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Roach KE, Bird AL, Pedoia V, Majumdar S, Souza RB. Automated evaluation of hip abductor muscle quality and size in hip osteoarthritis: Localized muscle regions are strongly associated with overall muscle quality. Magn Reson Imaging 2024; 111:237-245. [PMID: 38636675 DOI: 10.1016/j.mri.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/01/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
Limited information exists regarding abductor muscle quality variation across its length and which locations are most representative of overall muscle quality. This is exacerbated by time-intensive processes for manual muscle segmentation, which limits feasibility of large cohort analyses. The purpose of this study was to develop an automated and localized analysis pipeline that accurately estimates hip abductor muscle quality and size in individuals with mild-to-moderate hip osteoarthritis (OA) and identifies regions of each muscle which provide best estimates of overall muscle quality. Forty-four participants (age 52.7 ± 16.1 years, BMI 23.7 ± 3.4 kg/m2, 14 males) with and without mild-to-moderate radiographic hip OA were recruited for this study. Unilateral hip magnetic resonance (MR) images were acquired on a 3.0 T MR scanner and included axial T1-weighted fast spin echo and 3D axial Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation (IDEAL-IQ) spoiled gradient-recalled echo (SPGR) with multi-peak fat spectrum modeling and single T2* correction. A three dimensional (3D) V-Net convolutional neural network was trained to automatically segment the gluteus medius (GMED), gluteus minimus (GMIN), and tensor fascia lata (TFL) on axial IDEAL-IQ. Agreement between manual and automatic segmentation and associations between axial fat fraction (FF) estimated from IDEAL-IQ and overall muscle FF were evaluated. Dice scores for automatic segmentation were 0.94, 0.87, and 0.91 for GMED, GMIN, and TFL, respectively. GMED, GMIN, and TFL volumetric and FF measures were strongly correlated (r: 0.92-0.99) between automatic and manual segmentations, where all values fell within the 95% limits of agreement of [-9.79 cm3, 17.43 cm3] and [-1.99%, 2.89%], respectively. Axial FF was significantly associated with overall FF with the strongest correlations at 50%, 50%, and 65% the length of the GMED, GMIN, and TFL muscles, respectively (r: 0.93-0.97). An automated and localized analysis can provide efficient and accurate estimates of hip abductor muscle quality and size across muscle length. Specific regions of the muscle may be used to estimate overall muscle quality in an abbreviated evaluation of muscle quality.
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Affiliation(s)
- Koren E Roach
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA; Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, 1403-29th Street NW, Calgary, AB T2N 2T9, Canada.
| | - Alyssa L Bird
- Department of Physical Therapy and Rehabilitation Science, University of California - San Francisco, 1500 Owens Street, Suite 400, San Francisco, CA 94158, USA.
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA.
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA.
| | - Richard B Souza
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA; Department of Physical Therapy and Rehabilitation Science, University of California - San Francisco, 1500 Owens Street, Suite 400, San Francisco, CA 94158, USA.
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Mitomo S, Aizawa J, Hirohata K, Ohmi T, Ohji S, Furuya H, Kawasaki T, Sakai Y, Yagishita K, Okawa A. Effects of differences in femoral anteversion and hip flexion angle on hip abductor muscles activity during clam exercise in females. PLoS One 2024; 19:e0305515. [PMID: 38913672 PMCID: PMC11195955 DOI: 10.1371/journal.pone.0305515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/01/2024] [Indexed: 06/26/2024] Open
Abstract
This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle.
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Affiliation(s)
- Sho Mitomo
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Sports for Health Division, Japan Sports Agency, Tokyo, Japan
| | - Junya Aizawa
- Faculty of Health Science, Department of Physical Therapy, Juntendo University, Tokyo, Japan
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Hirohata
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehiro Ohmi
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidetaka Furuya
- Department of Rehabilitation, Sonoda Third Hospital, Tokyo, Japan
- Department of Rehabilitation, Sonoda Medical Institute Tokyo Spine Center, Tokyo, Japan
| | - Tomoko Kawasaki
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yayoi Sakai
- Department of Rehabilitation, Kawakita General Hospital, Tokyo, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Perraton Z, Mosler AB, Lawrenson PR, Weber Ii K, Elliott JM, Wesselink EO, Crossley KM, Kemp JL, Stewart C, Girdwood M, King MG, Heerey JJ, Scholes MJ, Mentiplay BF, Semciw AI. The association between lateral hip muscle size/intramuscular fat infiltration and hip strength in active young adults with long standing hip/groin pain. Phys Ther Sport 2024; 65:95-101. [PMID: 38101293 DOI: 10.1016/j.ptsp.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To investigate associations between lateral hip muscle size/intramuscular fat infiltration (MFI) and hip strength in active young adults with longstanding hip/groin pain. DESIGN Cross-sectional study. SETTING University/Clinical. PARTICIPANTS Sub-elite soccer and Australian Football players (n = 180; 37 female) with long standing hip/groin pain. MAIN OUTCOME MEASURES Muscle size (volume) and MFI of gluteus maximus, medius, and minimis, and tensor fascia latae (TFL) were assessed using magnetic resonance imaging. Isometric hip strength was measured with handheld dynamometry. Associations between muscle size/MFI were assessed using linear regression models, adjusted for body mass index and age, with sex-specific interactions. RESULTS Positive associations were identified between lateral hip muscle volume and hip muscle strength, particularly for gluteus maximus and gluteus minimus volume. For all muscles, hip abduction was associated with an increase in strength by up to 0.69 N (R2 ranging from 0.29 to 0.39). These relationships were consistent across sexes with no sex interactions observed. No associations were found between MFI and strength measures. CONCLUSION Greater lateral hip muscle volumes are associated with greater hip strength in active young adults with long standing hip/groin pain, irrespective of sex. Gluteus maximus and minimus volume showed the most consistent relationships with hip strength across multiple directions.
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Affiliation(s)
- Zuzana Perraton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Andrea B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| | - Peter R Lawrenson
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; Innovation and Research Centre, Community and Oral Health Directorate, Metro North Health, Brisbane, Australia.
| | - Kenneth Weber Ii
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA.
| | - James M Elliott
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; Faculty of Medicine and Health, Northern Sydney Local Health District & The University of Sydney, The Kolling Institute St Leonards, NSW, Australia.
| | - Evert O Wesselink
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Christopher Stewart
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Michael Girdwood
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
| | - Joshua J Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Mark J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Adam I Semciw
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Australia; Department of Allied Health Research, Northern Health, Epping, Victoria, Australia.
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Yasuda T, Ota S, Mitsuzawa S, Yamashita S, Tsukamoto Y, Takeuchi H, Onishi E. Preoperative Lower-Limb Muscle Predictors for Gait Speed Improvement after Total Hip Arthroplasty for Patients with Osteoarthritis. J Pers Med 2023; 13:1279. [PMID: 37623529 PMCID: PMC10455813 DOI: 10.3390/jpm13081279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
This study aimed to identify preoperative lower-limb muscle predictors for gait speed improvement after total hip arthroplasty (THA) with hip osteoarthritis. Gait speed improvement was evaluated as the subtraction of preoperative speed from postoperative speed. The preoperative muscle composition of ipsilateral hip abductors was evaluated using computed tomography. The females (n = 45) showed smaller total cross-sectional areas of the gluteal muscles than the males (n = 13). The gluteus maximus in the females showed lower lean muscle mass area (LMM) and higher ratios of the intramuscular fat area and the intramuscular adipose tissue area to the total muscle area (TM) than the males. Regression analysis revealed that LMM/TM of the glutei medius and minimus may correlate negatively with postoperative improvement in gait speed. Receiver operating characteristic curve analysis for prediction of minimum clinically important improvement in gait speed at ≥0.32 m/s resulted in the highest area under the curve for TM in the upper portion of the gluteus maximus with negative correlation. The explanatory variables of hip abductor muscle composition predicted gait speed improvement after THA more precisely in the females compared with the total group of both sexes. Preoperative muscle composition should be evaluated separately based on sex for the achievement of clinically important improvement in gait speed after THA.
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Affiliation(s)
- Tadashi Yasuda
- Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-machi, Chuo-ku, Kobe 650-0047, Japan
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Higgs JP, Diamond LE, Saxby DJ, Barrett RS, Graham DF. Individual muscle contributions to the acceleration of the centre of mass during gait in people with mild-to-moderate hip osteoarthritis. Gait Posture 2023; 104:151-158. [PMID: 37421811 DOI: 10.1016/j.gaitpost.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/29/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND People with mild-to-moderate hip osteoarthritis (OA) exhibit hip muscle weakness, alterations in hip kinematics and kinetics and hip contact forces during gait compared to healthy controls. However, it is unclear if those with hip OA use different motor control strategies to coordinate the motion of the centre of mass (COM) during gait. Such information could provide further critical assessment of conservative management strategies implemented for people with hip OA. RESEARCH QUESTION Do muscle contributions to the acceleration of the COM during walking differ between individuals with mild-to-moderate hip OA and controls? METHODS Eleven individuals with mild-to-moderate hip OA and 10 healthy controls walked at a self-selected speed while whole-body motion and ground reaction forces were measured. Muscle forces during gait were obtained using static optimisation and an induced acceleration analysis was performed to determine individual muscle contributions to the acceleration of the COM during single-leg stance (SLS). Between-group comparisons were made using independent t-tests via Statistical Parametric Modelling. RESULTS There were no between-group differences in spatial-temporal gait parameters or three-dimensional whole-body COM acceleration. The rectus femoris, biceps femoris, iliopsoas and gastrocnemius muscles in the hip OA group contributed less to the fore-aft accelerations of the COM (p < 0.05), and more to the vertical COM acceleration with the gluteus maximus (p < 0.05), during SLS, compared to the control group. SIGNIFICANCE Subtle differences exist in the way people with mild-to-moderate hip OA use their muscles to accelerate the whole-body centre of mass during the SLS phase of walking relative to healthy controls. These findings improve understanding of the complex functional consequences of hip OA and enhance our understanding of how to monitor the effectiveness of an intervention on biomechanical changes in gait in people with hip OA.
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Affiliation(s)
- Jeremy P Higgs
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - Laura E Diamond
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - David J Saxby
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - Rod S Barrett
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - David F Graham
- Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia; Montana State University, College of Education. Health & Human Development, Bozeman, MT 59717-2940, USA.
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Bian T, Zhang L, Man S, Li H, Li W, Zhou Y. A Cross-Sectional Study on Gluteal Muscles in Patients with Ankylosing Spondylitis at Different Stages of Hip Involvement. J Clin Med 2023; 12:jcm12020464. [PMID: 36675392 PMCID: PMC9866124 DOI: 10.3390/jcm12020464] [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: 12/17/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Hip involvement in ankylosing spondylitis (AS) is associated with severe functional impairment, and early diagnosis can improve the disease prognosis. We investigated gluteal muscle cross-sectional area (CSA) and radiodensity at different stages of hip involvement and their associations with AS-related clinical and laboratory parameters. This cross-sectional study included 83 patients with AS and 83 age- and sex-matched controls. Patients with AS were divided into three groups according to the Bath Ankylosing Spondylitis Radiology Hip Index system. The CSA and radiodensity of the gluteus maximus, medius, and minimus muscles were measured using computed tomography images. Muscle parameters were compared, and their relationships with clinical and laboratory parameters were evaluated. For the gluteus maximus, patients with AS had a lower CSA than controls, regardless of the degree of hip involvement. For the gluteus medius and minimus, patients with moderate/advanced hip involvement had significantly lower CSA and radiodensity than those with mild to no hip involvement. The severity of hip involvement was negatively associated with muscle parameters. CSA of the gluteus maximus decreased in early-stage hip involvement without any changes in radiographs, while radiodensity decreased in the later stages. Muscle parameters on computed tomography may be a more sensitive indicator than radiographic findings.
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Affiliation(s)
- Tao Bian
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
| | - Liang Zhang
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
| | - Siliang Man
- Department of Rheumatology and Immunology, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
| | - Hongchao Li
- Department of Rheumatology and Immunology, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
| | - Weiyi Li
- Department of Rehabilitation, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
| | - Yixin Zhou
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China
- Correspondence: ; Tel.: +86-10-58516724
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Artificial intelligence-based volumetric analysis of muscle atrophy and fatty degeneration in patients with hip osteoarthritis and its correlation with health-related quality of life. Int J Comput Assist Radiol Surg 2023; 18:71-78. [PMID: 36571719 PMCID: PMC9883321 DOI: 10.1007/s11548-022-02797-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/16/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Artificial intelligence (AI) technologies have enabled precise three-dimensional analysis of individual muscles on computed tomography (CT) or magnetic resonance images via automatic segmentation. This study aimed to perform three-dimensional assessments of pelvic and thigh muscle atrophy and fatty degeneration in patients with unilateral hip osteoarthritis using CT and to evaluate the correlation with health-related quality of life (HRQoL). METHODS The study included one man and 43 women. Six muscle groups were segmented, and the muscle atrophy ratio was calculated volumetrically. The degree of fatty degeneration was defined as the difference between the mean CT values (Hounsfield units [HU]) of the healthy and affected sides. HRQoL was evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). RESULTS The mean muscle atrophy rate was 16.3%, and the mean degree of muscle fatty degeneration was 7.9 HU. Multivariate correlation analysis revealed that the WOMAC stiffness subscale was significantly related to fatty degeneration of the hamstrings, the WOMAC physical function subscale was significantly related to fatty degeneration of the iliopsoas muscle, and the JHEQ movement subscale was significantly related to fatty degeneration of the hip adductors. CONCLUSION We found that fatty degeneration of the hamstrings, iliopsoas, and hip adductor muscles was significantly related to HRQoL in patients with hip osteoarthritis. These findings suggest that these muscles should be targeted during conservative rehabilitation for HOA and perioperative rehabilitation for THA.
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Yasuda T, Ota S, Yamashita S, Tsukamoto Y, Onishi E. Association of preoperative variables of ipsilateral hip abductor muscles with gait function after total hip arthroplasty: a retrospective study. ARTHROPLASTY 2022; 4:23. [PMID: 35773686 PMCID: PMC9248187 DOI: 10.1186/s42836-022-00126-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aimed to identify the association of preoperative variables of ipsilateral hip abductors with gait function after total hip arthroplasty (THA).
Methods
This study enrolled 42 patients who underwent unilateral primary THA for osteoarthritis. Gait speed and Timed Up-and-Go test were conducted 6 months postoperatively. Preoperative composition of the glutei medius and minimus and the upper portion of gluteus maximus was evaluated by computed tomography. Cross-sectional area ratio of individual composition to the total muscle was calculated. Preoperative variables associated with gait speed and Timed Up-and-Go test after THA were identified by using stepwise regression analysis.
Results
Faster gait speed and shorter Timed Up-and-Go test correlated with smaller cross-sectional area of low-density lean tissue or intramuscular adipose tissue (low-density lean tissue plus intramuscular fat) in the glutei medius and minimus and lower cross-sectional area ratio of low-density lean tissue to the total glutei medius and minimus. Faster gait speed and shorter Timed Up-and-Go test also correlated with larger cross-sectional area of lean muscle mass in the gluteus maximus, higher cross-sectional area ratio of lean muscle mass to the total gluteus maximus, and lower cross-sectional area ratio of intramuscular fat or intramuscular adipose tissue to the total gluteus maximus. Faster gait speed additionally correlated with larger total cross-sectional area of the gluteus maximus. Regression analysis showed that the total cross-sectional area of the gluteus maximus and the low-density lean tissue cross-sectional area of the glutei medius and minimus were the explanatory variables of gait speed and Timed Up-and-Go test after THA, respectively.
Conclusions
There was a potential association between preoperative composition of ipsilateral hip abductors and gait function 6 months after THA. This study indicates a predictive role of preoperative assessment of ipsilateral hip abductor composition in the recovery of gait function after THA.
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Retchford TH, Tucker KJ, Hart HF, Semciw AI, Weinrauch P, Grimaldi A, Cowan SM, Crossley KM, Kemp JL. No Difference in Hip Muscle Volumes and Fatty Infiltration in Those With Hip-Related Pain Compared to Controls. Int J Sports Phys Ther 2022; 17:851-862. [PMID: 35949368 PMCID: PMC9340835 DOI: 10.26603/001c.36528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Little is known about muscle morphology in people with hip-related pain, without signs of femoro-acetabular impingement syndrome (FAIS). Identifying changes in hip muscle volume, fatty infiltrate and establishing relationships between muscle volume and strength, may provide insight into potential early treatment strategies. Purposes To: (i) compare the volumes and fatty infiltrate of gluteus maximus, gluteus medius, gluteus minimis, tensor fascia latae and quadratus femoris between symptomatic and less-symptomatic sides of participants with hip-related pain; (ii) compare the volumes and fatty infiltrate of hip muscles between healthy controls and symptomatic participants; and (iii) explore relationships of hip muscle volumes to muscle strength and patient-reported outcome measures in people with hip-related pain. Study Design Cross-sectional study. Methods Muscle volume and fatty infiltrate (from magnetic resonance imaging), hip muscle strength, patient-reported symptoms, function and quality of life (QOL) were determined for 16 participants with hip-related pain (no clinical signs of FAIS; 37±9 years) and 15 controls (31±9 years). Using One Way Analysis of Co-Variance tests, muscle volume and fatty infiltrate was compared between the symptomatic and less-symptomatic sides in participants with hip-related pain as well as between healthy controls and symptomatic participants. In addition, hip muscle volume was correlated with hip muscle strength, hip-reported symptoms, function and QOL. Results No differences in all the studied muscle volumes or fatty infiltrate were identified between the symptomatic and less-symptomatic hips of people with hip-related pain; or between people with and without hip-related pain. Greater GMED volume on the symptomatic side was associated with less symptoms and better function and QOL (ρ=0.522-0.617) for those with hip-related pain. Larger GMAX volume was associated with greater hip abduction and internal rotation strength, larger GMED volume was associated with greater hip extension strength, and larger QF volume was associated with greater hip abduction strength (rho=0.507-0.638). Conclusion People with hip-related pain and no clinical signs of FAIS have hip muscle volumes that are not significantly different than those of matched pain-free controls or their less-symptomatic hip. Larger GMED muscle volume was associated with fewer symptoms and greater strength. Level of evidence Level 3a.
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Affiliation(s)
| | | | - Harvi F Hart
- La Trobe University; Bone and Joint Institute, Western University
| | - Adam I Semciw
- La Trobe University; Northern Centre for Health, Education and Research- The Northern Hospital
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10
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Perraton Z, Lawrenson P, Mosler AB, Elliott JM, Weber KA, Flack NA, Cornwall J, Crawford RJ, Stewart C, Semciw AI. Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: a scoping review of lateral hip musculature. BMC Musculoskelet Disord 2022; 23:533. [PMID: 35658932 PMCID: PMC9166386 DOI: 10.1186/s12891-022-05439-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Measures of hip muscle morphology and composition (e.g., muscle size and fatty infiltration) are possible with magnetic resonance imaging (MRI). Standardised protocols or guidelines do not exist for evaluation of hip muscle characteristics, hindering reliable and valid inter-study analysis. This scoping review aimed to collate and synthesise MRI methods for measuring lateral hip muscle size and fatty infiltration to inform the future development of standardised protocols. Methods Five electronic databases (Medline, CINAHL, Embase, SportsDISCUS and AMED) were searched. Healthy or musculoskeletal pain populations that used MRI to assess lateral hip muscle size and fatty infiltration were included. Lateral hip muscles of interest included tensor fascia late (TFL), gluteus maximus, gluteus medius, and gluteus minimus. Data on MRI parameters, axial slice location, muscle size and fatty infiltrate measures were collected and analysed. Cross referencing for anatomical locations were made between MRI axial slice and E-12 anatomical plastinate sections. Results From 2684 identified publications, 78 studies contributed data on volume (n = 31), cross sectional area (CSA) (n = 24), and fatty infiltration (n = 40). Heterogeneity was observed for MRI parameters and anatomical boundaries scrutinizing hip muscle size and fatty infiltration. Seven single level axial slices were identified that provided consistent CSA measurement, including three for both gluteus maximus and TFL, and four for both gluteus medius and minimus. For assessment of fatty infiltration, six axial slice locations were identified including two for TFL, and four for each of the gluteal muscles. Conclusions Several consistent anatomical levels were identified for single axial MR slice to facilitate muscle size and fatty infiltration muscle measures at the hip, providing the basis for reliable and accurate data synthesis and improvements in the validity of future between studies analyses. This work establishes the platform for standardised methods for the MRI assessment of lateral hip musculature and will aid in the examination of musculoskeletal conditions around the hip joint. Further studies into whole muscle measures are required to further optimise methodological parameters for hip muscle assessment.
Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05439-x.
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Affiliation(s)
- Zuzana Perraton
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Peter Lawrenson
- School of Allied Health, La Trobe University, Melbourne, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Department of Anatomy, School of Biomedical Sciences, The University of Otago, Dunedin, New Zealand
| | - Andrea B Mosler
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - James M Elliott
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Faculty of Medicine and Health and Northern Sydney Local Health District, The University of Sydney, The Kolling Institute, Sydney, Australia.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Kenneth A Weber
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - Natasha Ams Flack
- Department of Anatomy, School of Biomedical Sciences, The University of Otago, Dunedin, New Zealand
| | - Jon Cornwall
- University of Otago, Centre for Early Learning in Medicine, Otago Medical School, Dunedin, New Zealand
| | | | | | - Adam I Semciw
- School of Allied Health, La Trobe University, Melbourne, Australia. .,Allied Health Research, Northern Health, Epping, VIC, Australia.
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11
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Tran V, De Martino E, Hides J, Cable G, Elliott JM, Hoggarth M, Zange J, Lindsay K, Debuse D, Winnard A, Beard D, Cook JA, Salomoni SE, Weber T, Scott J, Hodges PW, Caplan N. Gluteal Muscle Atrophy and Increased Intramuscular Lipid Concentration Are Not Mitigated by Daily Artificial Gravity Following 60-Day Head-Down Tilt Bed Rest. Front Physiol 2021; 12:745811. [PMID: 34867450 PMCID: PMC8634875 DOI: 10.3389/fphys.2021.745811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/13/2021] [Indexed: 11/27/2022] Open
Abstract
Exposure to spaceflight and head-down tilt (HDT) bed rest leads to decreases in the mass of the gluteal muscle. Preliminary results have suggested that interventions, such as artificial gravity (AG), can partially mitigate some of the physiological adaptations induced by HDT bed rest. However, its effect on the gluteal muscles is currently unknown. This study investigated the effects of daily AG on the gluteal muscles during 60-day HDT bed rest. Twenty-four healthy individuals participated in the study: eight received 30 min of continuous AG; eight received 6 × 5 min of AG, interspersed with rest periods; eight belonged to a control group. T1-weighted Dixon magnetic resonance imaging of the hip region was conducted at baseline and day 59 of HDT bed rest to establish changes in volumes and intramuscular lipid concentration (ILC). Results showed that, across groups, muscle volumes decreased by 9.2% for gluteus maximus (GMAX), 8.0% for gluteus medius (GMED), and 10.5% for gluteus minimus after 59-day HDT bed rest (all p < 0.005). The ILC increased by 1.3% for GMAX and 0.5% for GMED (both p < 0.05). Neither of the AG protocols mitigated deconditioning of the gluteal muscles. Whereas all gluteal muscles atrophied, the ratio of lipids to intramuscular water increased only in GMAX and GMED muscles. These changes could impair the function of the hip joint and increased the risk of falls. The deconditioning of the gluteal muscles in space may negatively impact the hip joint stability of astronauts when reexpose to terrestrial gravity.
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Affiliation(s)
- Vienna Tran
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Enrico De Martino
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD, Australia
| | - Gordon Cable
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - James M. Elliott
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Faculty of Medicine and Health, The Kolling Research Institute Sydney, Northern Sydney Local Health District, The University of Sydney, Sydney, NSW, Australia
| | - Mark Hoggarth
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Jochen Zange
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Kirsty Lindsay
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Dorothée Debuse
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Andrew Winnard
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - David Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Jonathan A. Cook
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Sauro E. Salomoni
- NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Tobias Weber
- Space Medicine Team (HRE-OM), European Astronaut Centre, Cologne, Germany
- KBR GmbH, Cologne, Germany
| | - Jonathan Scott
- Space Medicine Team (HRE-OM), European Astronaut Centre, Cologne, Germany
- KBR GmbH, Cologne, Germany
| | - Paul W. Hodges
- NHMRC Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Nick Caplan
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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12
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Estes BT, Enomoto M, Moutos FT, Carson MA, Toth JM, Eggert P, Stallrich J, Willard VP, Veis DJ, Little D, Guilak F, Lascelles BDX. Biological resurfacing in a canine model of hip osteoarthritis. SCIENCE ADVANCES 2021; 7:eabi5918. [PMID: 34524840 PMCID: PMC8443182 DOI: 10.1126/sciadv.abi5918] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 05/31/2023]
Abstract
Articular cartilage has unique load-bearing properties but has minimal capacity for intrinsic repair. Here, we used three-dimensional weaving, additive manufacturing, and autologous mesenchymal stem cells to create a tissue-engineered, bicomponent implant to restore hip function in a canine hip osteoarthritis model. This resorbable implant was specifically designed to function mechanically from the time of repair and to biologically integrate with native tissues for long-term restoration. A massive osteochondral lesion was created in the hip of skeletally mature hounds and repaired with the implant or left empty (control). Longitudinal outcome measures over 6 months demonstrated that the implant dogs returned to normal preoperative values of pain and function. Anatomical structure and functional biomechanical properties were also restored in the implanted dogs. Control animals never returned to normal and exhibited structurally deficient repair. This study provides clinically relevant evidence that the bicomponent implant may be a potential therapy for moderate hip osteoarthritis.
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Affiliation(s)
| | - Masataka Enomoto
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | - Megan A. Carson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | - Peter Eggert
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jonathan Stallrich
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | | | - Deborah J. Veis
- Division of Bone and Mineral Diseases, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Shriners Hospitals for Children—St. Louis, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
| | - Dianne Little
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Farshid Guilak
- Cytex Therapeutics Inc., Durham, NC, USA
- Shriners Hospitals for Children—St. Louis, St. Louis, MO, USA
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA
- Center of Regenerative Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - B. Duncan X. Lascelles
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, NC, USA
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
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13
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Baida SR, King E, Richter C, Gore S, Franklyn-Miller A, Moran K. Hip Muscle Strength Explains Only 11% of the Improvement in HAGOS With an Intersegmental Approach to Successful Rehabilitation of Athletic Groin Pain. Am J Sports Med 2021; 49:2994-3003. [PMID: 34398640 PMCID: PMC8411474 DOI: 10.1177/03635465211028981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exercise-based rehabilitation targeting intersegmental control has high success rates and fast recovery times in the management of athletic groin pain (AGP). The influence of this approach on hip strength and lower limb reactive strength and how these measures compare with uninjured athletes (CON) remain unknown. Additionally, the efficacy of this program after return to play (RTP) has not been examined. PURPOSE First, to examine differences in isometric hip strength, reactive strength, and the Hip and Groin Outcome Score (HAGOS) between the AGP and CON cohorts and after rehabilitation; second, to examine the relationship between the change in HAGOS and the change in strength variables after rehabilitation; last, to track HAGOS for 6 months after RTP. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS A total of 42 athletes diagnosed with AGP and 36 matched controls completed baseline testing: isometric hip strength, lower limb reactive strength, and HAGOS. After rehabilitation, athletes with AGP were retested, and HAGOS was collected at 3 and 6 months after RTP. RESULTS In total, 36 athletes with AGP completed the program with an RTP time of 9.8 ± 3.0 weeks (mean ± SD). At baseline, these athletes had significantly lower isometric hip strength (abduction, adduction, flexion, extension, external rotation: d = -0.67 to -1.20), single-leg reactive strength (d = -0.73), and HAGOS (r = -0.74 to -0.89) as compared with the CON cohort. Hip strength (d = -0.83 to -1.15) and reactive strength (d = -0.30) improved with rehabilitation and were no longer significantly different between groups at RTP. HAGOS improvements were maintained or improved in athletes with AGP up to 6 months after RTP, although some subscales remained significantly lower than the CON group (r = -0.35 to -0.51). Two linear regression features (hip abduction and external rotation) explained 11% of the variance in the HAGOS Sports and Recreation subscale. CONCLUSION Athletes with AGP demonstrated isometric hip strength and reactive strength deficits that resolved after an intersegmental control rehabilitation program; however, improved hip strength explained only 11% of improvement in the Sports and Recreation subscale. HAGOS improvements after pain-free RTP were maintained at 6 months.
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Affiliation(s)
- Samuel R. Baida
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland,Samuel R. Baida, PT, PhD,
Sports Surgery Clinic, Santry, Dublin 9, Ireland (
) (Twitter: @Sam_Baida)
| | - Enda King
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,Department of Life Sciences, Roehampton
University, London, UK
| | - Chris Richter
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland
| | - Shane Gore
- School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland
| | - Andrew Franklyn-Miller
- Sports Medicine Department, Sports
Surgery Clinic, Dublin, Ireland,Centre for Health, Exercise and Sports
Medicine, University of Melbourne, Melbourne, Australia
| | - Kieran Moran
- School of Health and Human Performance,
Dublin City University, Dublin, Ireland,Insight Centre for Data Analytics,
Dublin City University, Dublin, Ireland
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14
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Baik SM, Cynn HS, Shim JH, Lee JH, Shin AR, Lee KE. Effects of Log-Rolling Position on Hip-Abductor Muscle Activation During Side-Lying Hip-Abduction Exercise in Participants With Gluteus Medius Weakness. J Athl Train 2021; 56:945-951. [PMID: 33150402 DOI: 10.4085/306-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Weakness of the gluteus medius and gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergistic muscles that are not targeted should be considered when prescribing side-lying hip-abduction (SHA) exercises. Log-rolling positions may affect hip-abductor activity during SHA. OBJECTIVE To determine the effects of log-rolling positions on gluteus medius, gluteus maximus, and tensor fasciae latae activity during SHA in participants with gluteus medius weakness. DESIGN Controlled laboratory study. SETTING University research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-one participants with gluteus medius weakness. INTERVENTION(S) Three types of SHA were performed: frontal-plane SHA in neutral position (SHA-neutral), frontal-plane SHA in anterior log-rolling position (SHA-anterior rolling), and frontal-plane SHA in posterior log-rolling position (SHA-posterior rolling). MAIN OUTCOME MEASURE(S) Surface electromyography was used to measure hip-abductor activity. One-way repeated-measures analysis of variance was calculated to assess the statistical significance of the muscle activity. RESULTS The SHA-anterior rolling showed greater gluteus medius and gluteus maximus activation than the SHA-neutral (P = .003 and P < .001, respectively) and SHA-posterior rolling (P < .001 and P < .001, respectively). The SHA-neutral demonstrated greater gluteus medius and gluteus maximus activation than the SHA-posterior rolling (P < .001 and P = .001, respectively). The SHA-anterior rolling produced less tensor fasciae latae activation than the SHA-neutral (P < .001) and SHA-posterior rolling (P < .001). The SHA-neutral showed less tensor fasciae latae activation than the SHA-posterior rolling (P < .001). CONCLUSIONS The SHA-anterior rolling may be an effective exercise for increasing activation of the gluteus medius and gluteus maximus while decreasing activation of the tensor fasciae latae in participants with gluteus medius weakness.
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Affiliation(s)
- Seung-Min Baik
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Republic of Korea.,Department of Physical Therapy, Baekseok University, Cheonan, Republic of Korea
| | - Heon-Seock Cynn
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Republic of Korea
| | - Jae-Hun Shim
- Department of Physical Therapy, Baekseok University, Cheonan, Republic of Korea
| | - Ji-Hyun Lee
- Department of Physical Therapy, Baekseok University, Cheonan, Republic of Korea
| | - A-Reum Shin
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Republic of Korea
| | - Kyung-Eun Lee
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Republic of Korea
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15
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Burgess LC, Taylor P, Wainwright TW, Swain ID. Strength and endurance deficits in adults with moderate-to-severe hip osteoarthritis, compared to healthy, older adults. Disabil Rehabil 2021; 44:5563-5570. [PMID: 34157244 DOI: 10.1080/09638288.2021.1939797] [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
PURPOSE This study compares lower limb muscle strength and endurance in adults with hip osteoarthritis, to an age-matched control group. METHODS Thirteen adults with moderate-to-severe hip osteoarthritis (as graded by the Oxford Hip Score) and fifteen older adults participated. Maximal voluntary isometric contraction of the knee extensors, knee flexors and hip abductors and isotonic endurance of the knee extensors were measured using a dynamometer. Function was assessed using the 30-second chair stand test, the 40 m fast-paced walk test and a stair negotiation test. Data were compared between groups using t-tests. RESULTS Participants with hip osteoarthritis demonstrated weakness in the affected limb when compared to the control limb during knee flexion (34%, p = 0.004) and hip abduction (46%, p = 0.001). Weakness was also observed in the contralateral knee flexors (31%, p = 0.01). When compared to the control limb, the knee extensors of the hip osteoarthritis group were exhausted prematurely in the affected (70%, p = 0.001) and contralateral limb (62%, p = 0.005). The hip osteoarthritis group took twice as long to stair climb (p = 0.002), walked 40% slower, (p < 0.001), and had a 35% lower sit-stand performance (p < 0.001). CONCLUSIONS Moderate-to-severe hip osteoarthritis may be characterised by bilateral deficits in lower-limb maximal strength, markedly lower knee extensor endurance and impaired functional performance.Implications for rehabilitationIn addition to bilateral deficits in maximal strength of the hip and knee muscles, moderate-to-severe hip osteoarthritis may be characterised by markedly lower muscular endurance of the knee extensors and impaired functional performance.The endurance capacity of the knee extensors can play an important role in daily function, and thus it is important to consider endurance training principles when prescribing exercise for this patient group.Research studies evaluating exercise programmes underpinned by endurance training principles are required to understand the benefits to patients with hip osteoarthritis, and to inform specific exercise prescription in clinical practice.
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Affiliation(s)
- Louise C Burgess
- Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK
| | - Paul Taylor
- Department of Clinical Science and Engineering, Salisbury District Hospital, Salisbury, UK.,Odstock Medical Limited, Salisbury District Hospital, Salisbury, UK.,Faculty of Health and Social Science, Bournemouth University, Bournemouth, UK
| | - Thomas W Wainwright
- Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK.,Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Ian D Swain
- Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK
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16
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Besomi M, Maclachlan L, Mellor R, Vicenzino B, Hodges PW. Tensor Fascia Latae Muscle Structure and Activation in Individuals With Lower Limb Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Sports Med 2021; 50:965-985. [PMID: 31898217 DOI: 10.1007/s40279-019-01251-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Dysfunction of the tensor fascia latae (TFL) muscle is often clinically implicated in many musculoskeletal disorders. OBJECTIVE To systematically review the literature of the TFL muscle to determine whether there are differences in its structure and activation between individuals with and without lower limb musculoskeletal conditions. DATA SOURCES A comprehensive search in MEDLINE, EMBASE, CINHAL, and LILACS was undertaken from year of inception to 9 July 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that directly investigated the structure or activity of the TFL muscle between individuals with a lower limb musculoskeletal condition and a pain-free control group. RESULTS Seventeen studies were included (n = 556 participants), eight reporting structure and ten activation of the TFL muscle. Conditions included lateral hip pain, hip joint pathology, ACL injury, iliotibial band syndrome, and patellofemoral joint osteoarthritis. Meta-analysis identified with low confidence (p value = 0.07) a small tendency towards hypertrophy in the affected side of participants with hip joint diseases (SMD 0.37, 95% CI [- 0.02, 0.77]). Moderate effect sizes were found for a higher cross-sectional area of the TFL/sartorius ratio in abductor tendon tear (SMD 0.74; 95% CI [0.05, 1.43, p value = 0.04), and for a smaller body mass normalized TFL volume in patellofemoral joint osteoarthritis (SMD - 0.61; 95% CI [- 1.23, 0.00], p value = 0.05). Normalised electromyography (EMG) amplitude did not differ between groups for any condition, but when EMG was analysed as linear envelopes or synergies, some differences in pattern of TFL activation were observed between individuals with lateral hip pain and controls. Timing of TFL activation did not differ between individuals with knee conditions and controls. CONCLUSIONS AND IMPLICATIONS Common clinical assumptions of the role of TFL muscle in lower limb musculoskeletal conditions are not well investigated and poorly supported by current research. There are contradictory findings on the muscle size of TFL. Differing methodology in muscle activation studies precludes a clear interpretation for comparison between groups. PROSPERO REGISTRATION NUMBER CRD42017076160.
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Affiliation(s)
- Manuela Besomi
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia
| | - Liam Maclachlan
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia
| | - Rebecca Mellor
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia
| | - Paul W Hodges
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia.
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17
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Morphometric analysis of all 24 hip muscles: A cadaveric study of 18 hip specimens with proposal of a new classification of muscles. Surg Radiol Anat 2020; 43:63-72. [PMID: 32734344 DOI: 10.1007/s00276-020-02539-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE There are few papers investigating the morphometry of hip muscles and reporting either a single muscle or a group of synergistic muscles. With the development of hip joint simulation, hip arthroplasty implants, and gait analysis, a set of biometric data covering all the muscles that act on the hip joint is needed. METHODS Using a rigorous dissection process on 18 cadaveric hips, measurements of all 24 hip muscles and bone parameters were conducted. We measured the following: (a) total femur, femoral shaft, and neck lengths, (b) total muscle lengths, (c) intra-muscular and extra-muscular (free) tendon lengths, (d) bone angles, (e) muscle pennation, sagittal, and frontal angles, (f) muscle weight, (g) muscle volume, (h) muscle cross-sectional area, and (i) and bending moment. Data on more than 12,000 morphometric or anatomical parameters were collected. Correlation values between bone variables, muscle variables, and in-between muscle variables were computed. Based on their compliance, muscles were classified using the ratio of belly length over the sum of intra-muscular and free tendons. RESULTS Values of the neck, shaft, and total femur lengths were highly correlated in relation to each other. The long muscles and the pelvitrochanteric muscles were highly correlated with femoral bone lengths. The proximal and distal intra-muscular tendon lengths were correlated to the total muscle length for all long muscles, independently of free tendon (extra-muscular) or muscle belly lengths. A very significant correlation was found between muscle weight variations among specimens. Three groups of muscles were identified based on their compliance. CONCLUSION This is the first comprehensive anatomical morphometric study which includes all the 24 muscles acting on the hip joint. It generates a unique anatomical dataset comprising all necessary data for musculoskeletal modeling and arthroplasty implants of the hip joint. A new muscle classification was proposed based on compliance where muscles of the same group would exhibit similar compliance and functional anatomy.
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18
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Homma D, Minato I, Imai N, Miyasaka D, Sakai Y, Horigome Y, Suzuki H, Shimada H, Dohmae Y, Endo N. Appropriate sites for the measurement of the cross-sectional area of the gluteus maximus and the gluteus medius muscles in patients with hip osteoarthritis. Surg Radiol Anat 2020; 43:45-52. [PMID: 32681225 DOI: 10.1007/s00276-020-02535-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the relationship between the volume, cross-sectional area, and peak isometric muscle strength of the gluteus maximus and gluteus medius muscles in patients with hip osteoarthritis, and to use this information to identify effective sites for measurement of the cross-sectional area of these muscles. METHODS Twenty-four patients with hip osteoarthritis were included. The muscle cross-sectional area and volume were calculated from magnetic resonance images. The cross-sectional area was calculated at three levels: the inferior point of the sacroiliac joint, just above the femoral head, and at the greatest muscle diameter. Peak isometric strength was assessed using hand-held dynamometry, using the extension and external rotation for the gluteus maximus and abduction and internal rotation for the gluteus medius. Measured outcomes were compared between the two muscles, and the association between muscle volume, cross-sectional area, and peak isometric muscle strength was evaluated using Pearson's correlation. RESULTS Volume was correlated with the cross-sectional area in the gluteus maximus (r ≥ 0.707) and with the cross-sectional area (r ≥ 0.637) and peak isometric strength (r ≥ 0.477) in the gluteus medius. There was no difference between the cross-sectional area measured at the greatest muscle diameter and just above the femoral head (p = 0.503) for the gluteus maximus and at the inferior point of the sacroiliac joint (p = 0.651) for the gluteus medius. CONCLUSION The cross-sectional area, when used to calculate the muscle volume, should be evaluated just above the femoral head for the gluteus maximus and at the inferior point of the sacroiliac joint for the gluteus medius.
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Affiliation(s)
- Daisuke Homma
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan. .,Division of Rehabilitation, Niigata Bandai Hospital, 2-2-8 Yachiyo, Chuou-ku, Niigata, Niigata, 950-8584, Japan.
| | - Izumi Minato
- Division of Orthopedic Surgery, Niigata Rinko Hospital, 1-114-3 Momoyama-cho, Higashi-ku, Niigata, Niigata, 950-0051, Japan
| | - Norio Imai
- Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Dai Miyasaka
- Division of Orthopedic Surgery, Niigata Bandai Hospital, 2-2-8 YachiyoChuou-ku, Niigata, Niigata, 950-8584, Japan
| | - Yoshinori Sakai
- Division of Orthopedic Surgery, Niigata General Hospital, 463 Kanege, Chuo-ku, Niigata, Niigata, 950-1197, Japan
| | - Yoji Horigome
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Hayato Suzuki
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Hayato Shimada
- Division of Orthopedic Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki, 311-4198, Japan
| | - Yoichiro Dohmae
- Division of Orthopedic Surgery, Niigata Bandai Hospital, 2-2-8 YachiyoChuou-ku, Niigata, Niigata, 950-8584, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
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Eizentals P, Katashev A, Oks A, Semjonova G. Smart shirt system for compensatory movement retraining assistance: feasibility study. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00420-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Popovic T, Samaan MA, Link TM, Majumdar S, Souza RB. Patients with Symptomatic Hip Osteoarthritis Have Altered Kinematics during Stair Ambulation. PM R 2020; 13:128-136. [PMID: 32383300 DOI: 10.1002/pmrj.12398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative joint disease. Understanding contributing factors to slowing or stopping disease progression is crucial. There has been no research describing lower extremity kinematics of the hip, knee, and ankle during stair ambulation in individuals with hip OA. OBJECTIVE To explore the differences in lower extremity kinematics between participants with clinical and morphological findings of hip OA and controls. DESIGN A cross-sectional study. SETTING Clinical research laboratory. PARTICIPANTS Participants with radiographic and symptomatic signs of hip OA (n = 42) and healthy controls (n = 30) were enrolled. INTERVENTIONS Participants underwent hip magnetic resonance imaging (MRI). The Scoring Hip Osteoarthritis with MRI (SHOMRI) method was used to assess cartilage abnormalities. Self-reported measures of hip pain and function were obtained using the Hip Disability and Osteoarthritis Outcome Score (HOOS). Participants were assigned into a symptomatic hip osteoarthritis group (HOA) with SHOMRI>0 and HOOS≤80, and a control group (CG) with SHOMRI = 0 and HOOS>90. Patients underwent 3D motion analysis during stair ascent/descent at self-selected speed. MAIN OUTCOME MEASURES The primary outcome measurements were peak hip, knee, and ankle kinematics. General Estimation Equations were used to compare kinematics between groups (P ≤ .05). RESULTS The HOA group ascended stairs with a more internally rotated hip (CG = 1.77 ± 6.3; HOA = 4.97 ± 4.2; P = .02), more abducted hip (CG = -5 ± 2.7, HOA = -3.5 ± 3; P = .02), and a more externally rotated knee (CG = -8.02 ± 3; HOA = -10.63 ± 6.3; P = .02) and ankle (CG = -11.8 ± 6.1; HOA = -16.3 ± 5.6; P = .01). Similarly, HOA participants descended stairs with a more extended knee (CG = -15.5 ± 4.9; HOA = -12 ± 4.9; P = .01), and more externally rotated knee (CG = -10.1 ± 4.4; HOA = -13.1 ± 6.6; P = .04) and ankle (CG = -13.5 ± 5.3; HOA = -17.9 ± 5.5; P = .002). CONCLUSION Participants with hip OA-related morphology and symptoms ambulate stairs utilizing abnormal lower extremity mechanics.
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Affiliation(s)
- Tijana Popovic
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - Michael A Samaan
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA.,Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Thomas M Link
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - Richard B Souza
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA.,Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, San Francisco, CA, USA
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21
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Peiris WL, Cicuttini FM, Constantinou M, Yaqobi A, Hussain SM, Wluka AE, Urquhart D, Barrett R, Kennedy B, Wang Y. Association between hip muscle cross-sectional area and hip pain and function in individuals with mild-to-moderate hip osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2020; 21:316. [PMID: 32438921 PMCID: PMC7240926 DOI: 10.1186/s12891-020-03348-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To examine the associations between hip muscle cross-sectional area and hip pain and function in community-based individuals with mild-to-moderate hip osteoarthritis. METHODS This study included 27 participants with mild-to-moderate hip osteoarthritis. Cross-sectional area of hip muscles, including psoas major, rectus femoris, gluteus maximus, gluteus medius and minimus, adductor longus and magnus, obturator internus, and obturator externus, were measured from magnetic resonance images. Hip pain and function were evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS) categorised into 5 subscales: pain, symptoms, activity of daily living, sport and recreation function, and hip-related quality of life (for each subscale 0 representing extreme problems and 100 representing no problems). RESULTS Mean age of the 27 participants was 63.2 (SD 7.6) years and 66.7% (n = 18) were female. After adjusting for age and gender, greater cross-sectional area of adductor longus and magnus was associated with a higher HOOS score in quality of life (regression coefficient 1.4, 95% confidence interval (CI) 0.2-2.7, p = 0.02), activity of daily living (regression coefficient 1.3, 95% CI 0.1-2.6, p = 0.04) and sport and recreation function (regression coefficient 1.6, 95% CI 0.1-3.0, p = 0.04). There was a trend towards an association between greater cross-sectional area of psoas major and a higher quality of life score (regression coefficient 3.6, 95% CI - 0.5 to 7.7, p = 0.08). The cross-sectional area of hip muscles was not significantly associated with HOOS pain or symptom score. CONCLUSION Greater cross-sectional area of hip adductors was associated with better function and quality of life in individuals with mild-to-moderate hip osteoarthritis. Greater cross-sectional area of hip flexors might be associated with better quality of life. These findings, while need to be confirmed in longitudinal studies, suggest that targeting the hip adductor and flexor muscles may improve function and quality of life in those with mild-to-moderate hip osteoarthritis.
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Affiliation(s)
- Waruna L Peiris
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Maria Constantinou
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Banyo, Brisbane, Queensland, 4014, Australia
| | - Abbas Yaqobi
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Donna Urquhart
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Rod Barrett
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia
| | - Ben Kennedy
- Qscan Radiology Clinics, Brisbane, Queensland, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.
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22
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Dorado C, López-Gordillo A, Serrano-Sánchez JA, Calbet JAL, Sanchis-Moysi J. Hypertrophy of Lumbopelvic Muscles in Inactive Women: A 36-Week Pilates Study. Sports Health 2020; 12:547-551. [PMID: 32396038 DOI: 10.1177/1941738120918381] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The use of Pilates in various fields of sport sciences and rehabilitation is increasing; however, little is known about the muscle adaptations induced by this training method. HYPOTHESIS A standardized Pilates training program for beginners (9 months; 2 sessions of 55 minutes per week) will increase the muscle volume and reduce potential side-to-side asymmetries of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles (gluteus maximus, medius, and minimus). STUDY DESIGN Controlled laboratory study. LEVEL OF EVIDENCE Level 3. METHOD A total of 12 inactive, healthy women (35.7 ± 5.4 years) without previous experience in Pilates were randomly selected to participate in a supervised Pilates program (36 weeks, twice weekly). Muscle volume (cm3) was determined using magnetic resonance imaging at the beginning and end of the intervention program. Side-to-side asymmetry was calculated as [(left - right volume) × 100/right volume]. RESULTS Small, nonsignificant (P > 0.05) differences in the volume of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles were observed between pre- and post-Pilates program timepoints. Before and after Pilates, side-to-side asymmetry was less than 6% and nonsignificant in all muscles analyzed. CONCLUSION Modern Pilates performed twice weekly for 9 months did not elicit substantial changes in the volume and degree of asymmetry of the selected lumbopelvic muscles in inactive women. CLINICAL RELEVANCE The benefits of Pilates in rehabilitation or training are likely elicited by neuromuscular rather than morphological adaptations. Pilates has no significant impact on muscle volume and does not alter side-to-side ratios in muscle volume (degree of asymmetry) of the lumbopelvic muscles.
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Affiliation(s)
- Cecilia Dorado
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ana López-Gordillo
- Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A Serrano-Sánchez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Joaquín Sanchis-Moysi
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
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23
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Mendis MD, Wilson SJ, Hayes DA, Hides JA. Hip muscle atrophy in patients with acetabular labral joint pathology. Clin Anat 2020; 33:538-544. [DOI: 10.1002/ca.23429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/30/2019] [Indexed: 12/15/2022]
Affiliation(s)
- M. Dilani Mendis
- School of Allied Health SciencesGriffith University Brisbane Queensland Australia
- Physiotherapy DepartmentMater Health Services South Brisbane Queensland Australia
| | - Stephen J. Wilson
- School of Information Technology and Electrical EngineeringThe University of Queensland Brisbane Queensland Australia
| | - David A. Hayes
- Brisbane Orthopaedic & Sports Medicine Centre Brisbane Queensland Australia
| | - Julie A. Hides
- School of Allied Health SciencesGriffith University Brisbane Queensland Australia
- Mater Back Stability Research ClinicMater Health Services South Brisbane Queensland Australia
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24
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Mendiolagoitia L, Rodríguez MÁ, Crespo I, del Valle M, Olmedillas H. Kinematic Gait Analysis After Primary Total Hip Replacement: A Systematic Review: Gait After Total Hip Replacement: A Systematic Review. Indian J Orthop 2020; 54:767-775. [PMID: 33133399 PMCID: PMC7573021 DOI: 10.1007/s43465-020-00101-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/28/2020] [Indexed: 02/04/2023]
Abstract
Total hip replacement (THR) is a surgical procedure indicated for patients affected by severe hip osteoarthritis. Although this technique has proved to be effective in relieving pain and restoring function, gait limitations may persist following this procedure. The objective of this systematic review was to evaluate gait kinematics after THR and compare the results with those of the pre-operative state and with healthy control individuals. PubMed/MEDLINE, Embase, Web of Science, CENTRAL and Scopus databases were searched until December 2019. Methodological quality and internal validity score of each study were assessed using the PEDro and the Newcastle-Ottawa scales. In all, ten studies met our inclusion criteria. Following THR, statistically significant improvements were seen in dynamic hip and knee range of motion of both the affected and the contralateral limb, single-limb support time symmetry, step length, stride length, walking speed and gait pattern. However, deficits were observed in all the previous parameters, as well as in hip adduction angle in comparison with healthy subjects. In conclusion, gait patterns improve after THR in comparison with the pre-operative state, although there are deficits relative to healthy individuals.
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Affiliation(s)
- Luis Mendiolagoitia
- Department of Cellular Morphology and Biology, Universidad de Oviedo, Oviedo, Spain
| | | | - Irene Crespo
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain ,Institute of Biomedicine, Universidad de León, León, Spain
| | - Miguel del Valle
- Department of Cellular Morphology and Biology, Universidad de Oviedo, Oviedo, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain ,Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
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25
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Could the tendon degeneration and the fatty infiltration of the gluteus medius affect clinical outcome in total hip arthroplasty? INTERNATIONAL ORTHOPAEDICS 2019; 44:275-282. [DOI: 10.1007/s00264-019-04468-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/11/2019] [Indexed: 01/24/2023]
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26
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Cowan RM, Semciw AI, Pizzari T, Cook J, Rixon MK, Gupta G, Plass LM, Ganderton CL. Muscle Size and Quality of the Gluteal Muscles and Tensor Fasciae Latae in Women with Greater Trochanteric Pain Syndrome. Clin Anat 2019; 33:1082-1090. [DOI: 10.1002/ca.23510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 09/24/2019] [Accepted: 10/27/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Rachael Mary Cowan
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
| | - Adam Ivan Semciw
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
| | - Jill Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
| | - Melissa Kate Rixon
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
| | | | - Lindsey Marie Plass
- The University of Chicago Medicine, Department of Therapy Services Illinois United States of America
| | - Charlotte Louise Ganderton
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University Victoria Australia
- Department of Health Professions, Swinburne University of Technology Victoria Australia
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27
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A clinically applicable tool for rapidly estimating muscle volume using ultrasound images. Eur J Appl Physiol 2019; 119:2685-2699. [PMID: 31654124 PMCID: PMC6858406 DOI: 10.1007/s00421-019-04242-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/10/2019] [Indexed: 11/03/2022]
Abstract
Purpose This study aimed to identify a safe, rapid, and accessible method of estimating muscle volume of key lower limb muscle groups to reduce the time-demand of acquiring this measurement and potentially facilitate its application as a clinical monitoring tool. Methods Unilateral MRI images were acquired from the 12th thoracic vertebrae to the base of the foot in 18 recreationally active males. Panoramic B-mode ultrasound images were acquired from the same leg at the mid-hip, 25%, 50%, and 75% of thigh length, and 25% of shank length. Body mass, height, limb lengths, and circumferences at the sites corresponding to the ultrasound images were acquired. A single investigator manually analysed all images. Regression analyses were conducted to identify models for estimating volume of the hip extensor, knee extensor and flexor, and ankle plantarflexor muscle groups. Results Models were developed for estimating hip extensor (SEE = 8.92%, R2 = 0.690), knee extensor (SEE = 5.24%, R2 = 0.707) and flexor (SEE = 7.89%, R2 = 0.357), and ankle plantarflexor (SEE = 10.78%, R2 = 0.387) muscle group volumes. The hip and knee extensor models showed good potential for generalisation. Systematic error was observed for the knee flexor and ankle plantarflexor models. Conclusions Hip extensor, knee extensor and flexor, and ankle plantarflexor muscle group volumes can be estimated using B-mode ultrasound images and anthropometric measurements. The error shown for each of the models was sufficient to identify previously reported differences in muscle volume due to training or injury, supporting their clinical application.
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28
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Poilliot A, Doyle T, Tomlinson J, Zhang M, Zwirner J, Hammer N. Quantification of fat in the posterior sacroiliac joint region: fat volume is sex and age dependant. Sci Rep 2019; 9:14935. [PMID: 31624283 PMCID: PMC6797796 DOI: 10.1038/s41598-019-51300-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/26/2019] [Indexed: 11/09/2022] Open
Abstract
Fat is appreciated as a structural component of synovial joints. It may serve a shock-absorbing function for the incongruent surfaces, vessels and ligaments, but has not been investigated in the posterior sacroiliac joint (PSIJ). Sixty-six cadaveric hemipelves were serially-sectioned and photographed. The amount of visible fat in the PSIJ was quantified using a modified version of Cavalieri’s method. Total volume, fat volume and fat percentage of the PSIJ were calculated in predefined sub-regions. Fat is consistently present in the PSIJ (1.9 ± 1.3 cm3). Fat volume correlates with the PSIJ total volume (p < 0.0001; r = 0.73) and age (p = 0.024; r = 0.24), and is smaller in males (1.4 ± 0.8 cm3) than females (2.4 ± 1.5 cm3). Fat volumes in the middle and inferior sub-regions of the PSIJ show side- (p < 0.0001) and sex-differences (p = 0.013 females, middle sub-region). Age and PSIJ total volume correlate between sexes in various sub-regions (p = 0.05 females superior sub-region; males inferior sub-region). Fat percentage differs between sexes and sub-regions (p = 0.018 females, superior sub-region) but is independent of age and sides. The presence of fat within the PSIJ is a normal finding and shows sex-dependant and age-related differences. It is unclear whether fat is linked to age-related degeneration or has a shock-absorbing role in stress- and load-dissipation in the PSIJ.
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Affiliation(s)
- Amélie Poilliot
- Department of Anatomy, University of Otago, Dunedin, New Zealand.
| | - Terence Doyle
- School of Medicine, University of Otago, Dunedin, New Zealand
| | - Joanna Tomlinson
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Ming Zhang
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Johann Zwirner
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Niels Hammer
- Department of Macroscopic and Clinical Anatomy, Medical University of Graz, Graz, Austria.,Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Fraunhofer IWU, Dresden, Germany
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29
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Malloy P, Stone AV, Kunze KN, Neal WH, Beck EC, Nho SJ. Patients With Unilateral Femoroacetabular Impingement Syndrome Have Asymmetrical Hip Muscle Cross-Sectional Area and Compensatory Muscle Changes Associated With Preoperative Pain Level. Arthroscopy 2019; 35:1445-1453. [PMID: 30926193 DOI: 10.1016/j.arthro.2018.11.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/15/2018] [Accepted: 11/21/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the symptomatic hip muscle cross-sectional area (CSA) in patients with unilateral femoroacetabular impingement syndrome (FAIS) with the asymptomatic-side hip muscle CSA and to determine whether correlations exist between the hip muscle CSA and preoperative pain level, preoperative symptom duration, and postoperative function. METHODS We performed a retrospective review of magnetic resonance imaging data of patients who underwent hip arthroscopy from January 2012 through June 2015 for the treatment of unilateral FAIS and who had a minimum of 2 years' follow-up after hip arthroscopy for FAIS. A picture archiving and communication system workstation with an embedded region-of-interest tool was used to measure the muscle CSA of both the symptomatic and asymptomatic sides in FAIS patients. One-way repeated-measures analyses of variance were used to determine differences between symptomatic and asymptomatic hip muscle CSAs. Spearman rank correlations were used to determine relations between the symptomatic-side hip muscle CSA and preoperative pain level, preoperative symptom duration, and multiple validated patient-reported outcomes to quantify the level of function. RESULTS A total of 50 patients met the inclusion criteria and were analyzed. The mean age of the patients was 34.22 ± 14.12 years, and 64% were women. Specific muscles of the symptomatic hip displaying significantly decreased CSAs compared with the asymptomatic hip included the gluteus maximus (P = .007), gluteus minimus (P = .022), and rectus femoris (P = .028). The tensor fascia lata (ρ = 0.358; P = .011), pectineus (ρ = 0.369, P = .008), adductor longus (ρ = 0.286, P = .044), and obturator externus (ρ = 0.339, P = .016) showed a moderate positive correlation with preoperative pain level on a visual analog scale in unilateral FAIS patients. No associations were found between the symptomatic-side hip muscle CSA in patients with unilateral FAIS and symptom duration or patient-reported function. CONCLUSIONS Patients with unilateral FAIS have a significantly decreased muscle CSA in the symptomatic hip compared with the asymptomatic hip. The symptomatic-side hip muscle CSA was correlated with the preoperative pain level on a visual analog scale. The association between the muscle CSA and preoperative pain level may represent a compensatory change in muscle function around the hip joint in patients with unilateral FAIS. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Philip Malloy
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Austin V Stone
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Kyle N Kunze
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - William H Neal
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Edward C Beck
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Shane J Nho
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
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30
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Mosquera Morales N, López Hermoza JG, Fernández Bravo A. [Tensor fascia lata unilateral hypertrophy: A case report]. Rehabilitacion (Madr) 2019; 53:65-67. [PMID: 30929834 DOI: 10.1016/j.rh.2018.10.003] [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] [Received: 02/18/2018] [Revised: 09/23/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
Abstract
Hypertrophy of the tensor fascia lata muscle is an uncommon clinical entity, which can simulate a soft tissue tumour. In most patients, it presents as a palpable proximal anterior thigh mass. The characteristic appearance on CT or MRI allows a confident diagnosis of muscle hypertrophy to be made, avoiding unnecessary diagnostic biopsy or surgical intervention. In cases with suspected radiculopathy, electromyography is also useful. We present an illustrative case of hypertrophy of the tensor fascia lata muscle and its outcome after rehabilitation treatment.
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Affiliation(s)
- N Mosquera Morales
- Servicio de Rehabilitación, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | - J G López Hermoza
- Servicio de Rehabilitación, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - A Fernández Bravo
- Servicio de Rehabilitación, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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31
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Chow TW, Wright MR, Hop CECA, Wong H. Evaluation of the predictive performance of physiologically based pharmacokinetic models for intramuscular injections of therapeutic proteins. Xenobiotica 2019; 49:1423-1433. [PMID: 30794022 DOI: 10.1080/00498254.2019.1571651] [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: 01/10/2023]
Abstract
Several physiologically-based pharmacokinetic (PBPK) models have been reported for intravenous (IV) and subcutaneous (SC) injections, but there has been a paucity of work for intramuscular (IM) injections. The primary objective of this work was a wide-scale evaluation of the predictive performance of IM PBPK models of therapeutic proteins. PBPK models for all administration routes available in the literature have regarded muscle as the total muscle (TM) in the body; however, anatomically, the body is composed of discrete muscle groups. Clinically, IM is administered to a specific muscle (SM). We explored the predictive performance of IM PBPK models with an SM or TM dosing site. The plasma concentration-time profiles of seven therapeutic proteins after an IM dose in humans served as the clinically observed data for model evaluation - this was a diverse group ranging from 30 to 149 kDa from six protein classes. Pharmacokinetic parameters Cmax, tmax, AUC0-∞, and ka were estimated. SM and TM IM PBPK approaches were compared using Average Fold Error (AFE) and Pearson Chi-Square LineShape analyses. This work represents the first wide-scale validation of IM PBPK models and suggests that these models predict IM PBPK reasonably well. The SM and TM approach provided comparable performance.
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Affiliation(s)
- Timothy W Chow
- Faculty of Pharmaceutical Sciences, The University of British Columbia , Vancouver , BC , Canada
| | - Matthew R Wright
- Department of Drug Metabolism and Pharmacokinetics, Genentech , South San Francisco , CA , USA
| | - Cornelis E C A Hop
- Department of Drug Metabolism and Pharmacokinetics, Genentech , South San Francisco , CA , USA
| | - Harvey Wong
- Faculty of Pharmaceutical Sciences, The University of British Columbia , Vancouver , BC , Canada
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Lawrenson PR, Crossley KM, Vicenzino BT, Hodges PW, James G, Croft KJ, King MG, Semciw AI. Muscle size and composition in people with articular hip pathology: a systematic review with meta-analysis. Osteoarthritis Cartilage 2019; 27:181-195. [PMID: 30389399 DOI: 10.1016/j.joca.2018.10.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To synthesise and evaluate the current evidence investigating muscle size and composition in non-inflammatory articular hip pathology. METHODS A systematic review of five electronic databases, using three concepts; articular hip pathology (e.g., osteoarthritis (OA)); hip muscles; and outcomes (e.g., muscle size and adiposity) was undertaken. Studies addressing non-inflammatory or non-traumatic articular hip pain, using measures of muscle size and adiposity were included and appraised for risk of bias. Data was extracted to calculate standardised mean differences (SMD) and pooled where possible for meta-analysis. RESULTS Thirteen cross-sectional studies were included; all studies measured muscle size and 5/13 measured adiposity. In OA, there was low to very low quality evidence of no difference in hip muscle size, compared with matched controls. In unilateral OA, there was low to very low quality evidence of smaller size in gluteus minimus (SMD -0.38; 95% confidence interval (CI) -0.74, -0.01), gluteus medius (-0.44; 95% CI: -0.83, -0.05) and gluteus maximus (-0.39; 95% CI: -0.75, -0.02) muscles in the symptomatic limb. Individual studies demonstrated non-uniform changes in muscle size in OA. No significant difference was observed in muscle size in other pathologies or in adiposity for any group. CONCLUSION There is some low quality evidence that specific hip muscles are smaller in unilateral hip OA. Variation in the magnitude of differences indicate changes in size are not uniform across all muscles or stage of pathology. Studies in larger cohorts investigating muscle size and composition across the spectrum of articular pathologies are required to clarify these findings.
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Affiliation(s)
- P R Lawrenson
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - K M Crossley
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
| | - B T Vicenzino
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - P W Hodges
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - G James
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - K J Croft
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - M G King
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
| | - A I Semciw
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
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Zacharias A, Pizzari T, Semciw AI, English DJ, Kapakoulakis T, Green RA. Comparison of gluteus medius and minimus activity during gait in people with hip osteoarthritis and matched controls. Scand J Med Sci Sports 2019; 29:696-705. [DOI: 10.1111/sms.13379] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/12/2018] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Anita Zacharias
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering La Trobe University Bendigo Victoria, Austalia
- Sport, Exercise and Rehabilitation Research Focus Area La Trobe University Bendigo Victoria Australia
| | - Tania Pizzari
- Sport, Exercise and Rehabilitation Research Focus Area La Trobe University Bendigo Victoria Australia
- La Trobe University Sports and Exercise Medicine Research Centre Bendigo Victoria Australia
| | - Adam I. Semciw
- Sport, Exercise and Rehabilitation Research Focus Area La Trobe University Bendigo Victoria Australia
- La Trobe University Sports and Exercise Medicine Research Centre Bendigo Victoria Australia
| | - Daniel J. English
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering La Trobe University Bendigo Victoria, Austalia
- Fusion Physiotherapy Bendigo Victoria Australia
| | | | - Rodney A. Green
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering La Trobe University Bendigo Victoria, Austalia
- Sport, Exercise and Rehabilitation Research Focus Area La Trobe University Bendigo Victoria Australia
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Diamond LE, Allison K, Dobson F, Hall M. Hip joint moments during walking in people with hip osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 2018; 26:1415-1424. [PMID: 29621605 DOI: 10.1016/j.joca.2018.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis investigated surrogate measures of hip joint loading during walking in people with hip osteoarthritis (OA). METHODS Five databases were searched up to January 14th, 2018. Studies that measured hip joint moments in the frontal or sagittal plane during walking in people with hip OA and used either a healthy control group or the unaffected leg to compare hip joint moments were included. Standardised mean differences (SMD) in sagittal and frontal plane moments were pooled as appropriate, using a random effect approach. Methodological quality was assessed using the Downs and Black checklist. RESULTS Thirteen studies with 1,141 participants were eligible and suitable for meta-analyses. Overall, people with hip OA had lower sagittal (SMD -0.55 (95% confidence interval (CI) -1.00 to -0.10) and frontal plane moments (SMD -0.63 (95% CI -0.92, -0.34) compared to controls. However, substantial heterogeneity was observed (I2 ≤ 89%). Results by disease stage suggest that people with end-stage hip OA have lower sagittal (SMD -0.96; -1.30, -0.61; I2 = 69%) and frontal (SMD -1.17; 95% CI -1.71, -0.64; I2 = 85%) plane moments compared to controls. People with less severe hip OA than end-stage disease have comparable sagittal (SMD 0.37; 95% CI -0.17, 0.90; I2 = 69%) and frontal (SMD -0.24; 95% CI -0.76, 0.27; I2 = 51%) plane moments compared to controls. CONCLUSION Hip joint loading may be dependent on disease stage. People with end-stage hip OA under-loaded compared to controls, while those who were not awaiting hip joint replacement had comparable hip joint loads to controls.
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Affiliation(s)
- L E Diamond
- Griffith University, Menzies Health Institute Queensland, School of Allied Health Sciences, Gold Coast, QLD 4222, Australia
| | - K Allison
- The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia; The University of Melbourne, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia
| | - F Dobson
- The University of Melbourne, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia
| | - M Hall
- The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia.
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Investigation on the measurement sites of the cross-sectional areas of the gluteus maximus and gluteus medius. Surg Radiol Anat 2018; 41:109-115. [PMID: 30191287 DOI: 10.1007/s00276-018-2099-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
PURPOSES To verify the relationship between muscle volume and muscular strength of different cross-sectional areas (CSAs) of the gluteus maximus and medius, and to clarify the effective evaluation index. METHODS Twenty healthy adults were enrolled in this cross-sectional study. Magnetic resonance images were evaluated, and CSAs of the gluteus maximus and medius were calculated. Calculation sites were the peak CSA, lowest end of the sacroiliac joint CSA, and just above the femoral head CSA. Muscle volume and muscular strength were measured. The correlation between muscular CSA, muscle volume, and muscular strength was verified using Pearson's correlation coefficient (p < 0.05). One-way analysis of variance and the Tukey-Kramer test were used to verify differences in each CSA (p < 0.05). RESULTS A significantly positive correlation was found between muscular CSA, muscle volume, and muscular strength of both muscles (p < 0.05). For the gluteus maximus, the muscular CSA calculated just above the femoral head showed a significantly larger value than that calculated at the lowest end of the sacroiliac joint (p < 0.05). For the gluteus medius, the peak CSA and muscular CSA calculated at the lowest end of the sacroiliac joint were significantly larger than that calculated just above the femoral head (p < 0.05). CONCLUSIONS The maximum CSA of the gluteus maximus was found just above the femoral head and that of the gluteus medius was near the lowest end of the sacroiliac joint; hence, CSAs should be calculated at these sites. The CSA reflected muscle volume and strength.
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Loureiro A, Constantinou M, Diamond LE, Beck B, Barrett R. Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits. BMC Musculoskelet Disord 2018; 19:303. [PMID: 30131064 PMCID: PMC6103991 DOI: 10.1186/s12891-018-2230-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/14/2018] [Indexed: 01/21/2023] Open
Abstract
Background Individuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. However, the extent and pattern of muscle weakness, including any between-limb asymmetries, in early stages of the disease are unclear. This study compared hip and knee muscle strength and volumes between individuals with mild-to-moderate symptomatic and radiographic hip OA and a healthy control group. Methods Nineteen individuals with mild-to-moderate symptomatic and radiographic hip OA (n = 12 unilateral; n = 7 bilateral) and 23 age-matched, healthy controls without radiographic hip OA or hip pain participated. Isometric strength of the hip and knee flexors and extensors, and hip abductors and adductors were measured. Hip and thigh muscle volumes were measured from lower limb magnetic resonance images. A full-factorial, two-way General Linear Model was used to assess differences between groups and between limbs. Results Participants in the hip OA group demonstrated significantly lower knee flexor, knee extensor, hip flexor, hip extensor and hip abductor strength compared to controls and had significantly lower volume of the adductor, hamstring and quadriceps groups, and gluteus maximus and gluteus minimus muscles, but not tensor fasciae latae or gluteus medius muscles. There were no between-limb strength differences or volume differences within either group. Conclusions Atrophic, bilateral hip and knee muscle weakness is a feature of individuals with mild-to-moderate hip OA. Early interventions to target muscle weakness and prevent the development of strength asymmetries that are characteristic of advanced hip OA appear warranted.
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Affiliation(s)
- Aderson Loureiro
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia.,Pontifical Catholic University (PUCRS), Porto Alegre, Brazil.,University of Rio dos Sinos (UNISINOS), São Leopoldo, Brazil
| | - Maria Constantinou
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia.,Australian Catholic University, Brisbane, QLD, 4014, Australia
| | - Laura E Diamond
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia. .,Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Belinda Beck
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Rod Barrett
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia
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Catelli DS, Kowalski E, Beaulé PE, Lamontagne M. Does the Dual-Mobility Hip Prosthesis Produce Better Joint Kinematics During Extreme Hip Flexion Task? J Arthroplasty 2017; 32:3206-3212. [PMID: 28578844 DOI: 10.1016/j.arth.2017.04.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/13/2017] [Accepted: 04/24/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) using dual-mobility (DM) design permits larger hip range of motion. However, it is unclear how it benefits the patients during activities of daily living. The purpose was to compare kinematic variables of the operated limb between THA patients using either DM or single-bearing (SB) implants during a squat task. METHODS Twenty-four THA patients were randomly assigned to either a DM or SB implant and matched to 12 healthy controls (CTRLs). They underwent 3-dimensional squat motion analysis before and 9 months after surgery. Sagittal and frontal plane angles of the pelvis and the hip were analyzed using statistical parametric mapping. Paired analyses compared presurgery and postsurgery squat depth. RESULTS Peak sagittal pelvis angle of DM was closer to normal compared with that of SB. Both implant groups had similar hip angle patterns and magnitude but significantly lower than the CTRLs. SB reached a much large hip abduction compared with the other groups. Both surgical groups had significantly worst squat depth than the CTRLs. CONCLUSION Neither THA implant groups were able to return pelvis and hip kinematics to the level of CTRLs. The deficit of DM implants at the pelvis combined with the poorer functional scores should caution clinicians to use this implant design in active patients. SB design causes a larger hip abduction to reach their maximum squat depth. Post-THA rehabilitation should focus on improving joint range of motion and strength.
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Affiliation(s)
- Danilo S Catelli
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; CAPES Foundation, Ministry of Education of Brazil, Brasilia DF, Brazil
| | - Erik Kowalski
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Paul E Beaulé
- Faculty of Medicine, Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Mario Lamontagne
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada; Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada
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Gluteus medius activation during running is a risk factor for season hamstring injuries in elite footballers. J Sci Med Sport 2017; 20:159-163. [DOI: 10.1016/j.jsams.2016.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 11/19/2022]
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Zacharias A, Pizzari T, English DJ, Kapakoulakis T, Green RA. Hip abductor muscle volume in hip osteoarthritis and matched controls. Osteoarthritis Cartilage 2016; 24:1727-1735. [PMID: 27163446 DOI: 10.1016/j.joca.2016.05.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/19/2016] [Accepted: 05/02/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Hip abductor muscle strength and function is negatively impacted by the presence of hip osteoarthritis (OA). This study aimed to quantify differences in hip abductor muscle volume, fatty infiltration and strength in a unilateral hip OA population when compared to a control group. Impact of radiographic severity of OA on these variables was also examined. METHODS Volumes of gluteus maximus (GMax), medius (GMed) minimus (GMin) and tensor fascia lata (TFL) was measured using MRI and muscle volume asymmetry between limbs was calculated. Fatty infiltrate within muscles was graded using the Goutallier classification system. Hip abduction and rotation strength was tested using a dynamometer. Differences between groups or limbs were analysed using t-tests and differences in fatty infiltration using non-parametric tests. RESULTS A statistically significant decrease in muscle volume was identified in GMax (P < 0.01), GMed (P < 0.02) and GMin (P < 0.01) on the affected side in the OA group compared to both the contralateral side and the control group and differences were related to severity of OA. Hip abduction and internal rotation strength was reduced in the OA group. Increased levels of fatty infiltration were identified in the affected limbs of the OA group for GMax (P = 0.01) and GMin (P = 0.04). CONCLUSION Gluteal muscle atrophy, increased gluteal fatty infiltration and hip strength deficits were evident in the affected hips of OA participants. Since severity of OA was related to the extent of atrophy and fatty deposits, rehabilitation programs targeting these muscles could reverse or halt the progression of these structural and functional deficits.
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Affiliation(s)
- A Zacharias
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria, Australia; Sport, Exercise and Rehabilitation Research Focus Area, Australia.
| | - T Pizzari
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Victoria, Australia; Sport, Exercise and Rehabilitation Research Focus Area, Australia
| | - D J English
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria, Australia; Fusion Physiotherapy, Bendigo, Victoria, Australia
| | | | - R A Green
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria, Australia; Sport, Exercise and Rehabilitation Research Focus Area, Australia
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Hypertrophy of the tensor fascia lata muscle as a complication of total hip arthroplasty. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2016; 27:255-259. [DOI: 10.1007/s00590-016-1854-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/07/2016] [Indexed: 11/26/2022]
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Skorupska E, Keczmer P, Łochowski RM, Tomal P, Rychlik M, Samborski W. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers. PLoS One 2016; 11:e0159587. [PMID: 27459688 PMCID: PMC4961367 DOI: 10.1371/journal.pone.0159587] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/06/2016] [Indexed: 01/21/2023] Open
Abstract
AIM Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP) and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects. METHOD Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images. RESULTS Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (p<0.001), gluteus minimus (p<0.01) and piriformis (p<0.05)). The ICC values indicated that the inter-rater reproducibility was greater than 0.90 for all measurements (LBLP and healthy subjects), except for the measurement of the right gluteus medius muscle in LBLP patients, which was equal to 0.848. CONCLUSION More than 50% of LBLP subjects presented symptomatic gluteus maximus, gluteus minimus and piriformis muscle atrophy. 3-D manual segmentation reliably measured muscle volume in all the measured pelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required.
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Affiliation(s)
- Elżbieta Skorupska
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Keczmer
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Rafał M. Łochowski
- Department of Mathematics and Mathematical Economics, Warsaw School of Economics, Warsaw, Poland
| | - Paulina Tomal
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Rychlik
- Department of Virtual Engineering, Poznan University of Technology, Poznan, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
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Cronin B, Johnson ST, Chang E, Pollard CD, Norcross MF. Greater Hip Extension but Not Hip Abduction Explosive Strength Is Associated With Lesser Hip Adduction and Knee Valgus Motion During a Single-Leg Jump-Cut. Orthop J Sports Med 2016; 4:2325967116639578. [PMID: 27104207 PMCID: PMC4827118 DOI: 10.1177/2325967116639578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane hip and knee motion during a single-leg jump-cutting task. Study Design: Descriptive laboratory study. Methods: Forty recreationally active females performed maximal isometric contractions and single-leg jump-cuts. From recorded torque data, hip extension and abduction RTD was calculated from torque onset to 200 ms after onset. Three-dimensional motion analysis was used to quantify frontal plane hip and knee kinematics during the movement task. For each RTD measure, jump-cut biomechanics were compared between participants in the highest (high) and lowest (low) RTD tertiles. Results: No differences in frontal plane hip and knee kinematics were identified between high and low hip abduction RTD groups. However, those in the high hip extension RTD group exhibited lower hip adduction (high, 3.8° ± 3.0°; low, 6.5° ± 3.0°; P = .019) and knee valgus (high, –2.5° ± 2.3°; low, –4.4° ± 3.2°; P = .046) displacements during the jump-cut. Conclusion: In movements such as cutting that are performed with the hip in a relatively abducted and flexed position, the ability of the gluteus medius to control hip adduction may be compromised. However, the gluteus maximus, functioning as a hip abductor, may take on a pivotal role in controlling hip adduction and knee valgus motion during these types of tasks. Clinical Relevance: Training with a specific emphasis on increasing explosive strength of the hip extensors may be a means through which to improve frontal plane hip and knee control during high-risk maneuvers such as cutting.
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Affiliation(s)
- Baker Cronin
- Sports Medicine Program, Department of Intercollegiate Athletics, University of California, Berkeley, Berkeley, California, USA
| | - Samuel T Johnson
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Eunwook Chang
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | | | - Marc F Norcross
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
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Uemura K, Takao M, Sakai T, Nishii T, Sugano N. Volume Increases of the Gluteus Maximus, Gluteus Medius, and Thigh Muscles After Hip Arthroplasty. J Arthroplasty 2016; 31:906-912.e1. [PMID: 26652475 DOI: 10.1016/j.arth.2015.10.036] [Citation(s) in RCA: 35] [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: 09/02/2015] [Revised: 10/15/2015] [Accepted: 10/26/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Muscle atrophy in osteoarthritis (OA) patients is expected to recover after total hip arthroplasty (THA) because of the increase in activity levels. Although some reports have shown an increase in the thigh muscles (Th) after THA, no reports of increases in the gluteal muscles and of analyses of the factors related to muscle recovery have been published. In this study, the changes in the gluteal and Th volumes after THA were quantitatively evaluated using computed tomography (CT) images, and the factors related to muscle recovery were analyzed. METHODS The subjects were 40 OA hips with CT images taken 3 weeks after THA (first postoperative [postop] CT) and more than 2 years after THA (second postop CT). The cross-sectional areas of gluteus maximus (G-max), gluteus medius (G-med), and Th were measured in both CT images. The factors related to muscle recovery that were measured and evaluated were age, gender, days from operation, surgical approach, Kellgren-Lawrence grades, and hip functional score (Japanese Orthopaedics Association hip score). RESULTS All measured cross-sectional areas of the operated side increased significantly from the first postop CT to the second postop CT (G-max, 40%; G-med, 11%; and Th, 20%). In the analysis of the factors related to muscle recovery, the increase rate of G-max correlated significantly with patient age, and the increase rate of G-med correlated significantly with the increase in Japanese Orthopaedics Association hip score. CONCLUSIONS Hip OA can lead to atrophy of the gluteal and Th, but the muscle volume can recover more than 2 years after THA.
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Affiliation(s)
- Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Takashi Sakai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Takashi Nishii
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
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Walsh R, Kinsella S. The effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) in relation to restricted internal rotation in the hip: A randomised control pilot study. ACTA ACUST UNITED AC 2016; 22:9-15. [PMID: 26995777 DOI: 10.1016/j.math.2016.01.007] [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: 07/02/2015] [Revised: 12/18/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND A loss of internal rotation (IR) of the hip is associated with hip pathology. Improving IR may improve hip range of motion (ROM) or prevent hip pathology. OBJECTIVES The purpose of this study was to compare the immediate effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) on young healthy male subjects with reduced IR of the hip. DESIGN A randomised controlled trial was performed. Twenty-Two subjects were randomised into a MWM group (n = 6), SMWM group (n = 8) or a control group (n = 8). METHOD The primary outcome measures included the functional internal rotation test (FIRT) for the hip and the passive seated internal rotation test (SIRT) for the hip. Outcomes were captured at baseline and immediately after one treatment of MWMs, SMWMs or control. RESULTS A two-way analysis of variance (ANOVA), group × time interaction was conducted. The ANOVA revealed the only significant improvement was in the MWM group for the FIRT (p = 0.01), over the control group. Subjects with reduced IR of the hip who receive a single session of MWMs exhibited significantly improved functional IR of their hip than the control group. CONCLUSIONS From the data presented, it can be suggested that caudal MWMs of the hip appear to have a positive effect on functional IR of healthy young hips. This may be due to addressing the positional fault theory or the arthrogenic muscular inhibition theory. SMWMs may be effective in augmenting treatments for patients waiting for hip operations.
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Affiliation(s)
- Riche Walsh
- Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland.
| | - Sharon Kinsella
- Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
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Lube J, Cotofana S, Bechmann I, Milani TL, Özkurtul O, Sakai T, Steinke H, Hammer N. Reference data on muscle volumes of healthy human pelvis and lower extremity muscles: an in vivo magnetic resonance imaging feasibility study. Surg Radiol Anat 2015; 38:97-106. [DOI: 10.1007/s00276-015-1526-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/22/2015] [Indexed: 10/23/2022]
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Caplan N, Stewart S, Kashyap S, Banaszkiewicz P, St Clair Gibson A, Kader D, Ewen A. The effect of total hip and hip resurfacing arthroplasty on vertical ground reaction force and impulse symmetry during a sit-to-stand task. Clin Biomech (Bristol, Avon) 2014; 29:1164-9. [PMID: 25293891 DOI: 10.1016/j.clinbiomech.2014.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to determine the influence of total hip arthroplasty and hip resurfacing arthroplasty on limb loading symmetry before, and after, hip reconstruction surgery during a sit-to-stand task. METHODS Fourteen patients were recruited that were about to receive either a total hip prosthesis (n=7) or a hip resurfacing prosthesis (n=7), as well as matched controls. Patients performed a sit-to-stand movement before, 3 months after, and 12 months after surgery. Peak vertical ground reaction force and impulse were measured for each leg, from which ground reaction force and impulse symmetry ratios were calculated. FINDINGS Before surgery, hip resurfacing patients showed a small asymmetry which was not different to normal for ground reaction force (0.88(0.28) vs. 1.00(0.11); p=0.311) or impulse (0.87(0.29) vs. 0.99(0.09); p=0.324) symmetry ratios. Total hip patients offloaded their affected hip by 30% in terms of impulse symmetry ratio (0.71(0.36) vs. 0.99(0.23); p=0.018). At 3 months following surgery asymmetries were seen that were different to normal in both hip resurfacing patients for ground reaction force (0.77(0.16); p=0.007), and total hip patients for ground reaction force (0.70(0.15); p=0.018) and impulse (0.72(0.16); p=0.011) symmetry ratios. By 12 months after surgery total hip patients regained a symmetrical loading pattern for both ground reaction force (0.95(0.06); p=0.676) and impulse (1.00(0.06); p=0.702) symmetry ratios. Hip resurfacing patients, however, performed the task by overloading their operated hip, with impulse symmetry ratio being larger than normal (1.16(0.16); p=0.035). INTERPRETATION Physiotherapists should appreciate the need for early recovery of limb loading symmetry as well as subsequent differences in the responses observed with different prostheses.
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Affiliation(s)
- N Caplan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
| | - S Stewart
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - S Kashyap
- Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, UK
| | - P Banaszkiewicz
- Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, UK
| | - A St Clair Gibson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - D Kader
- Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, UK
| | - A Ewen
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls. ACTA ACUST UNITED AC 2014; 19:405-10. [DOI: 10.1016/j.math.2014.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/18/2014] [Accepted: 02/23/2014] [Indexed: 02/05/2023]
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Lee JH, Cynn HS, Kwon OY, Yi CH, Yoon TL, Choi WJ, Choi SA. Different hip rotations influence hip abductor muscles activity during isometric side-lying hip abduction in subjects with gluteus medius weakness. J Electromyogr Kinesiol 2014; 24:318-24. [DOI: 10.1016/j.jelekin.2014.01.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 12/20/2013] [Accepted: 01/25/2014] [Indexed: 01/14/2023] Open
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Minimizing preoperative and postoperative limping in patients after total hip arthroplasty: relevance of hip muscle strength and endurance. Am J Phys Med Rehabil 2014; 92:1060-9. [PMID: 23739275 DOI: 10.1097/phm.0b013e3182970fc4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that hip muscle function (strength and endurance) improves after total hip arthroplasty and is important for minimizing limping gait. DESIGN Fifty-two patients who underwent total hip arthroplasty were assessed before and 6 mos after receiving a unilateral total hip endoprosthesis (Adaptiva stem with a Harris-Galante acetabular component). Severity of limping was assessed using a 4-point ordinal scale. Pain was assessed using a standardized ordinal scale. Eccentric, concentric, and isometric muscle strength and endurance of the hip extensors, flexors, adductors, and abductors were measured using a dynamometer. RESULTS Postoperative limping severity and pain were significantly lower and postoperative muscle strength and endurance were significantly higher than the preoperative values (P < 0.05). The association between impaired muscle strength and endurance and limping severity was stronger postoperatively than preoperatively. This association was stronger for the hip extensor and flexor muscles than for the hip adductor and abductor muscles. Pain level was not associated with postoperative limping severity. CONCLUSIONS Hip extensor and flexor muscle strength and endurance seem to be relevant for minimizing postoperative limping in patients after total hip arthroplasty. Rehabilitation programs should include exercises aimed at improving hip extensor and flexor strength and endurance to improve gait function.
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Bennell K, Hinman RS, Wrigley TV, Creaby MW, Hodges P. Exercise and osteoarthritis: cause and effects. Compr Physiol 2013; 1:1943-2008. [PMID: 23733694 DOI: 10.1002/cphy.c100057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is a common chronic joint condition predominantly affecting the knee, hip, and hand joints. Exercise plays a role in the development and treatment of OA but most of the literature in this area relates to knee OA. While studies indicate that exercise and physical activity have a generally positive effect on healthy cartilage metrics, depending upon the type of the activity and its intensity, the risk of OA development does appear to be moderately increased with sporting participation. In particular, joint injury associated with sports participation may be largely responsible for this increased risk of OA with sport. Various repetitive occupational tasks are also linked to greater likelihood of OA development. There are a number of physical impairments associated with OA including pain, muscle weakness and altered muscle function, reduced proprioception and postural control, joint instability, restricted range of motion, and lower aerobic fitness. These can result directly from the OA pathological process and/or indirectly as a result of factors such as pain, effusion, and reduced activity levels. These impairments and their underlying physiology are often targeted by exercise interventions and evidence generally shows that many of these can be modified by specific exercise. There is currently little clinical trial evidence to show that exercise can alter mechanical load and structural disease progression in those with established OA, although a number of impairments, that are amenable to change with exercise, appears to be associated with increased mechanical load and/or disease progression in longitudinal studies.
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Affiliation(s)
- Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia.
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