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Perrone M, Guidetti M, Galli M, Nho SJ, Wimmer MA, Malloy P. Hip joint contact forces are lower in people with femoroacetabular impingement syndrome during squat tasks. J Orthop Res 2024; 42:1045-1053. [PMID: 38032092 DOI: 10.1002/jor.25744] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/16/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
It remains unknown if hip joint forces during squat tasks are altered in people with femoroacetabular impingement syndrome (FAIS). The aim of this study is to compare hip joint forces between people with FAIS and healthy controls during double leg squat and single leg squat tasks and within limbs during a single leg squat task in people with FAIS. Kinematic and kinetic data were collected in eight people with FAIS and eight healthy matched controls using 3D motion capture and force plates. AnyBody Modeling System was used to perform musculoskeletal simulations to estimate hip joint angles, forces, and moments for all participants. Estimates were postprocessed with AnyPyTools and converted into normalized time series to be compared using a 1D statistical nonparametric mapping (SnPM) approach. SnPM with an independent samples t-test model was used to compare people with FAIS to controls, while a paired samples model was used to compare involved to uninvolved limb in people with FAIS. Patients demonstrated lower proximodistal force compared to controls (p < 0.01) and compared to the uninvolved side (p = 0.01) for single leg squat. The smaller joint contact forces in people with FAIS compared to controls could represent a strategy of reduced muscle forces to avoid pain and symptoms during this high demand task. These findings when combined with imaging data could help assess the severity of FAIS on hip related function during higher demand tasks.
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Affiliation(s)
- Mattia Perrone
- Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
- Department of Orthopedic Surgery, Division of Sports Medicine, Young Adult Hip Surgery Program, Rush University Medical Center, Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
| | - Martina Guidetti
- Department of Orthopedic Surgery, Division of Sports Medicine, Young Adult Hip Surgery Program, Rush University Medical Center, Chicago, Illinois, USA
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
| | - Shane J Nho
- Department of Orthopedic Surgery, Division of Sports Medicine, Young Adult Hip Surgery Program, Rush University Medical Center, Chicago, Illinois, USA
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Division of Sports Medicine, Young Adult Hip Surgery Program, Rush University Medical Center, Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Philip Malloy
- Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
- Department of Orthopedic Surgery, Division of Sports Medicine, Young Adult Hip Surgery Program, Rush University Medical Center, Chicago, Illinois, USA
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González-de-la-Flor Á, Valera-Calero JA, García-Fernández P, López-de-Uralde-Villanueva I, Fernández-de-Las-Peñas C, Plaza-Manzano G. Clinical Presentation Differences Among Four Subtypes of Femoroacetabular Impingement: A Case-Control Study. Phys Ther 2024; 104:pzad179. [PMID: 38157293 DOI: 10.1093/ptj/pzad179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/21/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The aims of this study were to assess the psychological, functional, and physical differences between patients with femoroacetabular impingement (FAI) syndrome and individuals who were asymptomatic (controls) to analyze clinical differences among 4 subtypes of FAI (cam type, cam type with labral tear, pincer type, and pincer type with labral tear), to calculate the correlations among the variables described, and to identify risk factors contributing to the hip function variance. METHODS A case-control study was conducted at a hospital rehabilitation unit with a cohort of individuals who were asymptomatic (controls) and a cohort of patients with FAI. Sociodemographic characteristics, pain intensity, psychological health status, hip range of motion (RoM), hip isometric strength, and hip function were assessed. RESULTS A total of 69 controls and 69 patients with FAI were analyzed. Although sociodemographic characteristics were comparable between samples, poorer hip RoM, strength, and psychological health were found for the cases. FAI subtypes showed no significant pain intensity, psychological health, or RoM differences (except for hip adduction), but hip strength differed among FAI subtypes. Multiple significant correlations between psychological health, pain intensity, RoM, strength, and hip function were found. The variance values of the International Hip Outcome Tool, Hip Outcome Score (HOS) for daily living activities, and HOS for sports activities were partially explained (47.6%, 36.0%, and 21.6%, respectively) on the basis of kinesiophobia, hip strength, self-efficacy, and anxiety. CONCLUSION Patients with FAI showed poorer psychological health, hip RoM, and strength than individuals who were asymptomatic and had similar sociodemographic characteristics. FAI subtype influenced the patients' clinical presentations. Hip strength, kinesiophobia, anxiety, and self-efficacy should be targeted for improving hip function, as they have been demonstrated to be important contributors to hip disability. IMPACT This study demonstrated that pain catastrophizing, hip strength, and hip adduction differed among FAI subtypes. However, hip function and pain intensity were comparable between FAI subtypes.
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Affiliation(s)
- Ángel González-de-la-Flor
- Department of Physical Therapy and Sport Medicine, Hospital Universitario Quironsalud Madrid, Madrid, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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da Costa Santos VB, Alvares AM, Chierotti P, Toffoli LV, Okino AM, Toginho Filho DDO, Macedo CDSG. Effects of photobiomodulation applied at different times on functional performance and ergogenic response of rugby athletes: Randomized clinical trial. J Bodyw Mov Ther 2024; 38:314-322. [PMID: 38763575 DOI: 10.1016/j.jbmt.2023.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 09/25/2023] [Accepted: 11/24/2023] [Indexed: 05/21/2024]
Abstract
BACKGROUND Photobiomodulation (PBM) is indicated to accelerate the recovery of athletes and reduce muscle damage caused by physical exercise. The objective of this study was to establish the best time to apply photobiomodulation to increase the functional performance and ergogenic response of rugby athletes. METHODS Randomized crossover clinical trial with 18 rugby athletes of both sexes. The interventions were carried out from January to May 2019. The blood levels of creatine kinase (CK) and lactate, and performance in the Modified Star Excursion Balance Test, Single Hop Test, Triple Hop Test, Bangsbo Sprint test (BST), and Yo-Yo intermittent recovery level 1 (YoyoIR1) were evaluated. The athletes underwent two blocks of exercises with the BST and Yoyo-IR1, as well as the random application of four interventions: without application of photobiomodulation (CO), pre-exercise photobiomodulation (PBpre), PBM during the exercise interval (PBint), or post-exercise photobiomodulation (PBpos). The photobiomodulation using light-emitting diodes (850 nm, 8 J/cm2) lasted 10 min and was applied to the quadriceps, hamstrings, and triceps surae muscles. The results were compared between groups and times, and the effect size for the interventions was established. RESULTS No differences were found between groups in CK, lactate, and performance in the functional tests between groups and times. Only the PBpre presented improved performance in the first Yoyo-1R1 test (p < 0.01), while the PBint improved in the second Yoyo-IR1 test and BST (p < 0.05). CONCLUSION The PBM did not change muscle damage markers or performance in the functional tests. For an ergogenic response, photobiomodulation applied before exercise improves performance, which can be maintained when PBM is performed in the exercise interval.
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Affiliation(s)
| | - Amanda Maximo Alvares
- Department of Physiotherapy, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina-PR, Brazil
| | - Priscila Chierotti
- Department of Physical Education, Physical Education and Sports Center, UEL, Londrina-PR, Brazil
| | - Leandro Vaz Toffoli
- Department of Biomedicine, Center for Biological and Health Sciences, Universidade do Norte do Paraná, Londrina-PR, Brazil
| | - Alessandra Miyuki Okino
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, UEL, Londrina-PR, Brazil
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Frasson VB, Vaz MA, Telöken MA, Gusmão PDF, Crestani MV, Baroni BM. Can a clinical assessment predict the functional status progression in patients with femoroacetabular impingement syndrome? Braz J Phys Ther 2024; 28:101050. [PMID: 38574558 PMCID: PMC10999820 DOI: 10.1016/j.bjpt.2024.101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Femoroacetabular impingement syndrome (FAIS) is a hip joint motion-related clinical disorder with a triad of symptoms, clinical signs, and imaging findings. However, scientific evidence is still unclear regarding the best treatment for FAIS. OBJECTIVES To assess the value of a physical therapy evaluation in predicting the progression of functional status over the subsequent years in patients with FAIS who are candidates for hip arthroscopy surgery. METHODS In this case-series study, patients with FAIS, candidates for hip arthroscopy surgery, underwent a standard physical therapy evaluation. Baseline data were collected between 2013 and 2019. In 2020/2021, the patients' functional status was assessed through the International Hip Outcome Tool (iHOT-33). Functional status progression was calculated as the difference between the follow-up and baseline iHOT-33 scores. A multivariate forward stepwise regression analysis was conducted to explore the relationship between baseline characteristics and the functional status progression. RESULTS From 353 patients who completed the baseline assessment, 145 completed the iHOT-33 follow-up. The mean (±SD) follow-up time was 58.7 (27.2) months (minimum 12 and maximum 103 months). The iHOT-33 scores increased 20.7 (21.8) points on average, ranging from -39.8 to 76.9 points. Among the 15 potential predictive factors assessed in this study, only baseline iHOT-33 score (β -0.44; -0.061, -0.27), femoral version (β 9.03; 1.36, 16.71), and body mass index (β -0.99; -1.98, -0.01) had the ability to predict the functional status progression. CONCLUSION Patients with a lower baseline iHOT-33 score, lower body mass index, and normal femoral version were more likely to increase their functional status after a minimum of one year of follow-up.
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Affiliation(s)
- Viviane Bortoluzzi Frasson
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rehabilitation Sciences Program, Porto Alegre, RS, Brazil; Physique - Centro de Fisioterapia, Porto Alegre, RS, Brazil.
| | - Marco Aurélio Vaz
- Physique - Centro de Fisioterapia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, School of Physical Education, Physical Therapy and Dance, Porto Alegre, RS, Brazil
| | | | | | | | - Bruno Manfredini Baroni
- Universidade Federal de Ciências da Saúde de Porto Alegre, Rehabilitation Sciences Program, Porto Alegre, RS, Brazil
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Alkhamis BA, Reddy RS, Alahmari KA, Alshahrani MS, Koura GM, Ali OI, Mukherjee D, Elrefaey BH. Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis. PLoS One 2024; 19:e0298625. [PMID: 38363786 PMCID: PMC10871501 DOI: 10.1371/journal.pone.0298625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/27/2024] [Indexed: 02/18/2024] Open
Abstract
The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.
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Affiliation(s)
- Batool Abdulelah Alkhamis
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Khalid A. Alahmari
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ghada Mohammed Koura
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Olfat Ibrahim Ali
- Physical Therapy Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Basant Hamdy Elrefaey
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Hugenberg G, Stallons J, Smith C, Brockhoff K, Gingras M, Yardley D, Ayeni O, Almasri M. Clinical Commentary: A Criteria-Based Testing Protocol for Return to Sport Post Hip Arthroscopy for Impingement. Int J Sports Phys Ther 2023; 18:1218-1229. [PMID: 37795325 PMCID: PMC10547071 DOI: 10.26603/001c.87629] [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: 04/27/2023] [Accepted: 08/09/2023] [Indexed: 10/06/2023] Open
Abstract
Overall, 84%-87% of athletes will return to sport following hip arthroscopy; however, some literature suggests that only 57% of athletes return to their preinjury level, and only 16.9% report optimal performance. This discrepancy may be due to a lack of consistency within the definition of return to sport as well as a lack of consistency within rehabilitation programs when determining return to sport readiness. Athletes who are returning to sport must demonstrate adequate range of motion, strength, and the ability to perform multi-directional movements without the risk of reinjury. There has yet to be a comprehensive, criteria-based, return to sport testing protocol that utilizes objective measures to ensure athletes are ready for return to sport. The goal of the authors was to create a criteria-based testing protocol for return to sport following hip arthroscopy utilizing components best supported in the literature. The following parameters were identified as key areas to assess for within a return to sport testing protocol: range of motion, strength, functional testing, self-reported outcomes including psychological readiness and time. The purpose of this clinical commentary is to propose a criteria-based testing protocol to be used following hip arthroscopy for impingement from early rehabilitation through return to previous level of sport. Criteria are presented clearly to promote objective progression through rehabilitation while still being mindful of the biological healing time required for safe and efficient progression. It is the authors' hope that in identifying and establishing a criteria-based testing protocol a higher percentage of athletes will be able to return to sport. Level of Evidence 5.
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Affiliation(s)
| | | | | | | | | | | | | | - Mahmoud Almasri
- Orthopedic Surgery Mercy Health
- Cincinnati SportsMedicine Research & Educational Foundation
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de Oliveira LA, Frasson VB, Torresan A, Vaz MA, Baroni BM. Single-Leg Squat Test in the Clinical Setting Does Not Discriminate Patients With Femoroacetabular Impingement Syndrome From Asymptomatic Individuals. J Sport Rehabil 2023:1-6. [PMID: 37225174 DOI: 10.1123/jsr.2022-0083] [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: 02/25/2022] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 05/26/2023]
Abstract
CONTEXT Laboratorial 3-dimensional kinematic analyses have shown changes in the single-leg squat's (SLS) pattern of patients with femoroacetabular impingement syndrome (FAIS). However, it is unknown whether clinicians are able to detect these changes using 2-dimensional kinematics. OBJECTIVE To compare the frontal plane 2-dimensional kinematics of patients with FAIS and asymptomatic individuals in the SLS test performed in a clinical setting. DESIGN Case-control study. SETTING Physical therapy clinic. PARTICIPANTS Twenty men with bilateral FAIS and 20 asymptomatic men. MAIN OUTCOME MEASURES Two-dimensional kinematic analysis was collected in the frontal plane during the execution of the SLS test. The outcomes were squat depth, pelvic drop (pelvis angle relative to the horizontal plane), hip adduction (femur angle relative to the pelvis), and knee valgus (femur angle relative to the tibia). RESULTS Most and least painful limbs of patients with FAIS had squat depth (9.8% [2.9%] and 9.5% [3.1%] of height), pelvic drop (4.2° [3.9°] and 3.7° [4.2°]), hip adduction (74.9° [5.8°] and 75.9° [5.7°]), and knee valgus (4.0° [11.0°] and 5.0° [9.9°]) similar to asymptomatic individuals (9.0% [2.3%], 4.8° [2.6°], 73.7° [4.9°], and -1.7° [8.5°]; P > .05 for all). CONCLUSION The frontal plane 2-dimensional kinematic analysis of the SLS test in the clinical setting is not able to distinguish patients with FAIS from asymptomatic individuals.
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Affiliation(s)
| | - Viviane Bortoluzzi Frasson
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS,Brazil
- Physique-Physical Therapy Centre, Porto Alegre, RS,Brazil
| | - Anna Torresan
- Physique-Physical Therapy Centre, Porto Alegre, RS,Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
| | - Marco Aurélio Vaz
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS,Brazil
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Bizzini M, Schaub G, Ferrari E, Monn S, Leunig M, Casartelli NC, Maffiuletti NA. Hip muscle strength in male and female patients with femoroacetabular impingement syndrome: Comparison to healthy controls and athletes. Phys Ther Sport 2023; 61:142-148. [PMID: 37054534 DOI: 10.1016/j.ptsp.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVES To examine hip muscle strength deficits in patients with femoroacetabular impingent syndrome (FAIS), with special emphasis on potential sex- and comparison-related (between-subject vs within-subject) differences. DESIGN Cross-sectional comparative study. PARTICIPANTS Forty FAIS patients (20 women), 40 healthy controls (20 women) and 40 athletes (20 women). MAIN OUTCOME MEASURES Hip abduction, adduction and flexion isometric strength was tested using a commercially-available dynamometer. Two between-subject comparisons (FAIS patients vs controls and FAIS patients vs athletes) and one within-subject comparison (inter-limb asymmetry) of strength deficits were conducted, based on the calculation of respective percent differences. RESULTS For all hip muscle groups, women were 14-18% weaker than men (p < 0.001), but no sex-related interactions were observed. For all hip muscle groups, FAIS patients were 16-19% weaker than controls (p = 0.001) and 24-30% weaker than athletes (p < 0.001). For FAIS patients, the involved hip abductors were 8.5% weaker than the uninvolved ones (p = 0.015), while no inter-limb asymmetry was observed for the other hip muscles. CONCLUSION Sex had no influence on hip muscle strength deficits in FAIS patients while a major impact of comparison method/group was observed. Hip abductors showed consistent deficits for all comparison methods, suggestive of a possible greater impairment compared to hip flexors and adductors.
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Hip Joint Biomechanical Parameters and Their Relationship With the Esthetic Functional Performance of the Développé à la Seconde Movement in Classical Ballet Dancers. J Appl Biomech 2023; 39:80-89. [PMID: 36805932 DOI: 10.1123/jab.2022-0200] [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: 08/09/2022] [Revised: 11/19/2022] [Accepted: 12/15/2022] [Indexed: 02/23/2023]
Abstract
Développé à la seconde is a classic ballet movement that requires the maintenance of a high hip joint range of motion (ROM) and muscle strength. However, the contribution of these hip joint biomechanical parameters to this movement's esthetic performance is unclear. Therefore, this study evaluated hip joint biomechanical characteristics of 21 experienced ballet dancers (15-29 y old) and verified the relationship between these variables with the développé à la seconde static and dynamic performance. Correlations between age, ballet practice time, gluteus maximus and gluteus medius thicknesses, ROM, and muscle strength with absolute and relative static and dynamic performances were verified. Flexors, extensors, and internal rotators peak strength and external rotation ROM were highly correlated with absolute and relative static performances (0.5-0.7). Flexors and extensors strength and external and internal rotation ROM showed the highest correlations with the développé dynamic performance (0.49-0.67). Flexor strength and flexor and internal rotation ROM predicted 26% to 41% of this movement's static and dynamic performances. Thus, from a biomechanical perspective, clinical assessment of hip strength and ROM may be used to predict the quality of the ballet dancers' performance of the développé à la seconde and guide classical ballet training.
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Choi M, Kim Y. Biomechanical Asymmetry of Strength and Dynamic Balance Kinetics in Middle-Ages with Adhesive Capsulitis of the Hip. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13093. [PMID: 36293688 PMCID: PMC9603790 DOI: 10.3390/ijerph192013093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/01/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
The representative clinical features of adhesive capsulitis of the hip (ACH) are restricted range of motion (ROM) and pain. However, reports on kinetics such as strength and dynamic balance that explain physical functions are rare. This study compared subjective hip scores using Copenhagen Hip and Groin Outcome Score (HAGOS) and ROM using a manual goniometer as well as strength using isokinetic equipment, and dynamic balance through the Y-balance test, between patients with ACH and healthy individuals. Data of 193 middle-aged participants (men: 99 and women: 94) were analyzed. The ACH group scored significantly lower in all six HAGOS sub-sections. Hip joint flexion, abduction, internal and external rotation ROM were significantly lower in ACH compared to healthy group. These results were the same for men and women. In the strength of men and women, flexion, adduction, and abduction, and dynamic balance in all three directions were significantly decreased in ACH. Meanwhile, there were no significant between-group differences in the functional decrease in extension and adduction of ROM, and extension strength. In conclusion, subjective evaluation and dynamic balance of patients with ACH were decreased in the all parts. In ROM, flexion, abduction, internal rotation, and external rotation were restricted except for extension and adduction. Men and women with ACH maintained extensor strength, but had weakened strength in flexion, adduction and abduction. This information will be useful for therapists to understand the biomechanical properties of ACH and to design effective rehabilitation programs.
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Affiliation(s)
- Moonyoung Choi
- Department of Sports Science Convergence, Dongguk University, Seoul 04620, Korea
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Korea
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Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults. Healthcare (Basel) 2022; 10:healthcare10081484. [PMID: 36011140 PMCID: PMC9408434 DOI: 10.3390/healthcare10081484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Femoroacetabular impingement (FAI) is caused by hip joint anomalies. Although asymptomatic and symptomatic FAI have been reported in young adults, information on biomechanical and functional characteristics of FAI is rare. We compared the subjective hip score, range of motion (ROM), dynamic balance, and hip strength between symptomatic FAI (FAIsym) and asymptomatic FAI (FAIasym) groups and healthy controls. Participants (n = 307; men: 155, women: 152) were classified according to morphological abnormalities and hip joint symptoms, comprising symptomatic FAI, asymptomatic FAI, and healthy controls. The Copenhagen Hip and Groin Outcome Score (HAGOS), hip ROM, Y-balance test (YBT), and isokinetic hip strength were measured. The types of FAI were not significantly differenent in both men and women. FAIsym exhibited significantly reduced HAGOS, whereas FAIasym showed no significant difference compared to the healthy group (men: healthy 91.7 vs. FAIasym 87.2 vs. FAIsym 49.9, women: healthy 91.7 vs. FAIasym 86.2 vs. FAIsym 53.9). Hip flexion, adduction, and internal and external rotation ROMs were only significantly reduced in symptomatic FAI. Asymptomatic and symptomatic FAI groups displayed significantly lower YBT scores than healthy controls (men healthy: 84.9 vs. FAIasym: 69.0 vs. FAIsym 58.7, women healthy 79.2 vs. FAIasym 64.0 vs. FAIsym 55.5). Isokinetic hip flexion, adduction, and abduction strengths were significantly lower in FAIsym. In conclusion, FAIasym showed no decrease in muscle strength but displayed reduced dynamic balance. Subjective satisfaction, ROM, muscle strength, and dynamic balance were lower in FAIsym compared to FAIasym and healthy groups.
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Neuromuscular Consequences of Lumbopelvic Dysfunction: Research and Clinical Perspectives. J Sport Rehabil 2022; 31:742-748. [PMID: 35894966 DOI: 10.1123/jsr.2021-0258] [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: 07/11/2021] [Revised: 05/10/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Injuries involving the lumbopelvic region (ie, lumbar spine, pelvis, hip) are common across the lifespan and include pathologies such as low back pain, femoroacetabular impingement syndrome, labrum tear, and osteoarthritis. Joint injury is known to result in an arthrogenic muscle response which contributes to muscle weakness and altered movement patterns. The purpose of this manuscript is to summarize the arthrogenic muscle response that occurs across lumbopelvic region pathologies, identify methods to quantify muscle function, and propose suggestions for future research. While each lumbopelvic region pathology is unique, there are a few common impairments and a relative consistent arthrogenic muscle response that occurs across the region. Hip muscle weakness and hip joint range of motion limitations occur with both lumbar spine and hip pathologies, and individuals with low back pain are known to demonstrate inhibition of the transversus abdominis and multifidus. Assessment of muscle inhibition is often limited to research laboratory settings, but dynamometers, ultrasound imaging, and electromyography offer clinical capacity to quantify muscle function and inform treatment pathways. Future studies should systematically determine the arthrogenic muscle response across multiple muscle groups and the timeline for changes in muscle function and determine whether disinhibitory modalities improve functional outcomes beyond traditional treatment approaches.
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Frasson VB, Herzog W, Johnston K, Pauchard Y, Vaz MA, Baroni BM. Do femoral version abnormalities play a role in hip function of patients with hip pain? Clin Biomech (Bristol, Avon) 2022; 97:105708. [PMID: 35763889 DOI: 10.1016/j.clinbiomech.2022.105708] [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: 06/14/2021] [Revised: 06/03/2022] [Accepted: 06/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND A high prevalence of femoral version abnormalities has been observed in hip pain patients, with impact on hip range of motion and muscle strength that should be elucidated. METHODS Cross-sectional study. Thirty-one patients with hip pain (16 men and 15 female) were subjected to Biplanar X-Rays to quantify femoral version using three-dimensional measurements. The 62 hips were divided into normal version (10-20°, n = 18), anteverted (>20°, n = 19), and retroverted (<10°, n = 25). Joint range of motion for flexion, internal rotation, and external rotation was assessed through digital goniometry. Maximal isometric hip strength (flexion, extension, internal rotation, external rotation at 0° and 30°, abduction, adduction) was evaluated through hand-held dynamometry. Hip rotation index was calculated as external rotation minus internal rotation. FINDINGS Anteverted hips had greater internal rotation, while retroverted hips had greater external rotation (p = 0.001). Anteverted hips were weaker than retroverted hips for external rotation at 30° (p < 0.001), abduction (p = 0.006) and adduction (p < 0.001), and weaker than normal version hips for extension (p = 0.018). All three groups had different rotation index: retroverted>normal>anteverted (p < 0.001). The ordinal logistic regression found higher values of rotation index with higher probability of being retroverted (common odds ratio = 1.20). There was a strong correlation between femoral version group and rotation index (rS = 0.76, p < 0.001). There was probability >70% of a hip being anteverted if the rotation index was <11°, and being retroverted if the index was >40°. INTERPRETATION Range of motion and muscle strength differed in hips with different femoral versions. The hip rotation index was a strong femoral version predictor.
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Affiliation(s)
- Viviane Bortoluzzi Frasson
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil; Physique - Physical Therapy Centre, Porto Alegre, RS, Brazil.
| | - Walter Herzog
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; Health Centre, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Kelly Johnston
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yves Pauchard
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Marco Aurélio Vaz
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada; Physique - Physical Therapy Centre, Porto Alegre, RS, Brazil; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Filan D, Mullins K, Carton P. Hip Range of Motion Is Increased After Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review. Arthrosc Sports Med Rehabil 2022; 4:e797-e822. [PMID: 35494261 PMCID: PMC9042900 DOI: 10.1016/j.asmr.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/08/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose To investigate the impact of arthroscopic correction of symptomatic femoroacetabular impingement on postoperative hip range of motion (ROM), as an objectively measured postoperative clinically reported outcome. Methods A systematic review of the current literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, OVID/MEDLINE, EMBASE, and Cochrane databases were queried in November 2020. Studies not reporting pre- to postoperative ROM measurements were excluded. Methodologic quality was assessed using the MINORS assessment, and certainty of evidence was assessed using the GRADE approach. Effect size using standardized mean differences assessed magnitude of change between pre- and postoperative ROM. Results In total, 23 studies were included evaluating 2,332 patients. Mean age ranged from 18 to 44.2 years. Flexion, internal rotation (IR), and external rotation (ER) were the predominantly measured ROMs reported in 91%, 100% and 65% of studies, respectively. Observed change following hip arthroscopy was considered significant in 57.1% (flexion), 74% (IR), and 20% (ER). Effect size of change in significantly improved ROMs were weak (16.7% flexion, 33.3% ER), moderate (58.3% flexion, 29.4% IR), and large (25% flexion, 64.7% IR, 66.7% ER). For goniometric assessment mean observed changes ranged as follows: flexion: 0.1° to 12.2°; IR: 3.6° to 21.9°; ER: –2.6° to 12.8°. For computed tomography–simulated assessment, the mean observed change ranged as follows: flexion: 3.0° to 8.0°; IR 9.3° to 14.0°. Conclusions Outcome studies demonstrate overall increased range of flexion and IR post-hip arthroscopy, with a moderate and large effect respectively. Change in ER is less impacted following hip arthroscopy. Certainty of evidence to support this observation is low. Current research evaluating changes in this functional ability is limited by a lack of prospective studies and non-standardized measurement evaluation techniques. Level of Evidence Level IV, systematic review of Level II-IV studies.
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Affiliation(s)
- David Filan
- UPMC Whitfield, Waterford, Ireland
- Address correspondence to David Filan, Suite 5, UPMC Whitfield, Butlerstown North, Cork Road, Waterford, Ireland.
| | | | - Patrick Carton
- Hip and Groin Clinic, Waterford, Ireland
- UPMC Whitfield, Waterford, Ireland
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Pazzinatto MF, Rio EK, Crossley KM, Coburn SL, Johnston R, Jones DM, Kemp JL. The relationship between kinesiophobia and self-reported outcomes and physical function differs between women and men with femoroacetabular impingement syndrome. Braz J Phys Ther 2022; 26:100396. [DOI: 10.1016/j.bjpt.2022.100396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 03/29/2023] Open
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Martins SCS, Resende RA, Pinheiro LSP, Souza TR, Pinto RZ, Andrade AGP, Lustosa LP, Ocarino JM. Prediction equation of hip external rotators maximum torque in healthy adults and older adults using the measure of hip extensors maximum torque. Braz J Phys Ther 2021; 25:415-420. [PMID: 32962913 PMCID: PMC8353290 DOI: 10.1016/j.bjpt.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/29/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The use of predictive equation of muscular torque can reduce physical effort and time spent during evaluation. OBJECTIVES To establish, validate, and test the accuracy of a prediction equation to estimate the hip external rotators (HER) torque in adults and older adults by means of hip extensors (HEX) torque measurement. METHODS Eighty-three healthy adults (development set) were assessed to test the association of HEX and HER torques and to establish the prediction equation. A separate 36 adults and 15 older adults (validation sets) were assessed to test the ability of the equation to estimate HER torque. Hip isometric strength was assessed by a handheld dynamometer. RESULTS Simple linear regression analysis revealed that HEX torque was associated with HER torque (r=0.80; p<0.0001), resulting in the following prediction equation: HERtorque=-0.02+(0.58 * HEXtorque). Paired t-test revealed no difference between directly measured and predicted values of HER torque in adults (mean difference=0.02; 95% CI=-0.115, 0.072) and older adults (mean difference=0.05; 95% CI=-0.02, 0.12). CONCLUSION The HEX and HER torques were strongly correlated. The prediction equation was valid, accurate, and can be used to estimate HER muscle strength in healthy adults and older adults, requiring only the direct measurement of HEX torque.
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Affiliation(s)
- Suelen Cristina Souza Martins
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Renan Alves Resende
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Larissa Santos Pinto Pinheiro
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Thales Rezende Souza
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rafael Zambelli Pinto
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - André Gustavo Pereira Andrade
- Graduate Program of Sports Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lygia Paccini Lustosa
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana Melo Ocarino
- Human Performance Laboratory, Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Miyasaki MR, Marcioli MAR, Cunha APRRD, Polesello GC, Marini MG, Fernandes KBP, Macedo CDSG. Greater trochanteric pain syndrome in women: Analysis of magnetic resonance, sagittal alignment, muscular strength and endurance of the hip and trunk. Int J Rheum Dis 2021; 24:941-947. [PMID: 34110084 DOI: 10.1111/1756-185x.14149] [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: 03/01/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION There are many studies on the Greater Trochanteric Pain Syndrome (GTPS), however its relationship with radiographic and biomechanics parameters is not established. OBJECTIVE To compare the magnetic resonance images (MRI) of the hip, radiographic parameters of sagittal alignment (pelvic incidence, sacral slope and lumbar lordosis), muscular strength and endurance in women with and without GTPS. METHODS Forty women, age over 45, IMC <30 Kg/m2 and sedentary, were recruited and distributed in two groups: GTPS group (GTPSG, n = 20) and Control group (CG, n = 20). All participants underwent MRI scans and X-ray for sagittal alignment analysis in the hip and performed tests for muscular strength and endurance of the hip and trunk. RESULTS No differences were found between the GTPSG and CG for the frequency of tendinopathy (P = .30), peritendinitis (P = .10), bursitis (P = .68) and enthesitis (P = .15), however the gluteus medius tendon tear was more prevalent in GTPSG (P = .05). There were no differences in radiographic parameters for pelvic incidence (P > .05), sacral slope (P > .05) and lumbar lordosis (P > .05). The GTPSG showed lower strength of all hip muscle groups (abductors, adductors, flexors, extensors and rotators; P < .01 for all), as well as lower endurance in the Supine Bridge test and Prone bridge test (P < .01). CONCLUSION The results of the MRI and radiographic parameters did not differentiate women with and without GTPS. However, the evaluation of muscle strength and endurance can establish the difference between groups.
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Affiliation(s)
| | | | | | | | | | | | - Christiane de Souza Guerino Macedo
- Postgraduation program in Rehabilitation Sciences, UEL/UNOPAR, Paraná, Brazil.,Physical Therapy Department, Universidade Estadual de Londrina (UEL), Paraná, Brazil
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Tateuchi H, Yamagata M, Asayama A, Ichihashi N. Influence of simulated hip muscle weakness on hip joint forces during deep squatting. J Sports Sci 2021; 39:2289-2297. [PMID: 34006185 DOI: 10.1080/02640414.2021.1929009] [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] [Indexed: 10/21/2022]
Abstract
This study aimed to determine the effects of simulated hip muscle weakness on changes in hip joint forces during deep squat motion. Ten healthy individuals performed squat motion at three different positions (0° foot angle [N-squat], 10° toe-in [IN-squat], and 30° toe-out [OUT-squat]). A scaled musculoskeletal model for each participant was used to calculate the muscle and hip joint forces. For each hip muscle, models of full strength, mild muscle weakness (15% decrease), and severe muscle weakness (30% decrease) were created. The muscles affecting the hip joint forces were identified, and the rate of change in the joint forces was compared among the three squat conditions. The anterior hip joint force was increased in the muscle weakness models of the inferior gluteus maximus (iGlutMax) and iGlutMax+deep external rotator (ExtRot) muscles. With 30% muscle weakness of these muscles, statistically significant differences in the rate of increase in the anterior joint force were observed in the following order: IN-squat (iGlutMax, 29.5%; iGlutMax+ExtRot, 41.4%), N-squat (iGlutMax, 18.3%; iGlutMax+ExtRot, 27.8%), and OUT-squat (iGlutMax, 5.6%; iGlutMax+ExtRot, 9.3%). OUT-squat may be recommended to minimize the increase in hip joint forces if accompanied by hip muscle weakness.
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Affiliation(s)
- Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Yamagata
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Graduate School of Human Development and Environment, Kobe University, Hyogo, Japan.,Japan Society for the Promotion of Science, Japan
| | - Akihiro Asayama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9040427. [PMID: 33917036 PMCID: PMC8067745 DOI: 10.3390/healthcare9040427] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Stretching is known to improve range of motion (ROM), and evidence has suggested that strength training (ST) is effective too. However, it is unclear whether its efficacy is comparable to stretching. The goal was to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of ST and stretching on ROM (INPLASY 10.37766/inplasy2020.9.0098). (2) Methods: Cochrane Library, EBSCO, PubMed, Scielo, Scopus, and Web of Science were consulted in October 2020 and updated in March 2021, followed by search within reference lists and expert suggestions (no constraints on language or year). Eligibility criteria: (P) Humans of any condition; (I) ST interventions; (C) stretching (O) ROM; (S) supervised RCTs. (3) Results: Eleven articles (n = 452 participants) were included. Pooled data showed no differences between ST and stretching on ROM (ES = −0.22; 95% CI = −0.55 to 0.12; p = 0.206). Sub-group analyses based on risk of bias, active vs. passive ROM, and movement-per-joint analyses showed no between-protocol differences in ROM gains. (4) Conclusions: ST and stretching were not different in their effects on ROM, but the studies were highly heterogeneous in terms of design, protocols and populations, and so further research is warranted. However, the qualitative effects of all the studies were quite homogeneous.
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Bagwell JJ, Powers CM. Persons with femoroacetabular impingement syndrome exhibit altered pelvifemoral coordination during weightbearing and non-weightbearing tasks. Clin Biomech (Bristol, Avon) 2019; 65:51-56. [PMID: 30978618 DOI: 10.1016/j.clinbiomech.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies have reported that persons with femoroacetabular impingement syndrome (FAIS) have diminished posterior tilt of the pelvis during functional tasks. It is not known how this movement impairment impacts pelvifemoral coordination during weightbearing and non-weightbearing movements. METHODS Fifteen persons with a diagnosis of FAIS and 15 matched controls performed a deep squat (weightbearing) and a maximum height stepping task (non-weightbearing). Peak hip flexion, posterior pelvis tilt excursion, and the ratio of sagittal plane pelvis to femur motion during the period of pelvis posterior tilt were calculated for each task. Two factor ANOVAs were used to evaluate differences between groups and tasks. FINDINGS With regards to peak hip flexion, there were no significant group differences for either task. When averaged across tasks, the FAIS group exhibited significantly less posterior tilt excursion (12.1° (SD 9.1°) vs 20.6° (SD 9.3°)) and smaller pelvifemoral ratios (0.24 (SD 0.14) vs 0.39 (SD 0.16)) compared to the control group. INTERPRETATION Persons with FAIS exhibit altered pelvifemoral coordination regardless of weightbearing status. This finding suggests that decreased hip and/or lumbopelvic mobility may contribute to altered movement patterns at the hip.
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Affiliation(s)
- Jennifer J Bagwell
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA.
| | - Christopher M Powers
- Division of Biokinesiology & Physical Therapy, University of Southern California, 1540 Alcazar Street, CHP-155, Los Angeles, CA 90740, USA.
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