, d -0.65; -0.97). No differences in muscle function or performance in functional tasks were observed between patients with hip-related pain and those with non-hip-related groin pain (p ≥ 0.136, d 0.00; 0.68). Both patient groups had worse muscle function and worse performance in functional tasks compared to controls (p ≤ 0.048, d -0.67; -1.83). CONCLUSIONS Both patients with and without hip-related pain had worse muscle function and worse performance in functional tasks compared to matched controls but no differences were observed between the patient groups. Only patients with hip-related pain had reduced ROM in internal rotation.
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Affiliation(s)
- Anders Pålsson
- Department of Health Sciences, Lund University, Lund, Sweden.
| | | | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden.
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85
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Hicks GE, Pohlig RT, Coyle PC, Sions JM, Weiner DK, Pugliese JM, Velasco TO, O’Brien VA. Classification of Geriatric Low Back Pain Based on Hip Characteristics With a 12-Month Longitudinal Exploration of Clinical Outcomes: Findings From Delaware Spine Studies. Phys Ther 2021; 101:6374826. [PMID: 34636887 PMCID: PMC8801002 DOI: 10.1093/ptj/pzab227] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/03/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study is to identify geriatric chronic low back pain (LBP) subgroups based on the presence of potentially modifiable hip impairments, using Latent Variable Mixture Modeling (LVMM), and to examine the prospective relationship between these subgroups and key outcomes over time. METHODS Baseline, 3-month, 6-month, and 12-month data were collected from a prospective cohort of 250 community-dwelling older adults with chronic LBP. Comprehensive hip (symptoms, strength, range of motion, and flexibility), LBP (intensity and disability), and mobility function (gait speed and 6-Minute Walk Test) examinations were performed at each timepoint. Baseline hip measures were included in LVMM; observed classes/subgroups were compared longitudinally on LBP and mobility function outcomes using mixed models. RESULTS Regarding LVMM, a model with 3 classes/subgroup fit best. Broadly speaking, subgroups were differentiated best by hip strength and symptom presence: subgroup 1 = strong and nonsymptomatic, subgroup 2 = weak and nonsymptomatic, and subgroup 3 = weak and symptomatic (WS). Regarding longitudinal mixed models, all subgroups improved in most outcomes over time. Specifically, over 12 months, the nonsymptomatic subgroups had lower LBP intensity and disability levels compared with the WS subgroup, whereas the strong and nonsymptomatic subgroup had better mobility function than the 2 "weak" subgroups. CONCLUSION These subgroup classifications may help in tailoring specific interventions in future trials. Special attention should be given to the WS subgroup given their consistently poor LBP and mobility function outcomes. IMPACT Among older adults with chronic low back pain, there are 3 hip subgroups: "strong and nonsymptomatic," "weak and nonsymptomatic," and "weak and symptomatic." People in these subgroups demonstrate different outcomes and require different treatment; proper identification will result in tailored interventions designed to benefit individual patients. In particular, people in the WS subgroup deserve special attention, because their outcomes are consistently poorer than those in the other subgroups.
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Affiliation(s)
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, Delaware, USA,Biostatistics Core, University of Delaware, Newark, Delaware, USA
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - J Megan Sions
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Debra K Weiner
- Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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Coyle PC, Knox PJ, Pohlig RT, Pugliese JM, Sions JM, Hicks GE. Hip Range of Motion and Strength Predict 12-Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies. ACR Open Rheumatol 2021; 3:850-859. [PMID: 34524738 PMCID: PMC8672177 DOI: 10.1002/acr2.11342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The objective of this study was to investigate whether poor hip range of motion (ROM) and strength predict 12‐month physical function decline among older adults with chronic low back pain (LBP) and whether hip osteoarthritis modifies those relationships. Methods At baseline, passive ROM and strength measurements were taken for hip flexion, extension, abduction, adduction, internal rotation, and external rotation; ultrasound images and self‐reported symptoms were used to evaluate hip osteoarthritis presence (eg, osteophytes and hip pain). At baseline and 12 months, performance‐based (repeated chair rise, self‐selected gait speed, 6‐minute walk test [6MWT]) and self‐reported (Quebec LBP Disability Questionnaire, Late‐Life Function & Disability Instrument [LLFDI] basic and advanced lower extremity scales) physical function outcomes were assessed. Regression models were constructed for each outcome predicted by baseline hip ROM and strength measures, with adjustment for potential covariates. To avoid collinearity, hip ROM and strength measures with the strongest unadjusted correlations were included in final models. The hip osteoarthritis presence by hip ROM/strength interaction was also explored. Results Hip abduction strength predicted repeated chair rise (β = −0.297, P < 0.001), gait speed (β = 0.160, P = 0.003), 6MWT (β = 0.159, P ≤ 0.001), Quebec LBP Disability Questionnaire (β = −0.152, P = 0.003), and LLFDI basic lower extremity scale (β = 0.171, P = 0.005) outcomes. Regarding hip ROM, extension predicted repeated chair rise (β = −0.110, P = 0.043) and LLFDI advanced lower extremity scale (β = 0.090, P = 0.007) outcomes, external rotation predicted gait speed (β = 0.122, P = 0.004) outcomes, and abduction predicted LLFDI basic lower extremity scale (β = 0.114, P = 0.026) outcomes. The hip osteoarthritis interaction was not significant for any model. Conclusion Reduced hip strength and ROM predict physical function decline; hip osteoarthritis presence may not modify these relationships.
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87
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Breen D, Farrell G, Delahunt E. The clinical assessment of hip muscle strength in professional rugby union players. Phys Ther Sport 2021; 52:115-120. [PMID: 34481341 DOI: 10.1016/j.ptsp.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Groin/hip injuries are prevalent in rugby union (RU). Assessment of hip muscle strength is important when designing bespoke injury prevention and rehabilitation programmes. OBJECTIVE The primary aim of this study was to determine normative values of hip muscle strength in elite-level RU players. A secondary aim of this study was to compare the Copenhagen Hip and Groin Outcome Score (HAGOS) between players with and without a history of groin/hip injury. DESIGN Cross-sectional cohort study. SETTING Professional RU club. PARTICIPANTS 58 male professional RU players competing in the PRO14 league elite club level competition. MAIN OUTCOME MEASURES Handheld dynamometry eccentric strength values of hip abduction (ABD), adduction (ADD), internal rotation (IR) and external rotation (ER), HAGOS. RESULTS Players' dominant (DOM) and non-dominant (NDOM) hip strength values were, 2.38 and 2.34 N m/kg for ABD, 2.79 and 2.71 N m/kg for ADD, 2.69 and 2.55 N m/kg for IR, and 2.65 and 2.54 N m/kg for ER. ADD:ABD strength ratio was 1.17 ± 0.26 for the DOM limb and 1.16 ± 0.24 for the NDOM limb. There was no clinically significant difference in strength between players' DOM and NDOM limbs. Players with a history of groin/hip injury scored lower on four of the HAGOS subscales (pain; symptoms; sport; quality of life) compared to those without a history of groin/hip injury. CONCLUSIONS This study may help establish normative hip strength and HAGOS values for elite-level RU players. The results presented have important implications for the assessment of hip muscle strength and could provide clinical markers for return-to-play following injury.
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Affiliation(s)
- David Breen
- The Performance Team MCFC Academy, Manchester City FC, CFA Etihad Campus, 400 Ashton New Road, Manchester, England, United Kingdom.
| | - Garreth Farrell
- Medical Department, Leinster Rugby, Newstead Building A, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin 4, Ireland.
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Baida SR, King E, Richter C, Gore S, Franklyn-Miller A, Moran K. Hip Muscle Strength Explains Only 11% of the Improvement in HAGOS With an Intersegmental Approach to Successful Rehabilitation of Athletic Groin Pain. Am J Sports Med 2021; 49:2994-3003. [PMID: 34398640 PMCID: PMC8411474 DOI: 10.1177/03635465211028981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exercise-based rehabilitation targeting intersegmental control has high success rates and fast recovery times in the management of athletic groin pain (AGP). The influence of this approach on hip strength and lower limb reactive strength and how these measures compare with uninjured athletes (CON) remain unknown. Additionally, the efficacy of this program after return to play (RTP) has not been examined. PURPOSE First, to examine differences in isometric hip strength, reactive strength, and the Hip and Groin Outcome Score (HAGOS) between the AGP and CON cohorts and after rehabilitation; second, to examine the relationship between the change in HAGOS and the change in strength variables after rehabilitation; last, to track HAGOS for 6 months after RTP. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS A total of 42 athletes diagnosed with AGP and 36 matched controls completed baseline testing: isometric hip strength, lower limb reactive strength, and HAGOS. After rehabilitation, athletes with AGP were retested, and HAGOS was collected at 3 and 6 months after RTP. RESULTS In total, 36 athletes with AGP completed the program with an RTP time of 9.8 ± 3.0 weeks (mean ± SD). At baseline, these athletes had significantly lower isometric hip strength (abduction, adduction, flexion, extension, external rotation: d = -0.67 to -1.20), single-leg reactive strength (d = -0.73), and HAGOS (r = -0.74 to -0.89) as compared with the CON cohort. Hip strength (d = -0.83 to -1.15) and reactive strength (d = -0.30) improved with rehabilitation and were no longer significantly different between groups at RTP. HAGOS improvements were maintained or improved in athletes with AGP up to 6 months after RTP, although some subscales remained significantly lower than the CON group (r = -0.35 to -0.51). Two linear regression features (hip abduction and external rotation) explained 11% of the variance in the HAGOS Sports and Recreation subscale. CONCLUSION Athletes with AGP demonstrated isometric hip strength and reactive strength deficits that resolved after an intersegmental control rehabilitation program; however, improved hip strength explained only 11% of improvement in the Sports and Recreation subscale. HAGOS improvements after pain-free RTP were maintained at 6 months.
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Affiliation(s)
- Samuel R. Baida
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland,Samuel R. Baida, PT, PhD,
Sports Surgery Clinic, Santry, Dublin 9, Ireland (
) (Twitter: @Sam_Baida)
| | - Enda King
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,Department of Life Sciences, Roehampton
University, London, UK
| | - Chris Richter
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland
| | - Shane Gore
- School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland
| | - Andrew Franklyn-Miller
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,Centre for Health, Exercise and Sports
Medicine, University of Melbourne, Melbourne, Australia
| | - Kieran Moran
- School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland
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89
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Is Hip Muscle Strength Associated with Dynamic Knee Valgus in a Healthy Adult Population? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147669. [PMID: 34300118 PMCID: PMC8304771 DOI: 10.3390/ijerph18147669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 01/11/2023]
Abstract
This study aimed to systematically review research investigating the association between hip muscle strength and dynamic knee valgus (DKV). Four databases (MEDLINE, PubMed, CINAHL, and SPORTDiscus) were searched for journal articles published from inception to October 2020. Seven studies investigating the association between hip muscle strength and DKV using a two-dimensional motion analysis system in healthy adults were included. The relationship between hip abductor muscle strength and DKV was negatively correlated in two studies, positively correlated in two studies, and not correlated in three studies. The DKV was associated with reduced hip extensor muscle strength in two studies and reduced hip external rotator muscle strength in two studies, while no correlation was found in three and five studies for each muscle group, respectively. The relationship between hip muscle strength, including abductors, extensors, and external rotators and DKV is conflicting. Considering the current literature limitations and variable methodological approaches used among studies, the clinical relevance of such findings should be interpreted cautiously. Therefore, future studies are recommended to measure the eccentric strength of hip muscles, resembling muscular movement during landing. Furthermore, high-demand and sufficiently challenging functional tasks revealing lower limb kinematic differences, such as cutting and jumping tasks, are recommended for measuring the DKV.
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90
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Wierks CH, Boersma JB, Pate MJ, Davis AT. Hip Strength Before and After Arthroscopic Femoroacetabular Impingement Surgery. Orthopedics 2021; 44:148-153. [PMID: 34039218 DOI: 10.3928/01477447-20210416-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Femoroacetabular impingement (FAI) and labral pathology are associated with pain, decreased function, and hip strength deficits. Existing data are in conflict regarding when hip strength normalizes following arthroscopic treatment of FAI. The objective of this study was to identify preoperative hip strength relative to the contralateral hip not undergoing surgery as well as when postoperative strength in 4 functional muscle groups normalizes following arthroscopic treatment of FAI. Ninety-eight individuals with radiographic evidence of FAI and labral pathology underwent arthroscopic labral repair. Pre-surgical hip strength testing was performed in the symptomatic "surgical hip" and the contralateral "non-surgical hip." Hip strength measurements were repeated at 8 and 16 weeks postoperatively. Significant preoperative hip strength deficits were noted in the surgical hip compared with the non-surgical hip in flexion, extension, and adduction. At 8 weeks postoperatively, hip strength in the surgical hip improved to being equivalent to that in the non-surgical hip in adduction and extension, remained equivalent to that of the non-surgical hip in abduction, and decreased in flexion relative to the non-surgical hip. At 16 weeks, hip strength remained equivalent in the surgical hip and the non-surgical hip in abduction and adduction, but the surgical hip exceeded the non-surgical hip in extension. While flexion strength improved between 8 and 16 weeks postoperatively for the surgical hip, it had not fully recovered to that of the non-surgical hip. Using a structured postoperative rehabilitation protocol, abduction strength was maintained at 8 weeks postoperatively, while adduction and extension strength had improved to those of the non-surgical hip. At 16 weeks postoperatively, hip abduction and adduction had strength equivalent to those of the non-surgical hip. Despite preoperative improvement, flexion of the surgical hip lagged behind that of the non-surgical hip 16 weeks postoperatively. [Orthopedics. 2021;44(3):148-153.].
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91
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Hedt CA, Pearson JM, Lambert BS, McCulloch PC, Harris JD. Sex-Related Hip Strength Measures Among Professional Soccer Players. J Strength Cond Res 2021; 35:1992-1999. [PMID: 30747903 DOI: 10.1519/jsc.0000000000003003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT Hedt, CA, Pearson, JM, Lambert, BS, McCulloch, PC, and Harris, JD. Sex-related hip strength measures among professional soccer players. J Strength Cond Res 35(7): 1992-1999, 2021-Lower-extremity musculoskeletal injuries in soccer are common among sexes. However, it remains unknown whether differences between sexes exist with regard to absolute or relative hip strength and how these differences may relate to injury. In the current study, we performed a retrospective cross-sectional analysis of pre-season data from male (♂n = 21) and female (♀n = 19) professional United States soccer organizations. Two years of pre-season data were collected for peak strength of lower extremity and hip musculature (no duplicates used). A 2 × 2 multivariate analysis of variance was used to detect differences in hip strength between sexes and dominant compared with nondominant legs. For all significant multivariate effects indicated by Wilks lambda and follow-up univariate analysis, a Tukey's post hoc test was used for pairwise univariate comparisons. A 2-tailed independent-samples T-test was used for comparison of height, body mass, body mass index (BMI), mean leg length, and strength ratios between dominant and nondominant limbs between sexes. Type I error was set at α = 0.05 for all analyses. Height (♂183.1 ± 6.8 cm, ♀170.0 ± 5.5 cm), body mass (♂79.0 ± 8.7 kg, ♀65.1 ± 5.6 kg), BMI (♂23.5 ± 1.3 kg·m-2, ♀22.5 ± 1.4 kg·m-2), and mean leg length (♂95.5 ± 4.34 cm, ♀ 88.3 ± 3.24 cm) differed between groups (p < 0.05). Sex differences (p < 0.05) were also found for hip abduction (dominant ♂19.5 ± 3.6 kg, ♀17.3 ± 2.2 kg; nondominant ♂18.5 ± 3.7 kg, ♀16.0 ± 2.3 kg), adduction (dominant ♂19.8 ± 3.0 kg, ♀16.7 ± 2.3 kg; nondominant ♂20.1 ± 2.9 kg, ♀17.6 ± 2.9 kg), external rotation (dominant ♂21.7 ± 3.4 kg, ♀17.7 ± 2.4 kg; nondominant ♂21.6 ± 3.9 kg, ♀16.8 ± 2.1 kg), and dominant hamstring strength (♂27.9 ± 6.5 kg, ♀23.0 ± 4.9 kg). The ratio of hip internal to external rotation strength differed in the nondominant leg (♂1.1 ± 0.2, ♀0.9 ± 0.2, p < 0.05). No significant differences were found between males and females when measures were normalized to body mass. These findings provide baseline pre-season normative data for professional soccer athletes and indicate that strength differences can be expected among different sexes, but are attenuated with attention to body mass. Further research should indicate how pre-season strength measures relate to injury.
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Affiliation(s)
- Corbin A Hedt
- Department of Orthopedics and Sports Medicine, Houston Methodist, Houston, Texas; and
| | - Jentry M Pearson
- Department of Orthopedics and Sports Medicine, Houston Methodist, Houston, Texas; and
| | - Bradley S Lambert
- Department of Orthopedics and Sports Medicine, Houston Methodist, Houston, Texas; and.,Department of Mechanical Engineering, Texas A&M University, College Station, Texas
| | - Patrick C McCulloch
- Department of Orthopedics and Sports Medicine, Houston Methodist, Houston, Texas; and
| | - Joshua D Harris
- Department of Orthopedics and Sports Medicine, Houston Methodist, Houston, Texas; and
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Kobayashi H, Tajika T, Warita T, Kitagawa T, Takamine S, Fujita H, Kushima N, Hashimoto S, Shitara H, Okamura K, Iizuka Y, Yanagawa T, Sakamoto M, Takagishi, Chikuda H. Cross-sectional Study of the Hip Joint Condition in Young Baseball Players. Prog Rehabil Med 2021; 6:20210027. [PMID: 34239996 PMCID: PMC8236841 DOI: 10.2490/prm.20210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/17/2021] [Indexed: 11/09/2022] Open
Abstract
Objective The hip joint is a crucial part of the kinetic chain for throwing baseball pitches. Nevertheless, few reports have described assessments of the functional development of the hip joint in young baseball players. Methods We examined 315 young baseball players, 7-14 years old, all of whom had completed a self-administered questionnaire including items related to the dominant side and throwing-related hip joint pain sustained during the previous year. We measured the hip ranges of motion (ROMs: external and internal rotation and flexion) and hip muscle strengths (external and internal rotation) on the dominant and non-dominant sides. The differences of hip ROMs and muscle strengths between the dominant and non-dominant sides and between age groups were investigated. Correlations were calculated between the players ages and hip ROMs and muscle strengths. Results No baseball player reported hip pain. The hip external rotation on the dominant side was smaller than that on the non-dominant side, whereas the hip internal rotation on the dominant side was greater than that on the non-dominant side. However, no significant difference was found between the dominant and non-dominant sides in terms of the hip muscle strength. Significant positive associations were found between the player's age and hip muscle strengths, whereas significant negative associations were found between the age and hip ROMs. Conclusions Our data concerning the relationship between age and hip joint development could be useful for supporting strategies for the prevention and rehabilitation of throwing injuries; however, hip injuries might be rare among young baseball players.
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Affiliation(s)
- Hiroki Kobayashi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Toshiro Warita
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takanori Kitagawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shuhei Takamine
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroaki Fujita
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Nobumasa Kushima
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shogo Hashimoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Koichi Okamura
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takashi Yanagawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masaaki Sakamoto
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Takagishi
- Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
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Soberón JR, Awoniyi CA, Perez MA, Vasilopoulos T, Canales BK. Obturator Nerve Blockade vs. Neuromuscular Blockade for the Prevention of Adductor Spasm in Patients Undergoing Transurethral Resection of Bladder Tumors: A Randomized Controlled Trial. PAIN MEDICINE 2021; 22:1253-1260. [PMID: 33537703 DOI: 10.1093/pm/pnaa448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The obturator nerve runs along the posterolateral walls of the bladder and electrosurgical stimulation in this region can result in adductor spasm which can occur suddenly and unexpectedly with potentially catastrophic results. METHODS Sixty patients were prospectively randomized to receive either a single-injection ultrasound-guided obturator nerve block (ONB) or intravenous rocuronium after induction of general anesthesia (i.e., neuromuscular block [NMB]). The primary objective was to compare the incidence of adductor spasm during posterolateral bladder tumor resection when ONB or NMB was used. Secondary objectives included assessment of fall risk and incidence of adverse events. RESULTS Five patients in the ONB group and six in the NMB group had nonlateral wall lesions. One patient in the ONB group suffered a cardiac arrest after induction of general anesthesia. Of the remaining 48 patients, six (10.2%) experienced adductor spasm. Most of these patients were in the NMB group (5/24, 20.8%), with only one patient (1/24, 4.2%) experiencing obturator reflex in the ONB group; this difference was not statistically significant (P=0.19). Patients in the ONB group had a greater decrease in mean hip adductor strength. Our study population was found to be at high risk of falls before surgery. There were no statistically significant group differences in the Timed Up and Go test, with time to perform the test increasing in both groups. CONCLUSIONS Both techniques are safe and efficacious for preventing adductor spasm. Our data and experience suggest that the ONB is relatively easy to perform and should be considered in patients with posterolateral bladder tumors.
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Affiliation(s)
- José R Soberón
- Department of Anesthesiology, North Florida/Southern Georgia Veterans Health System and the University of Florida, Gainesville, Florida, USA
| | - Caleb A Awoniyi
- Department of Anesthesiology, North Florida/Southern Georgia Veterans Health System and the University of Florida, Gainesville, Florida, USA
| | - Melissa Alvarez Perez
- Central Florida Pain Management (Physical Medicine and Rehabilitation), Ocala, Florida, USA
| | - Terrie Vasilopoulos
- Departments of Anesthesiology and Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Benjamin K Canales
- Department of Urology, University of Florida, Gainesville, Florida, USA.,Department of Surgery, North Florida/Southern Georgia Veterans Health System, Gainesville, Florida, USA
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94
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Hip Sway in Patients With Hip Osteoarthritis During One-Leg Standing With a Focus on Time Series Data. Motor Control 2021; 25:502-518. [PMID: 34098529 DOI: 10.1123/mc.2020-0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate the hip sway and the relationship between the center of pressure (CoP) and kinematic parameters regarding the time series scaling component α in patients with hip osteoarthritis (OA) during a one-leg standing task. The scaling exponent α, SD, hip sway maximal acceleration change, and balance performance, which was measured using CoP parameters, were compared between hip OA and control groups during a one-leg standing task. The relationships between balance performance with CoP parameters and kinematic parameters were investigated with the regression analysis. In the hip OA group, the scaling exponent α was smaller in the medial-lateral direction, and the SD and maximal amount of change in hip sway acceleration were larger in the anterior-posterior direction in the hip OA group. In this group, the CoP parameters were significantly associated with α in the medial-lateral direction (negatively) and in the anterior-posterior direction (positively). In the hip OA group, hip sway adaptability in the medial-lateral direction was limited, while the anterior-posterior direction showed greater movement.
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95
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Goncalves BA, Saxby DJ, Kositsky A, Barrett RS, Diamond LE. Reliability of hip muscle strength measured in principal and intermediate planes of movement. PeerJ 2021; 9:e11521. [PMID: 34141482 PMCID: PMC8179216 DOI: 10.7717/peerj.11521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 05/05/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Muscle strength testing is widely used in clinical and athletic populations. Commercially available dynamometers are designed to assess strength in three principal planes (sagittal, transverse, frontal). However, the anatomy of the hip suggests muscles may only be recruited submaximally during tasks performed in these principal planes. OBJECTIVE To evaluate the inter-session reliability of maximal isometric hip strength in the principal planes and three intermediate planes. METHODS Twenty participants (26.1 ± 2.7 years, 50% female) attended two testing sessions 6.2 ± 1.8 days apart. Participants completed 3-5 maximal voluntary isometric contractions for hip abduction, adduction, flexion, extension, and internal and external rotation measured using a fixed uniaxial load cell (custom rig) and commercial dynamometer (Biodex). Three intermediate hip actions were also tested using the custom rig: extension with abduction, extension with external rotation, and extension with both abduction and external rotation. RESULTS Moderate-to-excellent intraclass correlation coefficients were observed for all principal and intermediate muscle actions using the custom rig (0.72-0.95) and the Biodex (0.85-0.95). The minimum detectable change was also similar between devices (custom rig = 11-31%; Biodex = 9-20%). Bland-Altman analysis revealed poor agreement between devices (range between upper and lower limits of agreement = 77-131%). CONCLUSIONS Although the custom rig and Biodex showed similar reliability, both devices may lack the sensitivity to detect small changes in hip strength commonly observed following intervention.
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Affiliation(s)
- Basilio A.M. Goncalves
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J. Saxby
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Adam Kositsky
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Rod S. Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Laura E. Diamond
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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96
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Jacobsen JS, Jakobsen SS, Søballe K, Hölmich P, Thorborg K. Isometric hip strength impairments in patients with hip dysplasia are improved but not normalized 1 year after periacetabular osteotomy: a cohort study of 82 patients. Acta Orthop 2021; 92:285-291. [PMID: 33538223 PMCID: PMC8231359 DOI: 10.1080/17453674.2020.1864911] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - In patients with hip dysplasia, knowledge of hip muscle strength after periacetabular osteotomy is lacking. We investigated isometric hip muscle strength in patients with hip dysplasia, before and 1 year after periacetabular osteotomy, and compared this with healthy volunteers. Furthermore, we investigated whether pre- to post-surgical changes in self-reported pain and sporting function were associated with changes in isometric hip muscle strength.Patients and methods - Isometric hip muscle strength was assessed twice in 82 patients (11 men) with a mean age of 30 (SD 9) years, before and 1 year after surgery, and once in 50 healthy volunteers. Isometric hip muscle strength was assessed with a hand-held dynamometer. Copenhagen Hip and Groin Outcome Score was used to measure self-reported outcome.Results - Despite 1-year improvements in isometric hip flexion (0.1 Nm/kg; 95% CI 0.06-0.2) and abduction (0.1 Nm/kg; CI 0.02-0.2), the patients' muscle strength was 13-34% lower than the strength of the healthy volunteers both pre- and post-surgery (p < 0.01). Moreover, changes in self-reported pain were associated with changes in hip flexion (13 points per Nm/kg; CI 1-26) and abduction (14 points per Nm/kg; CI 3-25), while changes in self-reported sporting function were associated with changes in hip extension (9 points per Nm/kg; CI 1-18).Interpretation - Isometric hip muscle strength is impaired in symptomatic dysplastic hips measured before periacetabular osteotomy. 1 year after surgery, isometric hip flexion and abduction strength had improved but muscle strength did not reach that of healthy volunteers.
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Affiliation(s)
- Julie Sandell Jacobsen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus; ,Research Unit for General Practice in Aarhus, Aarhus; ,Correspondence:
| | | | - Kjeld Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus; ,Department of Clinical Medicine, Aarhus University, Aarhus;
| | - Per Hölmich
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre;
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre; ,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark
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97
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Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.
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98
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Regression Model for the Prediction of Risk of Pelvic Floor Muscle Weakness Among Older Adults. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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99
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Horsley BJ, Tofari PJ, Halson SL, Kemp JG, Dickson J, Maniar N, Cormack SJ. Does Site Matter? Impact of Inertial Measurement Unit Placement on the Validity and Reliability of Stride Variables During Running: A Systematic Review and Meta-analysis. Sports Med 2021; 51:1449-1489. [PMID: 33761128 DOI: 10.1007/s40279-021-01443-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Inertial measurement units (IMUs) are used for running gait analysis in a variety of sports. These sensors have been attached at various locations to capture stride data. However, it is unclear if different placement sites affect the derived outcome measures. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the impact of placement on the validity and reliability of IMU-derived measures of running gait. METHODS Online databases SPORTDiscus with Full Text, CINAHL Complete, MEDLINE (EBSCOhost), EMBASE (Ovid) and Scopus were searched from the earliest record to 6 August 2020. Articles were included if they (1) used an IMU during running (2) reported spatiotemporal variables, peak ground reaction force (GRF) or vertical stiffness and (3) assessed validity or reliability. Meta-analyses were performed for a pooled validity estimate when (1) studies reported means and standard deviation for variables derived from the IMU and criterion (2) used the same IMU placement and (3) determined validity at a comparable running velocity (≤ 1 m·s-1 difference). RESULTS Thirty-nine articles were included, where placement varied between the foot, tibia, hip, sacrum, lumbar spine (LS), torso and thoracic spine (TS). Initial contact, toe-off, contact time (CT), flight time (FT), step time, stride time, swing time, step frequency (SF), step length (SL), stride length, peak vertical and resultant GRF and vertical stiffness were analysed. Four variables (CT, FT, SF and SL) were meta-analysed, where CT was compared between the foot, tibia and LS placements and SF was compared between foot and LS. Foot placement data were meta-analysed for FT and SL. All data are the mean difference (MD [95%CI]). No significant difference was observed for any site compared to the criterion for CT (foot: - 11.47 ms [- 45.68, 22.74], p = 0.43; tibia: 22.34 ms [- 18.59, 63.27], p = 0.18; LS: - 48.74 ms [- 120.33, 22.85], p = 0.12), FT (foot: 11.93 ms [- 8.88, 32.74], p = 0.13), SF (foot: 0.45 step·min-1 [- 1.75, 2.66], p = 0.47; LS: - 3.45 step·min-1 [- 16.28, 9.39], p = 0.37) and SL (foot: 0.21 cm [- 1.76, 2.18], p = 0.69). Reliable derivations of CT (coefficient of variation [CV] < 9.9%), FT (CV < 11.6%) and SF (CV < 4.4%) were shown using foot- and LS-worn IMUs, while the CV was < 7.8% for foot-determined stride time, SL and stride length. Vertical GRF was reliable from the LS (CV = 4.2%) and TS (CV = 3.3%) using a spring-mass model, while vertical stiffness was moderately (r = 0.66) and nearly perfectly (r = 0.98) correlated with criterion measures from the TS. CONCLUSION Placement of IMUs on the foot, tibia and LS is suitable to derive valid and reliable stride data, suggesting measurement site may not be a critical factor. However, evidence regarding the ability to accurately detect stride events from the TS is unclear and this warrants further investigation.
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Affiliation(s)
- Benjamin J Horsley
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia.
| | - Paul J Tofari
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia
| | - Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Australia
| | - Justin G Kemp
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia
| | - Jessica Dickson
- Library and Academic Research Services, Australian Catholic University, Melbourne, Australia
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia
| | - Stuart J Cormack
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, 3065, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Australia
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100
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Yurdakul OV, Ince OE, Bagcier F, Kara M, Kultur E, Aydin T. Evaluating the strength of spinal and proximal girdle muscles in patients with axial spondyloarthritis: Correlation with activity, disability, and functionality. Int J Rheum Dis 2021; 24:701-710. [PMID: 33750032 DOI: 10.1111/1756-185x.14102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 01/01/2023]
Abstract
AIM To compare the muscle strength of muscle groups in axial spondyloarthritis (axSpA) patients with the muscle powers of healthy volunteers and to examine the relationship of muscle strengths with disease activity, functionality, and disability. METHOD One hundred males (50 axSpA, 50 healthy) were included in the study. Bath Disease Activity Index (BASDAI), Functional Index (BASFI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were recorded. The maximum (max) and mean cervical flexion, extension, lateral flexion (CF, CE, CLF), truncal flexion, extension (TF, TE), root joint flexion, extension, abduction, internal and external rotation (SF, SE, SAB, SIR and SER for the shoulder; HF, HE, HAB, HIR and HER for the hip) muscle strengths of the patients in both groups were measured by a handheld dynamometer. Total muscle strength (CT, TT, ST, HT) was found according to the sum of the max and mean values for each region. RESULTS All muscle strengths were lower in the axSpA group compared to the healthy volunteers. The symptom duration was found to have a weak-moderate negative correlation with CT, TT, ST, HT and all individual muscle strengths except for the TE, CF, HIR, and HER. BASDAI and HAQ-DI had weak-moderate negative correlations with HIR and HER. BASFI had a weak-moderate negative correlation with cervical measurements, TE, TF, SF, SER, SIR, and hip measurements. CONCLUSION All muscle strengths were lower in patients compared to healthy volunteers. Strengthening specific muscle groups for the desired goal can be a reasonable strategy. The study is prospectively registered and available at www.clinicaltrials.gov (NCT04435860).
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Affiliation(s)
- Ozan Volkan Yurdakul
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Ozlenen Eylul Ince
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Fatih Bagcier
- Cam and Sakura State Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey
| | - Mert Kara
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Esra Kultur
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Teoman Aydin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
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