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Lim W. The test-induced warm-up effect on hamstring flexibility tests. Hong Kong Physiother J 2024; 44:119-125. [PMID: 38510156 PMCID: PMC10949106 DOI: 10.1142/s1013702524500094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 10/30/2023] [Indexed: 03/22/2024] Open
Abstract
Background Although the effect of active warm-up (WU) on acute flexibility enhancement is well documented, the test-induced WU effect in muscle length test has not been widely studied. Objective This study aimed to verify the test-induced WU effect on hamstring flexibility tests. Methods The active knee extension (AKE) was performed using the right leg, whereas the straight leg raise (SLR) was performed using the left leg. Ten trials of AKE or SLR were performed: two as the pre-intervention trials (Pre); six as the WU intervention; and another two trials as the post-intervention (Post). During WU, subjects in the WO-Hold group performed six trials of the AKE or SLR without hold, and those in the W-Hold group performed six trials of the AKE or SLR with a 5 s hold. Results A significant difference was noted between Pre-AKE and Post-AKE, and between Pre-SLR and Post-SLR, respectively, in both the groups. The effect of WU is clear when performing consecutive AKE or SLR without any additional hold. Conclusion Practitioners should be cautious in interpreting the testing result to avoid overestimation of the treatment effect since the test itself may induce substantial WU effect to the target tissues.
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Affiliation(s)
- Wootaek Lim
- Department of Physical Therapy, College of Health and Welfare, Woosong University, Daejeon, Republic of Korea
- Department of Digital Bio-Health Convergence, College of Health and Welfare, Woosong University, Daejeon, Republic of Korea
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Goller M, Quittmann OJ, Alt T. How to activate the glutes best? Peak muscle activity of acceleration-specific pre-activation and traditional strength training exercises. Eur J Appl Physiol 2024; 124:1757-1769. [PMID: 38280014 PMCID: PMC11130056 DOI: 10.1007/s00421-023-05400-3] [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] [Received: 06/01/2023] [Accepted: 12/05/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE Isometric training and pre-activation are proven to enhance acceleration performance. However, traditional strength training exercises do not mirror the acceleration-specific activation patterns of the gluteal muscles, characterized by ipsilateral hip extension during contralateral hip flexion. Therefore, the aim of the study was to determine gluteal muscle activity of acceleration-specific exercises compared to traditional strength training exercises. METHODS In a cross-sectional study design, the peak electromyographic activity of two acceleration-specific exercises was investigated and compared to two traditional strength training exercises each for the gluteus maximus and medius. Twenty-four participants from various athletic backgrounds (13 males, 11 females, 26 years, 178 cm, 77 kg) performed four gluteus maximus [half-kneeling glute squeeze (HKGS), resisted knee split (RKS), hip thrust (HT), split squat (SS)] and four gluteus medius [resisted prone hip abduction (RPHA), isometric clam (IC), side-plank with leg abduction (SP), resisted side-stepping (RSS)] exercises in a randomized order. RESULTS The RKS (p = 0.011, d = 0.96) and the HKGS (p = 0.064, d = 0.68) elicited higher peak gluteus maximus activity than the SS with large and moderate effects, respectively. No significant differences (p > 0.05) were found between the HT, RKS and HKGS. The RPHA elicited significantly higher gluteus medius activity with a large effect compared to RSS (p < 0.001, d = 1.41) and a moderate effect relative to the SP (p = 0.002, d = 0.78). CONCLUSION The acceleration-specific exercises effectively activate the gluteal muscles for pre-activation and strength training purposes and might help improve horizontal acceleration due to their direct coordinative transfer.
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Affiliation(s)
- Maximilian Goller
- Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
| | - Oliver J Quittmann
- Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Tobias Alt
- Department of Biomechanics, Performance Analysis and Strength and Conditioning, Olympic Training and Testing Centre Westphalia, Dortmund, Germany
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van Benten E, Coppieters MW, Pool JJM, Pool-Goudzwaard AL. Differences in balance control despite self-reported resolution of pregnancy-related pelvic girdle pain. A cross-sectional study. Musculoskelet Sci Pract 2022; 62:102620. [PMID: 35839702 DOI: 10.1016/j.msksp.2022.102620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Motor control patterns are altered when women with pregnancy-related pelvic girdle pain (PGP) experience pain. In low back pain, these adaptations can persist after recovery. OBJECTIVES This study aimed to assess balance control in postpartum women with and without a history of PGP during pregnancy. DESIGN Cross-sectional study. METHOD Eighteen postpartum women who reported to be recovered from PGP, and twelve postpartum women without a history of PGP during pregnancy performed two clinical tests: the single leg stance and active straight leg raise test. Primary outcomes were ground reaction forces measured with a force platform. RESULTS Multiple linear regression analyses showed smaller lateral displacement (β = -11cm; 95%CI: 19 to -3; p = 0.008) and lower displacement velocity of the Centre of Pressure (COP) (Ratio of Geometric Means (RGM) 0.76; 95%CI: 0.59 to 0.99; p = 0.043) during single leg stance in the participants with a history of PGP compared to participants without a history of PGP. Push-off force (β = -4.8 N; 95%CI: 22.0 to 12.5; p = 0.57) and asymmetry of push-off force (RGM 1.77; 95%CI: 0.62 to 5.04; p = 0.27) did not differ between groups. During the active straight leg raise test, no differences in lateral displacement (β = 3 cm; 95%CI: 3 to 8; p = 0.30) and COP displacement velocity (RGM 1.03; 95%CI: 0.70 to 1.52; p = 0.87) were observed. CONCLUSIONS Although the women with a history of PGP considered themselves recovered, their balance control during single leg stance was poorer compared to those without a history of PGP. No differences were found during the active straight leg raise test.
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Affiliation(s)
- Esther van Benten
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3501 AA, Utrecht, the Netherlands.
| | - Michel W Coppieters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Menzies Health Institute Queensland, Brisbane and Gold Coast Campus, Griffith University, 170 Kessels Road, QLD 4111, Nathan, Australia
| | - Jan J M Pool
- HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3501 AA, Utrecht, the Netherlands
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; SOMT University of Physiotherapy, Softwareweg 5, 3821 BN, Amersfoort, the Netherlands
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Oshikawa T, Adachi G, Akuzawa H, Okubo Y, Kaneoka K. Coordinate activity of the quadratus lumborum posterior layer, lumbar multifidus, erector spinae, and gluteus medius during single-leg forward landing. J Electromyogr Kinesiol 2021; 61:102605. [PMID: 34563761 DOI: 10.1016/j.jelekin.2021.102605] [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: 04/13/2021] [Revised: 08/20/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022] Open
Abstract
This study aimed to clarify the differences in electromyographic activity between the quadratus lumborum anterior (QL-a) and posterior layers (QL-p), and the relationship among trunk muscles and gluteus medius (GMed) activities during forward landing. Thirteen healthy men performed double-leg and single-leg (ipsilateral or contralateral sides as the electromyography measurement of trunk muscles) forward landings from a 30 cm-height-box. The onset of electromyographic activity in pre-landing and the electromyographic amplitude of the unilateral QL-a, QL-p, abdominal muscles, lumbar multifidus (LMF), erector spinae (LES), and bilateral GMed were recorded. Two-way ANOVA was used to compare the onset of electromyographic activity (3 landing leg conditions × 10 muscles) and electromyographic amplitude among (3 landing leg conditions × 2 phases). The onset of QL-p was significantly earlier in contralateral-leg landing than in the double-leg and ipsilateral-leg landings. The onset of LMF and LES was significantly earlier than that of the abdominal muscles in contralateral-leg landing. QL-p activity and GMed activity on the contralateral leg side in the pre-landing were significantly higher in contralateral-leg landing than in the other leg landings. To prepare for pelvic and trunk movements after ground contact, LMF, LES, QL-p on non-support leg side, and GMed on support leg side showed early or high feedforward activation before ground contact during single-leg forward landing.
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Affiliation(s)
| | - Gen Adachi
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - Hiroshi Akuzawa
- Waseda Institute for Sport Sciences, Waseda University, Tokyo, Japan
| | - Yu Okubo
- Faculty of Health & Medical Care, Saitama Medical University, Saitama, Japan
| | - Koji Kaneoka
- Waseda Institute for Sport Sciences, Waseda University, Tokyo, Japan
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Ramachandra P. Telerehabilitation for pelvic girdle dysfunction in pregnancy during COVID-19 pandemic crisis: A case report. Physiother Theory Pract 2021; 38:2250-2256. [PMID: 33719853 DOI: 10.1080/09593985.2021.1898706] [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] [Indexed: 10/21/2022]
Abstract
Background: Pelvic girdle dysfunction is a common musculoskeletal disorder among pregnant women. It is a disabling condition affecting the ability of a pregnant woman to perform her daily functional activities. The scope of digital health in delivering rehabilitation services is growing exponentially, especially in the present COVID -19 pandemic crisis.Case description: A 29-year-old primigravida, at 32 weeks of gestation with severe pelvic girdle pain during bed transitions, sought physiotherapy consultation via video call, as she expressed difficulty in accessing Physiotherapy services due to the present pandemic crisis. Physiotherapy consultation was provided in 4 weekly sessions using a real-time video-based telerehabilitation program and the patient performed unsupervised exercise sessions for 30 minutes for 5 days per week for 4 weeks. The plan of care included muscle energy techniques, pelvic cloth belt, strengthening, stabilization exercises and stretching.Outcomes: The patient completed four sessions including evaluation and treatment and there was a reduction of pain scores for bed transitions from NPRS 8/10 during session one to NPRS 0/10 during session four. The Pelvic girdle dysfunction questionnaire showed a decrease in percentage scores from 54.6 to 4 at the end of physiotherapy sessions.Conclusion: Telerehabilitation was successfully used to manage a pregnant woman with pelvic girdle dysfunction.
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Affiliation(s)
- Preetha Ramachandra
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, KA, India
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Yoo HI, Hwang UJ, Ahn SH, Gwak GT, Kwon OY. Comparison of pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between people with and without nonspecific low back pain. Clin Biomech (Bristol, Avon) 2021; 83:105310. [PMID: 33721727 DOI: 10.1016/j.clinbiomech.2021.105310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Faults in postural alignment and movement of the pelvis are associated with non-specific low back pain. However, limited studies have investigated the differences in pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between subjects with and without non-specific low back pain. METHODS Thirty-one subjects with non-specific low back pain and 31 subjects without non-specific low back pain were examined. Angular measures of the pelvic rotation angle in the transverse plane were obtained in the supine position and during active straight leg raise using a Smart KEMA measurement system. FINDING The pelvic rotation angle in the transverse plane during active straight leg raise was significantly greater in subjects with non-specific low back pain than in healthy subjects (p < 0.05). However, the pelvic rotation angle in the transverse plane in the supine position and asymmetry index of the pelvic rotation angle during active straight leg raise were not significantly different between subjects with and those without non-specific low back pain. INTERPRETATION This indicates that a greater pelvic rotation angle in the transverse plane during active straight leg raise could be contributing factors to the development of a non-specific low back pain related to lumbopelvic instability.
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Affiliation(s)
- Hwa-Ik Yoo
- Department of Physical Therapy, Graduate School, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea; Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea
| | - Ui-Jae Hwang
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea
| | - Sun-Hee Ahn
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea
| | - Gyeong-Tae Gwak
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 220-710, South Korea.
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Werin MB, Maenhout AG, Icket J, Jacxsens N, Kempkes E, Cools AM. Does the Activity in Scapular Muscles During Plyometric Exercises Change When the Kinetic Chain Is Challenged?-An EMG Study. J Strength Cond Res 2020; 36:1793-1800. [PMID: 33065707 DOI: 10.1519/jsc.0000000000003747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Werin, MB, Maenhout, AG, Icket, J, Jacxsens, N, Kempkes, E, and Cools, AM. Does the activity in scapular muscles during plyometric exercises change when the kinetic chain is challenged?-An EMG study. J Strength Cond Res XX(X): 000-000, 2020-Plyometric exercises for the shoulder are used in rehabilitation and in workout regime when the sport demands high speed power training. The aim of this clinical laboratory electromyography (EMG) study was to determine whether scapular muscle performance differs during plyometric shoulder exercises when changing the demand on the kinetic chain. Thirty healthy overhead athletes, with a mean age of 22.7 years (±2.2), performed 6 exercises, with both a low and a high demand on the kinetic chain, in prone, side and standing in positions. The EMG activity of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) on the tested side and bilateral of gluteus maximus (GM) and abdominal oblique externus (OE) was registered with wireless surface EMG. Intermuscular muscle ratios UT/SA, UT/MT, and UT/LT were also calculated. The level of significance set for the study was alpha = 0.05. The muscle ratio UT/SA was significantly lower (p < 0.05) when high demand on the kinetic chain compared with low. SA muscle activity showed significantly (<0.001) higher values in the prone position with high demand on the kinetic chain compared with low. All 3 trapezius muscle parts had significantly higher values (p < 0.001) in the prone compared with side and standing positions. The GM and OE showed significantly higher (p ≤ 0.01) activity in positions more demanding for the kinetic chain. When composing a strengthening or a rehabilitation program for athletes, the knowledge of how scapular and trunk muscles interact can be used to amplify the strengthening effect.
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Affiliation(s)
- Maria B Werin
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
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Elsais WM, Preece SJ, Jones RK, Herrington L. Could Relative Movement Between the Adductor Muscles and the Skin Invalidate Surface Electromyography Measurement? J Appl Biomech 2020; 36:319-325. [PMID: 32796135 DOI: 10.1123/jab.2019-0299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/20/2020] [Accepted: 05/13/2020] [Indexed: 10/27/2023]
Abstract
The superficial hip adductor muscles are situated in close proximity to each other. Therefore, relative movement between the overlying skin and the muscle belly could lead to a shift in the position of surface electromyography (EMG) electrodes and contamination of EMG signals with activity from neighboring muscles. The aim of this study was to explore whether hip movements or isometric contraction could lead to relative movement between the overlying skin and 3 adductor muscles: adductor magnus, adductor longus, and adductor gracilis. The authors also sought to investigate isometric torque-EMG relationships for the 3 adductor muscles. Ultrasound measurement showed that EMG electrodes maintained a position which was at least 5 mm within the muscle boundary across a range of hip flexion-extension angles and across different contraction levels. The authors also observed a linear relationship between torque and EMG amplitude. This is the first study to use ultrasound to track the relative motion between skin and muscle and provides new insight into electrode positioning. The findings provide confidence that ultrasound-based positioning of EMG electrodes can be used to derive meaningful information on output from the adductor muscles and constitute a step toward recognized guidelines for surface EMG measurement of the adductors.
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The Pelvic Girdle Pain deadlock: 2. Topics that, so far, have remained out of focus. Musculoskelet Sci Pract 2020; 48:102166. [PMID: 32560869 DOI: 10.1016/j.msksp.2020.102166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION In our preceding paper, we concluded that Pelvic Girdle Pain (PGP) should be taken seriously. Still, we do not know its causes. Literature reviews on treatment fail to reveal a consistent pattern, and there are patients who do not respond well to treatment. We designated the lack of progress in research and in the clinic as 'deadlock', and proposed a 'deconstruction' of PGP, that is to say, taking PGP apart into its relevant dimensions. PURPOSE We examine the proposition that PGP may emerge as local inflammation. Inflammation would be a new dimension to be taken into account, between biomechanics and psychology. To explore the consequences of this idea, we present four different topics that, so far, have remained out of focus. One: The importance of microtrauma. Two: Ways to counteract chronification. Three: The importance of sickness behaviour when systemic inflammation turns into neuroinflammation of the brain. And Four: The mainly emotional and cognitive nature of chronic pain, and how aberrant neuroinflammation may render chronic pain intractable. For intractable pain, sleep and stress management are promising treatment options. IMPLICATIONS The authors hope that the present paper helps to stimulate the flexible creativity that is required to deal with the biological and psychological impact of PGP. Measuring inflammatory mediators in PGP should be a research priority. It should be understood that the boundaries between biology and psychology are becoming blurred. Clinicians must frequently monitor pain, disability, and mood, and be ready to switch treatment whenever the patient does not improve.
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Schopper C, Faschingbauer M, Moeller RT, Gebhard F, Duerselen L, Seitz A. Modified Candy-Package technique vs Cerclage technique for refixation of the lesser trochanteric fragment in pertrochanteric femoral fractures. A biomechanical comparison of 10 specimens. Injury 2020; 51:1763-1768. [PMID: 32580889 DOI: 10.1016/j.injury.2020.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Separation of the lesser trochanteric fragment in pertrochanteric 3-part fractures leads to a significant weakening of the medial cortical wall. Because of the attachment of the Iliopsoas muscle to this structure, the lesser trochanteric fragment tends to cranial dislocation along this muscle's action direction. Refixation of these fractures using an intramedullary nail and an additional wiring osteosynthesis can be considered an operative standard. Based on an intramedullary osteosynthesis procedure, the question was raised whether a 2-point fixation method was favourable over a 1-point method regarding the pull-out resistance of the lesser trochanteric fragment against the Iliopsoas muscle's force. METHODS Based on an intramedullary osteosynthesis (PFNA, DePuy/Synthes/SUI), two groups á five human femora were defined depending on the refixation technique of the lesser trochanteric fragment (1-point supertrochanteric "Cable" vs 2-point super/subtrochanteric fixation "Candy-Package" performed with a 1.25-mm steel cerclage). The specimens were tested using a novel traction setup, simulating the activity pattern of the Iliopsoas muscle. The target value was the resistance of the refixated lesser trochanteric fragment against a defined pull-out force produced by the Iliopsoas muscle. The main parameters considered were the peak traction force (Fmax) and the maximum summative work (WFmax) at construct failure. RESULTS The Fmax and WFmax displayed a significant difference in favour of the Candy-Package (2-point super/subtrochanteric fixation) group (822 N vs. 476 N, 13.8 k Nmm vs 4.4 k Nmm, respectively; P = 0.01). CONCLUSIONS The Candy-Package technique is a method that displays significantly more resistance than a single cerclage osteosynthesis regarding fragment loosening under the application of a simulated Iliopsoas muscle force in the course of a biomechanical proximal femoral 3-part fracture model.
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Affiliation(s)
- C Schopper
- Clinic for Orthopedic Trauma, University Hospital Ulm DE, Ulm, Germany.
| | - M Faschingbauer
- Clinic for Orthopedics, University Hospital Ulm DE, Ulm, Germany
| | - R-T Moeller
- Clinic for Orthopedic Trauma, University Hospital Ulm DE, Ulm, Germany
| | - F Gebhard
- Clinic for Orthopedic Trauma, University Hospital Ulm DE, Ulm, Germany
| | - L Duerselen
- Institute of Orthopedic Research and Biomechanics, University Ulm DE, Ulm, Germany
| | - A Seitz
- Institute of Orthopedic Research and Biomechanics, University Ulm DE, Ulm, Germany
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Aldabe D, Milosavljevic S, Bussey MD. A multivariate model for predicting PPGP considering postural adjustment parameters. Musculoskelet Sci Pract 2020; 48:102153. [PMID: 32560861 DOI: 10.1016/j.msksp.2020.102153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/25/2019] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Prospective studies have described evidence about the risk of developing pregnancy-related pelvic girdle pain (PPGP) such as, parity, previous history of low back and pelvic girdle pain. No previous studies have prospectively associated PPGP with postural control. AIM This study aimed to identify postural control predictors of PPGP during pregnancy. METHODS Forty-six pregnant women were surveyed throughout their pregnancy for the presence of PPGP. At baseline, participants were evaluated for muscle latencies, mediolateral centre-of-pressure (COP) displacement and velocity during single-leg lift performed with eyes open and closed. PPGP was considered if they presented with one positive clinical assessment as well as pain within the pelvic area. RESULTS Eighteen (45%) of the participants developed PPGP. This group presented with PPGP around a mean 29th week (SD = 5.7), with mean pelvic pain intensity of 4 mm VAS (SD = 2) on a (0-10 cm VAS) and mean PPGP questionnaire score of 21.5 points (SD = 10.6) out of a possible 100 points with 0 indicating no functional disability. The two factors that were significantly associated with PPGP were the right and left biceps femoris (BF) muscle. For every 50 ms of difference of BF muscles latency between eyes open and closed, the risk of PPGP increases by 20% (right BF) and 30% (left BF) to develop PPGP. CONCLUSION(S) This study shows that BF muscle delay during single-leg lift presented at baseline was a significant predictor for the development of PPGP in late pregnancy.
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Affiliation(s)
- Daniela Aldabe
- School of Physiotherapy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Stephan Milosavljevic
- School of Physiotherapy, University of Saskatchewan, Health Sciences Building, E-Wing Suite 3400, 3rd Floor, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
| | - Melanie D Bussey
- School of Physical Education, Sports and Exercise Science, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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The pelvic girdle pain deadlock: 1. Would 'deconstruction' help? Musculoskelet Sci Pract 2020; 48:102169. [PMID: 32560871 DOI: 10.1016/j.msksp.2020.102169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Pelvic Girdle Pain (PGP) is an important clinical problem that deserves more attention. Several treatment regimens have been presented that appear to be somewhat promising, but it was reported that about 10% of patients still suffer from the problems 11 years after their inception. This situation should be improved. PURPOSE We present a personalized history, with first the acceptance of the concept of 'PGP', around 2005, and then continued problems in really understanding PGP's nature and causes. We propose to engage in 'deconstruction' of PGP, that is, disentangling the large variety of processes involved. IMPLICATIONS Deconstructing PGP is a venture into the unknown. Still, science should proceed on the basis of what we know already. To understand PGP, experts emphasize the importance of biomechanics or of psychology, and we propose to insert 'inflammation' between these two levels of understanding, that is to say, the full development from low grade local inflammation to systemic inflammation and neuroinflammation. Inflammation is bidirectionally related to biomechanical as well as psychological processes. For clinicians, challenging our "beliefs and understanding of PGP, rather than being 'stuck' with a preferred modus operandi" has major practical implications. It requires continuous monitoring of the patient, and a willingness to change direction. More scientific disciplines are relevant to understanding, and treating, PGP than a single human being can master. Creative flexibility of clinicians would be a promising starting point to improve overall treatment effects in PGP.
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Solana-Tramunt M, Ortegón A, Morales J, Nieto A, Nishishinya MB, Villafañe JH. Diagnostic accuracy of lumbopelvic motor control tests using pressure biofeedback unit in professional swimmers: A cross-sectional study. J Orthop 2019; 16:590-595. [PMID: 31686760 DOI: 10.1016/j.jor.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 03/11/2019] [Accepted: 06/02/2019] [Indexed: 11/18/2022] Open
Abstract
Hypothesis To determine the effect of receiving the visual feedback of the sphygmomanometer on lumbopelvic motor control (LPMC) tests in professional swimmers. Method 31 professional swimmers to participate in the study. The outcome was maximum absolute mmHg variation in the pressure biofeedback unit's manometer with and without visual feedback on four LPMC tests. Results Test scores were significantly affected by visual feedback F = 10.07, p = 0.002, η2 p = 0.117 and the type of test F = 32.53, p < 0.001, η2 p = 0.300. Conclusion Visual feedback has a positive effect on the Active Straight Leg Raise Test (ASLR), the Knee Lift Abdominal Test (KLAT) scores completed by professional swimmers.
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Affiliation(s)
- Mònica Solana-Tramunt
- Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Spain
- Royal Spanish Swimming Federation, Barcelona, Spain
| | - Alberto Ortegón
- Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Spain
- Lecturer on NSCA Certified Personal Trainer (NSCA-CPT®), Spain
| | - José Morales
- Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Spain
| | - Ainhoa Nieto
- Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Spain
| | - María Betina Nishishinya
- Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Spain
- Instituto Traumatológico Quirón, Spain
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14
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Abstract
The principles of form and force closure were introduced to describe the complex mechanism of sacroiliac joint (SIJ) stability. Form closure refers to a theoretical stable state of a joint with close fitting articular surfaces, where no extra forces are needed to maintain the stable state of the system during loading and unloading situations. If the sacrum would fit in the pelvis with perfect form closure, no lateral compressional forces would be needed to maintain stability. However, such a construction would make mobility practically impossible. Force closure is the theoretical state where lateral force and friction resulting in joint compression, are required for the joint to withstand a vertical load. Structures that contribute to SIJ stability via "form closure" include (1) the configuration of the interfacing joint surfaces, along with dorsocranial "wedging" of the sacrum into the ilia; (2) the corresponding ridges and grooves of the articular surfaces of the SIJs and resultant high coefficient of friction; and (3) the integrity of the binding ligaments, which are among the strongest in the body. Shearing forces absorbed in the SIJ occur because of a combination of person-specific anatomical features. This results in unique form and force closure situations that provide effective and tailored joint accommodation that balance both friction and compression in the joint. Force closure occurs because of altered joint reaction force via taut ligaments, fascia, muscles, and the ground reaction force they are reacting to at the moment. In the ideal state, force closure creates a perpendicular compressive reaction force to the SIJ to adapt and overcome the forces of gravity. In order for force closure to be effective, sacral nutation must occur and is considered to be anticipatory for joint loading. Sacral nutation results in tensing all of the dorsal SIJ ligaments (interosseous, dorsal sacroiliac) with the exception of one, the long dorsal ligament (LDL). This prepares the pelvis to absorb and increase in load. As a result, the posterior ilium are pressed together causing an increase in SIJ compression. This review will discuss the importance of understanding form and force closure principles because they are related to understanding the relationship of anatomy and function of the SIJ.
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Affiliation(s)
- Andry Vleeming
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Anatomy, University of New England College of Osteopathic Medicine, Biddeford, ME
| | - Mark Schuenke
- Department of Anatomy, University of New England College of Osteopathic Medicine, Biddeford, ME
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15
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Suehiro T, Yakushijin Y, Nuibe A, Ishii S, Kurozumi C, Ishida H. Effect of pelvic belt on the perception of difficulty and muscle activity during active straight leg raising test in pain-free subjects. J Exerc Rehabil 2019; 15:449-453. [PMID: 31316940 PMCID: PMC6614771 DOI: 10.12965/jer.1938140.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/17/2019] [Indexed: 11/24/2022] Open
Abstract
A pelvic belt decreases patient-reported perception of difficulty during the active straight leg raising (ASLR) test in individuals with pelvic girdle pain. However, the influence of a pelvic belt on the perception of difficulty during ASLR was not investigated in pain-free subjects. Therefore, this influence excluding the impact of pain is not clear. This paper aimed to clarify the effect of a pelvic belt on the perception of difficulty and muscle activity during ASLR performance in the subjective heavier side leg in pain-free subjects. Twenty pain-free female subjects participated. ASLR using the subjective heavier side leg was performed under two conditions: without and with a pelvic belt. Muscle activation of the external oblique, internal oblique, rectus abdominis, rectus femoris, and biceps femoris was measured during ASLR using a surface electromyograph. Difference in perceived difficulty in performing ASLR with and without a belt was assessed. In total, 80% of subjects had decreased perception of difficulty using a pelvic belt during ASLR. For ASLR performed with a pelvic belt, muscle activity significantly decreased in the contralateral rectus abdominis, ipsilateral external oblique, and bilateral internal oblique (P<0.05), while it significantly increased in the contralateral biceps femoris (P<0.05). There were no significant differences in muscle activity of the ipsilateral rectus abdominis, contralateral external oblique, and ipsilateral rectus femoris between the two conditions (P>0.05). In conclusion, using a pelvic belt can decrease the perception of difficulty during ASLR, and the pelvic belt may improve impairment of load transfer between the trunk and pelvis.
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Affiliation(s)
- Tadanobu Suehiro
- Department of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Yuri Yakushijin
- Department of Rehabilitation, Matsuyama Rehabilitation Hospital, Matsuyama, Japan
| | - Ami Nuibe
- Department of Rehabilitation Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Sakura Ishii
- Department of Rehabilitation, Saiseikai Kibi Hospital, Okayama, Japan
| | - Chiharu Kurozumi
- Department of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Hiroshi Ishida
- Department of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
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16
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Cholewicki J, Breen A, Popovich JM, Reeves NP, Sahrmann SA, van Dillen LR, Vleeming A, Hodges PW. Can Biomechanics Research Lead to More Effective Treatment of Low Back Pain? A Point-Counterpoint Debate. J Orthop Sports Phys Ther 2019; 49:425-436. [PMID: 31092123 PMCID: PMC7394249 DOI: 10.2519/jospt.2019.8825] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SYNOPSIS Although biomechanics plays a role in the development and perhaps the persistent or recurrent nature of low back pain (LBP), whether biomechanics alone can provide the basis for intervention is debated. Biomechanics, which refers to the mechanics of the body, including its neuromuscular control, has been studied extensively in LBP. But, can gains be made in understanding LBP by research focused on this component of biology in the multifactorial biopsychosocial problem of LBP? This commentary considers whether biomechanics research has the potential to advance treatment of LBP, and how likely it is that this research will lead to better treatment strategies. A point-counterpoint format is taken to present both sides of the argument. First, the challenges faced by an approach that considers biomechanics in isolation are presented. Next, we describe 3 models that place substantial emphasis on biomechanical factors. Finally, reactions to each point are presented as a foundation for further research and clinical practice to progress understanding of the place for biomechanics in guiding treatment of LBP. J Orthop Sports Phys Ther 2019;49(6):425-436. Epub 15 May 2019. doi:10.2519/jospt.2019.8825.
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17
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Influence of Sacroiliac Bracing on Muscle Activation Strategies During 2 Functional Tasks in Standing-Tolerant and Standing-Intolerant Individuals. J Appl Biomech 2019; 35:107-115. [PMID: 30421635 DOI: 10.1123/jab.2018-0197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
People who develop low back pain during standing (standing-intolerant) are a subclinical group at risk for clinical low back pain. Standing-intolerant individuals respond favorably to stabilization exercise and may be similar to people with sacroiliac joint dysfunction that respond to stabilization approaches including sacroiliac joint (SIJ) bracing. The purpose was to characterize muscle activation and response to SIJ bracing in standing-tolerant and standing-intolerant individuals during forward flexion and unilateral stance. Trunk and hip electromyography data were collected from 31 participants (17 standing-tolerant and 14 standing-intolerant) while performing these tasks with and without SIJ bracing. Kinematics were captured concurrently and used for movement phase identification. Cross-correlation quantified trunk coactivation and extensor timing during return-to-stand from forward flexion; root mean square amplitude quantified gluteal activity during unilateral stance. The standing-intolerant group had elevated erector spinae-external oblique coactivation without bracing, and erector spinae-internal oblique coactivation with bracing during return-to-stand compared with standing-tolerant individuals. Both groups reversed extensor sequencing during return-to-stand with bracing. Standing-tolerant individuals had higher hip abductor activity in nondominant unilateral stance and increased hip extensor activity with bracing. SIJ bracing could be a useful adjunct to other interventions targeted toward facilitating appropriate muscle activation in standing-intolerant individuals.
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18
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Yamane M, Aoki M, Sasaki Y, Kawaji H. Understanding the Muscle Activity Pattern of the Hip Flexors during Straight Leg Raising in Healthy Subjects. Prog Rehabil Med 2019; 4:20190007. [PMID: 32789254 DOI: 10.2490/prm.20190007] [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: 12/18/2018] [Accepted: 02/06/2019] [Indexed: 11/09/2022] Open
Abstract
Objective The aim of this study was to elucidate the activities of the hip flexor muscles during straight leg raising (SLR) in healthy subjects. We also investigated the activities of these muscles during SLR with deep flexion, abduction, and external rotation. Methods The ten dominant right legs of ten male volunteers were analyzed in this study. Twelve SLR motion tasks were performed; these comprised combinations of hip flexion at 30°, 45°, and 60°; abduction at 0° and 20°; and external rotation at 0° and 30°. The activities of the psoas major (PM) and iliacus (IL) were measured using fine-wire electrodes, whereas the activities of the rectus femoris, sartorius, adductor longus, and tensor fasciae latae muscles were measured using surface electrodes. The percentage of the maximal voluntary isometric muscle contraction (%MVC) during SLR was calculated for each muscle and used for data analyses. The Friedman test and the Wilcoxon signed-rank test were performed for statistical analyses. The significance level was set at P <0.05. Results The %MVCs for the PM and IL at 60° flexion were significantly larger than those at 30° or 45° flexion. Moreover, for a constant hip flexion, the %MVC values for the PM and IL showed no significant changes when hip abduction and external rotation were added. For the other muscles, the %MVC values showed no significant change with increasing hip flexion with or without added abduction and external rotation. Conclusion Our findings suggest that subjects who perform SLR of up to 60° mainly activate the PM and IL at larger hip flexion angles, whereas the other muscles included in the analysis do not contribute greatly to increased flexion angles during SLR.
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Affiliation(s)
- Masahiro Yamane
- Department of Rehabilitation, Health Sciences University of Hokkaido Hospital, Sapporo, Japan
| | - Mitsuhiro Aoki
- Department of Physical Therapy, School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - Yuji Sasaki
- Department of Physical Therapy, School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - Hayato Kawaji
- Department of Rehabilitation, Health Sciences University of Hokkaido Hospital, Sapporo, Japan
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19
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Shin SS, Shin GC, Kim DH, Sim HM, Jeong JG, Yoo WG. The effects of a posterior superior iliac spine support device on upper trunk acceleration during gait in individuals with flat lumbar back posture. Technol Health Care 2018; 26:873-878. [PMID: 30282382 DOI: 10.3233/thc-181466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The orientation of the pelvis is of particular importance to the sagittal curve of the spine and has geometric relationships with the top of the spine and lumbar lordosis. Changes in spinal shape or disruptions of sagittal balance in the spine, such as a flattened lumbar spine, have significant negative effects. OBJECTIVE The aim of this study was to investigate the effects of the posterior superior iliac spine support device (PSD) on upper trunk acceleration during gait in individuals with flat lumbar back posture. METHODS In total, 10 young male subjects with reduced lumbar lordosis (global lumbar lordosis angle (T10-S2): <-20∘) were recruited for this study. Participants walked 7 m with and without wearing a PSD at a self-selected speed while fitted with an accelerometer attached over the T7 spinous process. RESULTS The normalized AP acceleration of T7 with PSD (40.57 ± 11.22%) was significantly higher than those without PSD (37.10 ± 10.46%, p= 0.035). CONCLUSIONS We found that wearing the PSD immediately improved pelvic physiological movement during walking in individuals with lumbar flat back posture. Our findings may help healthcare professionals manage flat back posture in asymptomatic younger individuals.
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20
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Paquette MR, Peel SA, Smith RE, Temme M, Dwyer JN. The Impact of Different Cross-Training Modalities on Performance and Injury-Related Variables in High School Cross Country Runners. J Strength Cond Res 2018; 32:1745-1753. [DOI: 10.1519/jsc.0000000000002042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Drew M, Palsson T, Hirata R, Izumi M, Lovell G, Welvaert M, Chiarelli P, Osmotherly P, Graven-Nielsen T. Experimental pain in the groin may refer into the lower abdomen: Implications to clinical assessments. J Sci Med Sport 2017; 20:904-909. [DOI: 10.1016/j.jsams.2017.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/14/2017] [Accepted: 04/16/2017] [Indexed: 11/27/2022]
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22
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Kim JM, Je HD, Kim HD. Effects of pelvic compression belts on the kinematics and kinetics of the lower extremities during sit-to-stand maneuvers. J Phys Ther Sci 2017; 29:1311-1317. [PMID: 28878454 PMCID: PMC5574350 DOI: 10.1589/jpts.29.1311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/09/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effects of a pelvic compression belt (PCB) and chair height on the kinematics and kinetics of the lower extremity during sit-to-stand (STS) maneuvers in healthy people. [Subjects and Methods] Twenty-two people participated in this study. They were required to perform STS maneuvers under four conditions. Hip joint moment and angular displacement of the hip, knee, and ankle were measured. A PCB was also applied below the anterior superior iliac spine. [Results] The angular displacement of the ankle joint increased while performing STS maneuvers from a normal chair with a PCB in phase 1, and decreased during phase 2 when performing STS maneuvers from a high chair. The overall angular displacement in phase 3 was decreased while rising from a chair with a PCB and rising from a high chair. When performed STS maneuvers from a high chair, the angular displacement of the hip, knee, and ankle joint decreased considerably in phase 3. This decreased lower extremity motion in phase 3 indicated that participants required less momentum to complete the maneuver. [Conclusion] The results of this study suggest that a PCB might be appropriate for patients with pelvic girdle pain and lower back pain related to pregnancy.
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Affiliation(s)
- Jong Moon Kim
- Department of Physical Therapy, College of Health Science, Korea University, Republic of Korea
| | - Hyun Dong Je
- Department of Pharmacology, College of Pharmacy, Catholic University of Daegu, Republic of Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Republic of Korea
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23
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An investigation into the immediate effects of pelvic taping on hamstring eccentric force in an elite male sprinter - A case report. Phys Ther Sport 2017; 28:15-22. [PMID: 28923589 DOI: 10.1016/j.ptsp.2017.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 07/17/2017] [Accepted: 08/04/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hamstring Injuries commonly cause missed training and competition time in elite sports. Injury surveillance studies have demonstrated high injury and re-injury rates, which have not improved across sports despite screening and prevention programmes being commonplace. The most commonly suggested intervention for hamstring prevention and rehabilitation is eccentric strength assessment and training. CASE DESCRIPTION This case study describes the management of an elite sprinter with a history of hamstring injury. A multi-variate screening process based around lumbar-pelvic dysfunction and hamstring strength assessment using the Nordbord is employed. The effect of external pelvic compression using a taping technique, on eccentric hamstring strength is evaluated. OUTCOMES A persistent eccentric strength asymmetry of 17% was recorded as well as lumbar-pelvic control deficits. Pelvic taping appears to improve load transfer capability across the pelvis, resulting in correction of eccentric strength asymmetry. DISCUSSION Screening strategies and interventions to prevent hamstring injury have failed to consistently improve injury rates across various sports. In this case study external pelvic compression resulted in normalising eccentric strength deficits assessed using the Nordbord. The inclusion of lumbar-pelvic motor control assessment, in relation to hamstring strength and function, as part of a multi-variate screening strategy requires further research.
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24
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Kibsgård TJ, Röhrl SM, Røise O, Sturesson B, Stuge B. Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain. Clin Biomech (Bristol, Avon) 2017; 47:40-45. [PMID: 28582642 DOI: 10.1016/j.clinbiomech.2017.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 05/05/2017] [Accepted: 05/25/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Active Straight Leg Raise is a functional test used in the assessment of pelvic girdle pain, and has shown to have good validity, reliability and responsiveness. The Active Straight Leg Raise is considered to examine the patients' ability to transfer load through the pelvis. It has been hypothesized that patients with pelvic girdle pain lack the ability to stabilize the pelvic girdle, probably due to instability or increased movement of the sacroiliac joint. This study examines the movement of the sacroiliac joints during the Active Straight Leg Raise in patients with pelvic girdle pain. METHODS Tantalum markers were inserted in the dorsal sacrum and ilium of 12 patients with long-lasting pelvic girdle pain scheduled for sacroiliac joint fusion surgery. Two to three weeks later movement of the sacroiliac joints during the Active Straight Leg Raise was measured with radiostereometric analysis. FINDINGS Small movements were detected. There was larger movement of the sacroiliac joint of the rested leg's sacroiliac joint compared to the lifted leg's side. A mean backward rotation of 0.8° and inward tilt of 0.3° were seen in the rested leg's sacroiliac joint. INTERPRETATION The movements of the sacroiliac joints during the Active Straight Leg Raise are small. There was a small backward rotation of the innominate bone relative to sacrum on the rested leg's side. Our findings contradict an earlier understanding that a forward rotation of the lifted leg's innominate occur while performing the Active Straight Leg Raise.
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Affiliation(s)
- Thomas J Kibsgård
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
| | - Stephan M Röhrl
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
| | - Olav Røise
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
| | - Bengt Sturesson
- Department of Orthopaedics, Aleris specialistvård, Ängelholm Hospital, Ängelholm, Sweden
| | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
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25
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Cha HG, Wu YT, Kim MK. The effects of a pelvic belt on trunk and lower extremity muscles in the bridge position. J Phys Ther Sci 2016; 28:3293-3295. [PMID: 28174437 PMCID: PMC5276746 DOI: 10.1589/jpts.28.3293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/02/2016] [Indexed: 01/05/2023] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of a pelvic belt on
the activities of trunk and lower extremity muscles in normal adults. [Subjects and
Methods] The subjects were 20 normal individuals without a history of orthopedic problems.
The pelvic compression belt (The Com-Pressor, OPTP, Minneapolis, MN, USA) was an
adjustable body belt with four elastic compression bands that provide stabilizing pressure
and was designed to adjust the amount of force applied and to alter sites of compression.
The body belt was placed below the anterior superior iliac spine, and stabilizing pressure
was applied to the belt using the elastic compression bands in the bridge position after
confirming the site of compression. [Results] The subjects showed a significant decrease
in muscle activation in the erector spinae, oblique internus abdominis, rectus femoris,
and biceps femoris while wearing the pelvic belt. [Conclusion] The use of a pelvic
compression belt with external pelvic compression might improve pelvic joint stability and
alter neuromotor control of the lumbopelvic and thigh muscles.
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Affiliation(s)
- Hyun-Gyu Cha
- Department of Physical Therapy, College of Kyungbuk, Republic of Korea
| | - Yan-Ting Wu
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Republic of Korea
| | - Myoung-Kwon Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Republic of Korea
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Thorborg K, Bandholm T, Zebis M, Andersen LL, Jensen J, Hölmich P. Large strengthening effect of a hip-flexor training programme: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2016; 24:2346-52. [PMID: 25796586 DOI: 10.1007/s00167-015-3583-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 03/11/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the effect on hip-flexion strength of a 6-week hip-flexor training programme using elastic bands as resistance. We hypothesized that the training group, compared to a control group, would increase their hip-flexion strength more. METHODS Thirty-three healthy subjects (45 % females), 24(5) years of age, were included in a randomized controlled trial and allocated to heavy strength training of the hip-flexor muscles or to control (no strength training). Strength training of the hip-flexors (dominant leg) was performed three times 10 min per week for 6 weeks. The strength training group progressed from 15 repetition maximum (RM) (week 1) to 8 RM (week 6). Isometric hip-flexion strength (primary outcome) was measured by a blinded assessor using a reliable test procedure. RESULTS In the strength training group, the isometric hip-flexion strength of the trained leg increased by 17 %, (p < 0.001). The between-group difference in hip-flexion strength change in the trained leg (dominant leg, training group) versus the non-trained leg (dominant leg, control group) was significantly different from baseline to follow-up, corresponding to a mean change of 0.34 (95 % CI 0.17-0.52) Nm/kg, in favour of the strength training group (p < 0.001). CONCLUSION Simple hip-flexor strength training using elastic bands as external loading, for only 6 weeks, substantially improves hip-flexor muscle strength. This simple exercise programme seems promising for future prevention and treatment of acute and longstanding hip-flexor injuries, such as acute rectus femoris injuries and longstanding iliopsoas-related pain and impingement. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Kristian Thorborg
- Sports Orthopedic Research Center Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Hvidovre, Italiensvej 1, 2300, Copenhagen S, Denmark. .,Physical Medicine and Rehabilitation Research - Copenhagen (PMR-C), and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research - Copenhagen (PMR-C), and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Copenhagen, Denmark.,Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
| | - Mette Zebis
- Gait Analysis Laboratory, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jesper Jensen
- Sports Orthopedic Research Center Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Hvidovre, Italiensvej 1, 2300, Copenhagen S, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Hvidovre, Italiensvej 1, 2300, Copenhagen S, Denmark
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Nishi K, Saiki K, Imamura T, Okamoto K, Wakebe T, Ogami K, Hasegawa T, Moriuchi T, Sakamoto J, Manabe Y, Tsurumoto T. Degenerative changes of the sacroiliac auricular joint surface-validation of influential factors. Anat Sci Int 2016; 92:530-538. [PMID: 27343049 DOI: 10.1007/s12565-016-0354-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 06/14/2016] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to clarify the relevance of degenerative changes in the sacroiliac joint (SIJ) and the joints in the lower limb and lumbar spine using age estimation methods. We also examined the shape of the auricular surface to determine the effect of degenerative changes on each joint. A total of 200 iliac auricular surfaces from 100 Japanese male skeletons were examined macroscopically in accordance with conventional methods of age estimation. From the obtained estimated age, we calculated the deflection values, which represented the degree of degenerative changes of the joints. For comparison, we used osteophyte score data of the hip, knee, and zygapophyseal joints in lumbar spines from previous studies which had used the same bone specimens. As a quantitative indicator of auricular surface morphology, we defined the constriction ratio (CR) of the auricular surface and compared the CR values obtained with various measured values. Degenerative changes in the SIJ were positively correlated with those in both the hip joint and zygapophyseal joint, but a correlation with knee joints was found only on the left side. In skeletons from individuals aged ≥60 years as time of death, the CR was significantly different between the group with high scores and those with low scores in both the hip and sacroiliac joints. It has been suggested that degenerative changes in SIJs interact with those in the hip joint and zygapophyseal joint. In addition, the shape of the auricular surface may also be a relevant factor for degenerative changes in these joints.
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Affiliation(s)
- Keita Nishi
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,Department of Rehabilitation, Wajinkai Hospital, Nagasaki, Japan.
| | - Kazunobu Saiki
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takeshi Imamura
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Keishi Okamoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Tetsuaki Wakebe
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Keiko Ogami
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takashi Hasegawa
- Department of Rehabilitation, Wajinkai Hospital, Nagasaki, Japan
| | - Takefumi Moriuchi
- Department of Community-based Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshitaka Manabe
- Department of Oral Anatomy and Dental Anthropology, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Toshiyuki Tsurumoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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The Influence of Centralization and Directional Preference on Spinal Control in Patients With Nonspecific Low Back Pain. J Orthop Sports Phys Ther 2016; 46:258-69. [PMID: 26813757 DOI: 10.2519/jospt.2016.6158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective cohort, test-retest design. BACKGROUND Directional preference (DP) with centralization (CEN) and DP without CEN are common pain-pattern responses assessed by Mechanical Diagnosis and Therapy (MDT). Although there is evidence that MDT can reduce pain and disability in the short term by treating the patient with direction-specific exercises concordant with the patient's DP, the mechanism responsible for this is unclear. OBJECTIVE To determine whether clinical signs of impaired spinal control improve immediately after eliciting a DP-with-CEN response or a DP-without-CEN response in patients with nonspecific low back pain. METHODS Participants underwent a standardized MDT assessment and were classified into the following pain-pattern subgroups: DP with CEN, DP without CEN, or no DP. Clinical signs of impaired spinal control were assessed pre-MDT assessment and post-MDT assessment by an independent examiner. Four spinal control tests were conducted: aberrant lumbar movements while bending forward, the active straight leg raise (ASLR) test, the Trendelenburg test, and the prone instability test. Differences in spinal control pre-MDT assessment and post-MDT assessment were calculated for the 3 pain-pattern subgroups and compared with chi-square tests. We hypothesized that a larger proportion of patients in the DP-with-CEN subgroup would exhibit improved spinal control than patients categorized as DP without CEN or no DP. RESULTS Of 114 patients recruited, 51 patients (44.7%) were categorized as DP with CEN, 23 (20.2%) as DP without CEN, and 40 (35.1%) as no DP. Before MDT assessment, between 28.9% (Trendelenburg test) and 63.7% (ASLR test) of patients showed impaired spinal control. After MDT assessment, a larger proportion of patients in the DP-with-CEN subgroup (43%) showed improvement than those in the no-DP subgroup (7%) on aberrant lumbar movements (P = .02). Likewise, more patients in the DP-with-CEN subgroup (50%) improved on the ASLR test than those in the no-DP subgroup (8%, P<.01) or the DP-without-CEN subgroup (7%, P = .01). Changes in Trendelenburg test and prone instability test outcomes did not reach statistical significance. CONCLUSION Immediately following MDT assessment, a larger proportion of patients with a DP-with-CEN pain pattern showed improvement in clinical signs of spinal control compared to patients with a DP-without-CEN or no-DP pain pattern. The current study was registered in the Dutch trial registry at http://www.trialregister.nl/trialreg/index.asp (NTR4246). LEVEL OF EVIDENCE Therapy, level 2b.
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Jeon IC, Kwon OY, Weon JH, Choung SD, Hwang UJ. Comparison of psoas major muscle thickness measured by sonography during active straight leg raising in subjects with and without uncontrolled lumbopelvic rotation. ACTA ACUST UNITED AC 2016; 21:165-9. [DOI: 10.1016/j.math.2015.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 11/15/2022]
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Jonely H, Brismée JM, Desai MJ, Reoli R. Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach. J Man Manip Ther 2015; 23:20-6. [PMID: 26309378 DOI: 10.1179/2042618614y.0000000086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Sacroiliac joint pain and dysfunction affect 15-25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction. CASE DESCRIPTION A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises. OUTCOMES The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient's Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient's rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up. DISCUSSION A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up.
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Affiliation(s)
- Holly Jonely
- The George Washington University School of Medicine & Health Sciences Department of Physical Therapy, Washington, DC, USA
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Mehul J Desai
- International Spine, Pain & Performance Center, Washington, DC, USA
| | - Rachel Reoli
- The George Washington University School of Medicine & Health Sciences Department of Physical Therapy, Washington, DC, USA
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Pelvic Belt Effects on Health Outcomes and Functional Parameters of Patients with Sacroiliac Joint Pain. PLoS One 2015; 10:e0136375. [PMID: 26305790 PMCID: PMC4549265 DOI: 10.1371/journal.pone.0136375] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 07/31/2015] [Indexed: 02/07/2023] Open
Abstract
Introduction The sacroiliac joint (SIJ) is a common source of low back pain. However, clinical and functional signs and symptoms correlating with SIJ pain are widely unknown. Pelvic belts are routinely applied to treat SIJ pain but without sound evidence of their pain-relieving effects. This case-control study compares clinical and functional data of SIJ patients and healthy control subjects and evaluates belt effects on SIJ pain. Methods 17 SIJ patients and 17 healthy controls were included in this prospective study. The short-form 36 survey and the numerical rating scale were used to characterize health-related quality of life in patients in a six-week follow-up and the pain-reducing effects of pelvic belts. Electromyography data were obtained from the gluteus maximus, biceps femoris, rectus femoris and medial vastus. Alterations of muscle activity, variability and gait patterns were compared in patients and controls along with the belts’ effects in a dynamic setting when walking. Results Significant improvements were observed in the short-form 36 survey of the SIJ patients, especially in the physical health subscores. Minor declines were also observed in the numerical rating scale on pain. Belt-related changes of muscle activity and variability were similar in patients and controls with one exception: the rectus femoris activity decreased significantly in patients with belt application when walking. Further belt effects include improved cadence and gait velocity in patients and controls. Conclusions Pelvic belts improve health-related quality of life and are potentially attributed to decreased SIJ-related pain. Belt effects include decreased rectus femoris activity in patients and improved postural steadiness during locomotion. Pelvic belts may therefore be considered as a cost-effective and low-risk treatment of SIJ pain. Trial Registration ClinicalTrials.gov NCT02027038
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Experimental Pelvic Pain Impairs the Performance During the Active Straight Leg Raise Test and Causes Excessive Muscle Stabilization. Clin J Pain 2015; 31:642-51. [DOI: 10.1097/ajp.0000000000000139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Effects of external pelvic compression on electromyographic activity of the hamstring muscles during unipedal stance in sportsmen with and without hamstring injuries. ACTA ACUST UNITED AC 2015; 20:412-9. [DOI: 10.1016/j.math.2014.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/09/2014] [Accepted: 10/16/2014] [Indexed: 11/19/2022]
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Soisson O, Lube J, Germano A, Hammer KH, Josten C, Sichting F, Winkler D, Milani TL, Hammer N. Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction. PLoS One 2015; 10:e0116739. [PMID: 25781325 PMCID: PMC4364533 DOI: 10.1371/journal.pone.0116739] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 12/14/2014] [Indexed: 12/02/2022] Open
Abstract
Introduction The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application. Methods Morphometric and functional data pertaining to pelvic belt effects were compared in 17 SIJ patients and 17 controls. Lumbar spine and pelvis morphometries were obtained from 3T magnetic resonance imaging. Functional electromyography data of pelvis and leg muscles and center of pressure excursions were measured in one-leg stance. The numerical rating scale was used to evaluate immediate pain-reducing effects. Results Pelvic morphometry was largely unaltered in SIJ patients and also by pelvic belt application. The angle of lumbar lateral flexion was significantly larger in SIJ patients without belt application. Muscle activity and center of pressure were unaffected by SIJ pain or by belt application in one-leg stance. Nine of 17 patients reported decreased pain intensities under moderate belt application, four reported no change and four reported increased pain intensity. For the entire population investigated here, this qualitative description was not confirmed on a statistical significant level. Discussion Minute changes were observed in the alignment of the lumbar spine in the frontal plane in SIJ patients. The potential pain-decreasing effects of pelvic belts could not be attributed to altered muscle activity, pelvic morphometry or body balance in a static short-term application. Long-term belt effects will therefore be of prospective interest.
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Affiliation(s)
- Odette Soisson
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Juliane Lube
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Andresa Germano
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | | | - Christoph Josten
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Freddy Sichting
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | - Dirk Winkler
- Department of Neurosurgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Thomas L. Milani
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | - Niels Hammer
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- * E-mail:
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Brizzolara K, Wang-Price S, Roddey T, Wilson I. The effect of pelvic compression on deep abdominal muscle thickness during the active straight leg raise test. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2015. [DOI: 10.12968/ijtr.2015.22.2.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims: The estimated prevalence of sacroiliac joint (SIJ) pain is 13–30% in patients with non-specific low back pain. One common presentation is pain at or near the SIJ, and common physical therapy interventions include lumbopelvic stabilisation programmes and pelvic compression belts. The aim of this study was to: i) assess how compression of the SIJ affects the thickness of the deep abdominal muscles during the active straight leg raise (ASLR); ii) determine between-day intra-tester reliability of ultrasound imaging to assess percentage change in thickness of the deep abdominal muscles. Methods: Participants (n=15) with unilateral symptoms near the SIJ and age-matched and sex-matched controls (n=15) were recruited for this study. Ultrasound imaging was used to obtain the thickness of the transverse abdominis (TrA) and internal oblique (IO) muscles. Measurements were taken at rest and during the ASLR, with and without pelvic compression. Results: Two separate two-way (group × pelvic compression) analysis of variance (ANOVA) designs with repeated measures were used to analyse the thickness of the TrA and IO muscles; interactions were not significant for percentage change in the TrA (p=0.57) or IO (p=0.10) muscles. Intra-tester reliability was higher when testing with pelvic compression and in the control group (ICC: 0.85–0.89 vs 0.70–0.76). Conclusions: Pelvic compression did not immediately affect the muscular response of the TrA or IO muscles during the ASLR. Pelvic compression belts may be used to address the passive systems of the pelvis by increasing stability; however, specific localised exercises may be needed to improve the percentage change in thickness of the deep abdominal muscles during the ASLR.
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Affiliation(s)
- Kelli Brizzolara
- Assistant professor, School of Physical Therapy, Texas Woman's University, Denton, USA
| | - Sharon Wang-Price
- Associate professor and professional programme coordinator, School of Physical Therapy, Texas Woman's University, Denton, USA
| | - Toni Roddey
- Professor and coordinator of research, School of Physical Therapy, Texas Woman's University, Denton, USA
| | - Iseult Wilson
- Lecturer in physiotherapy, School of Health Sciences, University of Ulster, UK
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36
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Patient-reported perception of difficulty as a clinical indicator of dysfunctional neuromuscular control during the prone hip extension test and active straight leg raise test. ACTA ACUST UNITED AC 2014; 19:602-7. [DOI: 10.1016/j.math.2014.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 05/28/2014] [Accepted: 06/05/2014] [Indexed: 11/17/2022]
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Kim JW, Kwon OY, Kim TH, An DH, Oh JS. Effects of external pelvic compression on trunk and hip muscle EMG activity during prone hip extension in females with chronic low back pain. ACTA ACUST UNITED AC 2014; 19:467-71. [DOI: 10.1016/j.math.2014.04.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 11/17/2022]
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38
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Kwon YJ, Hyung EJ, Yang KH, Lee HO. How different modes of child delivery influence abdominal muscle activities in the active straight leg raise. J Phys Ther Sci 2014; 26:1271-4. [PMID: 25202194 PMCID: PMC4155233 DOI: 10.1589/jpts.26.1271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/20/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20 cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects.
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Affiliation(s)
- Yu-Jeong Kwon
- Department of Physical Therapy, Dong-Eui Institute of Technology, Republic of Korea
| | - Eun-Ju Hyung
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Republic of Korea
| | - Kyung-Hye Yang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Republic of Korea
| | - Hyun-Ok Lee
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Republic of Korea
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Neuromuscular response of the trunk to inertial based sudden perturbations following whole body vibration exposure. J Electromyogr Kinesiol 2014; 24:977-85. [PMID: 25241645 DOI: 10.1016/j.jelekin.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/12/2014] [Accepted: 08/14/2014] [Indexed: 11/21/2022] Open
Abstract
The effects of whole body vibration exposure on the neuromuscular responses following inertial-based trunk perturbations were examined. Kinematic and surface EMG (sEMG) data were collected while subjects were securely seated on a robotic platform. Participants were either exposed to 10 min of vibration or not, which was followed by sudden inertial trunk perturbations with and without timing and direction knowledge. Amplitude of sEMG was analyzed for data collected during the vibration protocol, whereas the onset of sEMG activity and lumbar spine angle were analyzed for the perturbation protocol. Data from the vibration protocol did not show a difference in amplitude of sEMG for participants exposed to vibration and those not. The perturbation protocol data showed that those not exposed to vibration had a 14% faster muscle onset, despite data showing no difference in fatigue level.
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Oh JS. Effects of Pelvic Belt on Hip Extensor Muscle EMG Activity during Prone Hip Extension in Females with Chronic Low Back Pain. J Phys Ther Sci 2014; 26:1023-4. [PMID: 25140087 PMCID: PMC4135188 DOI: 10.1589/jpts.26.1023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/08/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study assessed the effects of a pelvic belt (PB) on the electromyography
(EMG) activity of the elector spinae (ES), gluteus maximus (GM), and biceps femoris (BF)
in females with chronic low back pain (CLBP) during prone hip extension (PHE). [Subjects]
Twenty female with CLBP were recruited. Surface EMG data were collected from the ES, GM,
and BF muscles during a PHE task. [Results] The EMG activity in the ES bilaterally, and
the right GM decreased significantly when a PB was applied compared with when a PB was not
applied. [Conclusion] This suggests that a PB is effective for altering the activation
pattern of the hip extensor muscles in females with CLBP during PHE.
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Affiliation(s)
- Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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Madokoro S, Miaki H, Yamazaki T. The Effect of the Abdominal Drawing-in Manoeuvre during Forward Steps. J Phys Ther Sci 2014; 26:889-93. [PMID: 25013290 PMCID: PMC4085215 DOI: 10.1589/jpts.26.889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] A decrease in hip extension has been reported to be a factor in short step
width and slow walking speed. Hip motion is related to pelvic and spinal motion, and
transversus abdominis (TrA) activation is important for stabilising the pelvis and spine.
The abdominal drawing-in manoeuvre (ADIM) can be performed to activate the TrA. The
purpose of this study was to examine the influence of the ADIM on forward steps as a gait
exercise. [Subjects] The subjects were 20 healthy men (mean age, 20.8 ± 2.4 years).
[Methods] Thicknesses of the lateral abdominal muscles during forward step posture with
and without ADIM were measured using ultrasound, and kinematics of the hip and pelvis were
examined using a three-dimensional motion capture system. [Results] Thicknesses of the TrA
and internal oblique increased during forward steps with ADIM. In addition, hip extension
increased and pelvic rotation and oblique angles decreased during forward step with ADIM.
[Conclusion] We believe that ADIM activates the so-called corset muscles, which
consequently stabilise the pelvis and spine and increase hip extension. Our results
suggest that an ADIM could increase hip extension during gait exercise.
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Affiliation(s)
- Sachiko Madokoro
- Division of Rehabilitation Science, Department of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Hiroichi Miaki
- Division of Rehabilitation Science, Department of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Toshiaki Yamazaki
- Division of Rehabilitation Science, Department of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
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Kim YR, Kim JW, An DH, Yoo WG, Oh JS. Effects of a Pelvic Belt on the EMG Activity of the Abdominal Muscles during a Single-leg Hold in the Hook-lying Position on a Round Foam Roll. J Phys Ther Sci 2013; 25:793-5. [PMID: 24259855 PMCID: PMC3820407 DOI: 10.1589/jpts.25.793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 03/01/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of a pelvic belt on the electromyography (EMG) activity of the abdominal muscles during a single-leg hold in the hook-lying position on a round foam roll. [Subjects] Seventeen healthy female volunteers were recruited for this study. [Methods] The participants performed single-leg-hold exercises on a round foam roll with and without a pelvic belt. Surface EMG was recorded from the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) bilaterally. [Results] The EMG activity of the bilateral RA, EO, and IO was significantly lower when the pelvic belt applied. [Conclusions] Our finding that the bilateral EO, IO, and RA muscles were less active with a pelvic belt during trunk-stabilizing exercises on an unstable surface suggests that the pelvic belt provided "form closure".
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Affiliation(s)
- Yu-Ri Kim
- Department of Physical Therapy, Good Gang An Hospital
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Hammer N, Steinke H, Lingslebe U, Bechmann I, Josten C, Slowik V, Böhme J. Ligamentous influence in pelvic load distribution. Spine J 2013; 13:1321-30. [PMID: 23755919 DOI: 10.1016/j.spinee.2013.03.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 01/03/2013] [Accepted: 03/20/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The influence of the posterior pelvic ring ligaments on pelvic stability is poorly understood. Low back pain and sacroiliac joint (SIJ) pain are described being related to these ligaments. Computational approaches involving finite element (FE) modeling may aid to determine their influence. Previous FE models lacked in precise ligament geometries and material properties, which might have influence on the results. PURPOSE AND STUDY DESIGN The aim of this study is to investigate ligamentous influence in pelvic stability by means of FE using precise ligament material properties and morphometries. METHODS An FE model of the pelvis bones was created from computer tomography, including the pubic symphysis joint (PSJ) and the SIJ. Ligament data were used from 55 body donors: anterior (ASL), interosseous (ISL), and posterior (PSL) sacroiliac ligaments; iliolumbar (IL), inguinal (IN), pubic (PL), sacrospinous (SS), and sacrotuberous (ST) ligaments; and obturator membrane (OM). Stress-strain data were gained from iliotibial tract specimens. A vertical load of 600 N was applied. Pelvic motion related to altered ligament and cartilage stiffness was determined in a range of 50% to 200%. Ligament strain was investigated in the standing and sitting positions. RESULTS Tensile and compressive stresses were found at the SIJ and the PSJ. The center of sacral motion was at the level of the second sacral vertebra. At the acetabula and the PSJ, higher ligament and cartilage stiffnesses decrease pelvic motion in the following order: SIJ cartilage>ISL>ST+SS>IL+ASL+PSL. Similar effects were found for the sacrum (SIJ cartilage>ISL>IL+ASL+PSL) but increased ST+SS stiffnesses increased sacral motion. The influence of the IN, OM, and PL was less than 0.1%. Compared with standing, total ligament strain was reduced to 90%. Increased strains were found for the IL, ISL, and PSL. CONCLUSIONS Posterior pelvic ring cartilage and ligaments significantly contribute to pelvic stability. Their effects are region- and stiffness dependent. While sitting, load concentrations occur at the IL, ISL, and PSL, which goes in coherence with the clinical findings of these ligaments serving as generators of low back pain.
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Affiliation(s)
- Niels Hammer
- Faculty of Medicine, Institute of Anatomy, University of Leipzig, Liebigstraße 13, 04103 Leipzig, Germany; Department of Trauma and Reconstructive Surgery, Faculty of Medicine, University of Leipzig, Liebigstraße 13, 04103 Leipzig, Germany.
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Stuge B, Sætre K, Ingeborg Hoff B. The automatic pelvic floor muscle response to the active straight leg raise in cases with pelvic girdle pain and matched controls. ACTA ACUST UNITED AC 2013; 18:327-32. [DOI: 10.1016/j.math.2012.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 12/04/2012] [Accepted: 12/17/2012] [Indexed: 01/08/2023]
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45
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Effects of the pelvic rotatory control method on abdominal muscle activity and the pelvic rotation during active straight leg raising. ACTA ACUST UNITED AC 2013; 18:220-4. [DOI: 10.1016/j.math.2012.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 10/07/2012] [Accepted: 10/09/2012] [Indexed: 11/18/2022]
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46
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Jung HS, Jeon HS, Oh DW, Kwon OY. Effect of the pelvic compression belt on the hip extensor activation patterns of sacroiliac joint pain patients during one-leg standing: A pilot study. ACTA ACUST UNITED AC 2013; 18:143-8. [DOI: 10.1016/j.math.2012.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 07/13/2012] [Accepted: 09/12/2012] [Indexed: 10/27/2022]
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Lee KS, Ko E, Lim CG. Effect of Pelvic Belt on Gluteal Muscles Activity during Therapeutic Exercise. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kang Sung Lee
- Department of Prosthetics and Orthotics, Hanseo University
| | - Eunhye Ko
- Professional Physical Therapy and Rehabilitation P.C.: 143-70 Sanford Ave 1FL, Flushing, NY 11355, USA
| | - Chae Gil Lim
- Department of Physical Therapy, Gachon University
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Sudarshan A. Physical therapy management of osteitis pubis in a 10-year-old cricket fast bowler. Physiother Theory Pract 2012; 29:476-86. [DOI: 10.3109/09593985.2012.753650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hu H, Meijer OG, Hodges PW, Bruijn SM, Strijers RL, Nanayakkara PW, van Royen BJ, Wu W, Xia C, van Dieën JH. Understanding the Active Straight Leg Raise (ASLR): An electromyographic study in healthy subjects. ACTA ACUST UNITED AC 2012; 17:531-7. [DOI: 10.1016/j.math.2012.05.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 05/21/2012] [Accepted: 05/23/2012] [Indexed: 10/28/2022]
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Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 2012; 221:537-67. [PMID: 22994881 PMCID: PMC3512279 DOI: 10.1111/j.1469-7580.2012.01564.x] [Citation(s) in RCA: 283] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2012] [Indexed: 12/28/2022] Open
Abstract
This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure.
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Affiliation(s)
- A Vleeming
- Department of Anatomy, University of New England College of Osteopathic Medicine, Biddeford, ME, USA
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