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Coburn SL, Crossley KM, Kemp JL, Gassert F, Luitjens J, Warden SJ, Culvenor AG, Scholes MJ, King MG, Lawrenson P, Link TM, Heerey JJ. Association between hip muscle strength/function and hip cartilage defects in sub-elite football players with hip/groin pain. Osteoarthritis Cartilage 2024; 32:943-951. [PMID: 38648877 DOI: 10.1016/j.joca.2024.03.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To explore associations between hip muscle strength and cartilage defects (presence and severity) on magnetic resonance imaging (MRI) in young adults with hip/groin pain participating in sub-elite football. DESIGN Sub-elite football players with hip/groin pain (>6 months) completed assessments of isometric hip strength and functional task performance. Hip cartilage defects were assessed using the Scoring Hip Osteoarthritis with MRI tool. This exploratory, cross-sectional study used logistic and negative binomial models to assess the relationships between hip muscle strength or functional task performance and hip cartilage defects, controlling for body mass index, age, testing site and cam morphology, incorporating sex-specific interaction terms. RESULTS One hundred and eighty-two (37 women) sub-elite (soccer or Australian football) players with hip/groin pain (age 26 ± 7 years) were included. Greater hip extension strength was associated with higher cartilage total score (adjusted incidence rate ratio [aIRR] 1.01, 95%CI: 1.0 to 1.02, p = 0.013) and superolateral cartilage score (adjusted odds ratio (aOR) 1.03, 95% confidence interval (CI): 1.01 to 1.06, p < 0.01). In female sub-elite football players, greater hip external rotation strength was associated with lateral cartilage defects (aOR 1.61, 95%CI: 1.05 to 2.48, p = 0.03) and higher cartilage total score (aIRR 1.25, 95%CI: 1.01 to 1.66, p = 0.042). A one-repetition increase in one-leg rise performance was related to lower odds of superomedial cartilage defects (aOR 0.96, 95%CI: 0.94 to 0.99, p < 0.01). CONCLUSIONS Overall, there were few associations between peak isometric hip muscle strength and overall hip cartilage defects. It is possible that other factors may have relevance in sub-elite football players. Additional studies are needed to support or refute our findings that higher one leg rise performance was associated with reduced superomedial cartilage defect severity and greater hip extension strength was related to higher cartilage defect severity scores.
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Affiliation(s)
- S L Coburn
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
| | - K M Crossley
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - J L Kemp
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - F Gassert
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - J Luitjens
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - S J Warden
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Physical Therapy, School of Health & Human Sciences, Indiana 15 University, Indianapolis, IN, USA
| | - A G Culvenor
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - M J Scholes
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - M G King
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - P Lawrenson
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
| | - T M Link
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
| | - J J Heerey
- La Trobe University Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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González-de-la-Flor Á. A New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain. Pain Ther 2024; 13:457-479. [PMID: 38698256 PMCID: PMC11111658 DOI: 10.1007/s40122-024-00604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Hip-related pain is a common issue in active adults affecting their quality of life, mobility, and overall function, and it can lead to persistent disability. However, diagnosing hip-related pain is challenging due to the many potential sources and causes, including intra-articular and extra-articular pathology, and referred pain from other areas (lumbar or groin related pain). To address this, there is a need for a clinical algorithm based on the best available evidence and expert consensus. This algorithm could guide healthcare professionals in assessing and managing patients with hip-related pain, during the diagnosis, test selection, intervention, monitoring, and promoting collaboration among various healthcare providers. This clinical algorithm for hip-related pain is a comprehensive, flexible, adaptable to different settings, and regularly updated to incorporate new research findings. This literature review aims to establish a clinical algorithm specifically for prescribing exercise treatment to patients with hip-related pain, addressing their individual needs and enhancing their overall care.
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Affiliation(s)
- Ángel González-de-la-Flor
- Faculty of Sport Sciences, Universidad Europea de Madrid, Calle Tajo s/n, 28670, Villaviciosa de Odón, Madrid, Spain.
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Grosklos M, Fanning J, Friedberg G, Lewis CL, Di Stasi S. Increased Duration and Intensity of Physical Activity Are Associated With Increased Pain in Individuals With Femoroacetabular Impingement Syndrome: An Ecological Momentary Assessment Study. Arch Phys Med Rehabil 2024; 105:725-732. [PMID: 38185311 PMCID: PMC10994740 DOI: 10.1016/j.apmr.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To investigate the relation between accelerometer-measured physical activity and real-time pain in individuals with femoroacetabular impingement syndrome (FAIS). We tested the hypothesis that increased duration of high intensity activity would contribute to momentary increases in pain. DESIGN Observational study. SETTING Participants' natural, day-to-day environment. PARTICIPANTS Population-based sample of 33 individuals with unilateral FAIS. Important eligibility criteria included no concomitant hip disorders or previous hip surgery. Key sociodemographic features include that all participants were required to have a smartphone. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Duration and intensity of physical activity as measured by a waist-worn accelerometer, and instantaneous pain reported in real-time smartphone-based ecological momentary assessment surveys. Physical activity variables included each person's average sedentary time, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) in the 90 minutes proceeding all pain surveys as well as fluctuation in sedentary, LPA, and MVPA above or below average prior to each individual survey. RESULTS Linear mixed models revealed that the significant predictors of pain included fluctuation in sedentary time (B=-0.031, P<.001), average LPA (B=0.26, P=.035), and the interaction between fluctuation in LPA and fluctuation in MVPA (B=0.001, P<.001). Fluctuation in sedentary time above a person's average was associated with lower pain, while average LPA and fluctuations above average in both LPA and MVPA were associated with higher pain. CONCLUSIONS These results suggest that individuals with FAIS can engage in health-enhancing MVPA but should focus on avoiding concurrent increase above average in both high intensity and LPA in the same 90-minute period. Future work is warranted testing the efficacy of such an approach on pain. Additionally, given that high levels of LPA may arise from a host of socioeconomic factors, additional research is needed to disentangle the effect of LPA on pain in FAIS.
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Affiliation(s)
- Madeline Grosklos
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH.
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC
| | - Gregory Friedberg
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH; Ohio State College of Medicine, The Ohio State University, Columbus, OH
| | - Cara L Lewis
- Department of Physical Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | - Stephanie Di Stasi
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH; Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
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Niethammer TR, Aurich M, Brucker PU, Faber S, Diemer F, Pietschmann MF, Schoch W, Zinser W, Müller PE. Follow-up Treatment after Cartilage Therapy of the Knee Joint - a Recommendation of the DGOU Clinical Tissue Regeneration Working Group. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024. [PMID: 38224697 DOI: 10.1055/a-2206-7242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
The first follow-up treatment recommendation from the DGOU's Clinical Tissue Regeneration working group dates back to 2012. New scientific evidence and changed framework conditions made it necessary to update the follow-up treatment recommendations after cartilage therapy.As part of a multi-stage member survey, a consensus was reached which, together with the scientific evidence, provides the basis for the present follow-up treatment recommendation.The decisive criterion for follow-up treatment is still the defect localisation. A distinction is made between femorotibial and patellofemoral defects. In addition, further criteria regarding cartilage defects are now also taken into account (stable cartilage edge, location outside the main stress zone) and the different methods of cartilage therapy (e. g. osteochondral transplantation, minced cartilage) are discussed.The present updated recommendation includes different aspects of follow-up treatment, starting with early perioperative management through to sports clearance and resumption of contact sports after cartilage therapy has taken place.
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Affiliation(s)
- Thomas R Niethammer
- Muskuloskelettales Universitätszentrum München (MUM), Klinik für Orthopädie und Unfallchirurgie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Matthias Aurich
- Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Halle (Saale), Halle, Deutschland
- Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinikum Bergmannstrost, Halle (Saale), Deutschland
| | - Peter U Brucker
- ATOS Klinik München, München, Deutschland
- Biomechanik im Sport, Fakultät für Sport- und Gesundheitswissenschaft, Technische Universität München, München
| | - Svea Faber
- Muskuloskelettales Universitätszentrum München (MUM), Klinik für Orthopädie und Unfallchirurgie, Klinikum der Universität München, LMU München, München, Deutschland
| | | | - Matthias F Pietschmann
- Muskuloskelettales Universitätszentrum München (MUM), Klinik für Orthopädie und Unfallchirurgie, Klinikum der Universität München, LMU München, München, Deutschland
- OrthoPraxis Oberhaching, Oberhaching
| | | | - Wolfgang Zinser
- Orthoexpert, Knittelfeld, Österreich
- Metagil Physikalisches Ambulatorium, Knittelfeld, Österreich
| | - Peter E Müller
- Muskuloskelettales Universitätszentrum München (MUM), Klinik für Orthopädie und Unfallchirurgie, Klinikum der Universität München, LMU München, München, Deutschland
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5
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O'Brien MJM, Heerey J, Semciw AI, Mechlenburg I, Jacobsen JS, King MG, Scholes MJ, Lawrenson PR, Crossley K, Agricola R, Souza RB, Kemp JL. Does hip muscle strength and functional performance differ between football players with and without hip dysplasia? Phys Ther Sport 2023; 64:1-7. [PMID: 37598519 DOI: 10.1016/j.ptsp.2023.08.002] [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: 05/17/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To compare hip muscle strength and functional performance in football players with and without hip dysplasia and investigate if the relationships were modified by sex. DESIGN Cross-sectional study. METHODS This study compared football players with hip dysplasia (HD group) and without hip dysplasia (control group). Hip muscle strength (Nm/kg) and functional task performance were assessed in both groups. Linear regression with generalized estimating equations were used to assess differences between groups. Sex was assessed as a potential effect modifier. RESULTS 101 football players were included (HD group, n = 50, control group, n = 51). There was no difference in hip muscle strength or functional performance between the HD group and the control group. Results ranged from hip extension strength (Estimate -0.13.95%CI: 0.29 to 0.02, P = 0.087) to hip external rotation strength (Estimate 0.00.95%CI: 0.05 to 0.05, P = 0.918). No relationships were modified by sex or age. CONCLUSIONS Similar levels of hip muscle strength and functional performance were found in active football players with and without hip dysplasia. These findings differ from other studies. This may be due to our cohort having less advanced hip dysplasia than the surgical populations that have been previously investigated, or due to a beneficial effect of football participation on muscle strength and functional performance in people with hip dysplasia.
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Affiliation(s)
- Michael J M O'Brien
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia. m.o'
| | - Joshua Heerey
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Adam Ivan Semciw
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Victoria, Australia
| | - Inger Mechlenburg
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Julie S Jacobsen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark; Research Unit for General Practice, Aarhus, Denmark
| | - Matthew G King
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Victoria, Australia
| | - Mark J Scholes
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Peter R Lawrenson
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Kay Crossley
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Rintje Agricola
- Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, Rotterdam, the Netherlands
| | - Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, CA, USA
| | - Joanne L Kemp
- La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
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6
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Girdwood M, Mentiplay BF, Scholes MJ, Heerey JJ, Crossley KM, O'Brien MJM, Perraton Z, Shawdon A, Kemp JL. Hip Muscle Strength, Range of Motion, and Functional Performance in Young Elite Male Australian Football Players. J Sport Rehabil 2023; 32:910-919. [PMID: 37758256 DOI: 10.1123/jsr.2022-0450] [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: 12/20/2022] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 10/03/2023]
Abstract
CONTEXT Hip and groin injuries are common in field sports such as football, with measurement of hip strength and range of motion (ROM) recommended for assessment of these conditions. We aimed to report hip strength, hip ROM, and functional task performance in young elite Australian football athletes. DESIGN Cross-sectional study. METHODS Fifty-eight newly drafted Australian Football League athletes completed hip abduction, adduction, internal rotation, external rotation, and flexion strength testing with an adjustable stabilized or hand-held dynamometer. Hip internal rotation and external rotation, bent knee fall out, and ankle dorsiflexion ROM were also measured. Players completed hop for distance, side bridge, and star excursion balance functional tests. We compared findings between the dominant and nondominant limbs. RESULTS We found small deficits unlikely to be clinically meaningful in the dominant limb for hip abduction and adduction strength, and a small deficit in the nondominant limb for external rotation strength and side bridge time. Athletes had lower hip internal rotation (mean difference 2.56°; 95% confidence interval, 0.87 to 4.26) and total rotation ROM (2.03°; 95% confidence interval, 0.06 to 4.01) on the dominant limb. CONCLUSIONS There were no meaningful differences between dominant and nondominant limbs for hip strength, ROM, or functional tests. Our results may be used for benchmarking young male Australian football athletes when targeting optimal strength and returning from injury.
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Affiliation(s)
- Michael Girdwood
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Benjamin F Mentiplay
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Mark J Scholes
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Joshua J Heerey
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Kay M Crossley
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Michael J M O'Brien
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Zuzana Perraton
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Anik Shawdon
- Australian Football League, Melbourne, VIC, Australia
| | - Joanne L Kemp
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
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7
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O'Brien MJM, Kemp JL, Semciw AI, Mechlenburg I, Jacobsen JS, King MG, Scholes MJ, Lawrenson PR, Agricola R, Souza RB, Heerey J. Football Players With Hip Dysplasia: The Relationship Between Muscle Strength, Functional Performance, Self-reported Sport and Recreation, Cartilage Defects, and Sex. A Cross-sectional Study. J Orthop Sports Phys Ther 2023; 53:626–633. [PMID: 37683117 DOI: 10.2519/jospt.2023.12026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE: In symptomatic football players with hip dysplasia, we aimed to explore the relationships between self-reported sport and recreation ability and (1) hip muscle strength, (2) functional performance, and investigate if these relationships were modified by sex or cartilage defects. METHODS: In this cross-sectional study, football players (n = 50) with longstanding (>6 months) hip and/or groin pain, a positive flexion/adduction/internal rotation test, and a lateral-center-edge angle <25° were included. Hip muscle strength and functional performance were assessed. Self-reported sport and recreation ability was quantified using the sports and recreational subscales from the International Hip Outcome Tool-33 (iHOT-Sport) and the Copenhagen Hip and Groin Outcome Score (HAGOS-Sport). Relationships were evaluated using regression models with sex and cartilage defects as potential effect modifiers. RESULTS: There was a positive linear relationship between the one-leg-rise test and the iHOT-Sport subscale (β = 0.61; 95% CI: 0.09, 1.14). A polynomial (concave) relationship was found between peak eccentric adduction strength and the HAGOS-Sport subscale (β = -30.88; 95% CI: -57.78, -3.99). Cartilage defects modified the relationship between peak isometric adduction strength and HAGOS-Sport, with those with cartilage defects having a polynomial (convex) relationship (β = 36.59; 95% CI: 12.74, 60.45), and those without cartilage defects having no relationship. CONCLUSION: One-leg-rise performance and adduction strength were associated with self-reported sport and recreation ability, indicating a possible relationship between physical function, hip joint structure, and sport and recreation ability in football players with hip dysplasia. J Orthop Sports Phys Ther 2023;53(10):1-8. Epub: 8 September 2023. doi:10.2519/jospt.2023.12026.
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8
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Bonello C, King MG, Crossley KM, Heerey JJ, Scholes MJ, Lawrenson P, Girdwood MA, Kemp JL, Mosler AB, Mentiplay BF, Semciw AI. The association between hip/groin pain and hip strength in football players: An exploratory analysis of the FORCe cohort. J Sci Med Sport 2023; 26:471-475. [PMID: 37532657 DOI: 10.1016/j.jsams.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Explore associations between peak hip strength in football players with hip/groin pain and healthy controls. DESIGN Cross-sectional study. METHODS Male and female sub-elite football players (soccer and Australian football) with hip/groin pain >6-month duration and players without hip/groin pain were recruited across Melbourne and Brisbane, Australia. Demographic information and two questionnaires; the Copenhagen Hip and Groin Outcome Score and the International Hip Outcome Tool 33 were collected. Hand-held dynamometry was used to measure isometric hip strength for flexion, extension, abduction, adduction, internal rotation, and external rotation. Linear mixed effects models were used to compare strength measures between groups. RESULTS 190 football players with hip/groin pain (mean ± standard deviation age, 27.8 ± 6.3 years) and 64 controls (age, 27.3 ± 5.6 years) were included in this study. Of these, 291 symptomatic limbs and 128 control limbs were used for analyses. Symptomatic players had lower peak hip adduction (adjusted mean difference = -0.18: 95 % confidence interval -0.27 to -0.08, P : 0.001), external rotation (-0.06: 95 % confidence interval -0.09 to -0.02, P : 0.003), and internal rotation strength (-0.06: 95 % confidence interval -0.10 to -0.03, P : 0.001) compared to controls. A sport-specific interaction was observed for hip abduction strength. When separated by football code, abduction strength was lower in symptomatic Australian football players compared to their same sport peers (-0.20: 95 % confidence interval -0.33 to -0.06, P : 0.004), but not in symptomatic soccer players (-0.05: 95 % confidence interval -0.15 to 0.06, P : 0.382). CONCLUSIONS Hip adduction, internal rotation, and external rotation strength appears lower in football players with hip/groin pain independent of sex and football code. Hip abduction strength was lower in symptomatic Australian football players but not in soccer players.
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Affiliation(s)
- C Bonello
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia.
| | - M G King
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - K M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - J J Heerey
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - M J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - P Lawrenson
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - M A Girdwood
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - J L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - A B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - B F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
| | - A I Semciw
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia
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9
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Stewart C, King MG, Kemp JL, Mentiplay BF, O'Brien MJ, Perraton Z, Lawrenson PR, Semciw AI. Hip muscle activity in people with hip-related pain compared to asymptomatic controls: A systematic review. J Electromyogr Kinesiol 2023; 71:102784. [PMID: 37331133 DOI: 10.1016/j.jelekin.2023.102784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Altered hip and thigh muscle activity have been observed across a spectrum of articular hip pathologies, including hip osteoarthritis, femoroacetabular impingement syndrome, and labral pathology. No systematic reviews have examined muscle activity associated with hip pathology and hip-related pain across the life span. A greater understanding of impairments in hip and thigh muscle activity during functional tasks may assist in the development of targeted treatment strategies. METHODS We conducted a systematic review using the PRISMA guidelines. A literature search was performed in five databases (MEDLINE, CINAHL, EMBASE, Sports Discuss, and PsychINFO). Studies were included that (i) investigated people with hip-related pain (femoroacetabular impingement syndrome, labral tears) or hip osteoarthritis; and (ii) reported on muscle activity using electromyography of hip and thigh muscles during functional tasks such as walking, stepping, squatting, or lunging. Two independent reviewers performed data extraction and assessed risk of bias using a modified version of the Downs and Black checklist. RESULTS Non-pooled data demonstrated a limited level of evidence. Overall, differences in muscle activity appeared to be more prevalent in people with more advanced hip pathology. CONCLUSIONS We found that impairments in muscle activity in those with intra-articular hip pathology measured using electromyography were variable but appeared to be greater in severe hip pathology (e.g., hip OA).
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Affiliation(s)
- Christopher Stewart
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia
| | - Matthew G King
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia
| | - Joanne L Kemp
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia; La Trobe Sports and Exercise Medicine Research Center, La Trobe University
| | - Benjamin F Mentiplay
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia
| | - Michael Jm O'Brien
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia
| | - Zuzana Perraton
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia
| | - Peter R Lawrenson
- University of Queensland, School of Health and Rehabilitation Sciences, Australia
| | - Adam I Semciw
- La Trobe University, School of Allied Health, Human Services, and Sport, Australia.
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10
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Lewis CL, Uemura K, Atkins PR, Lenz AL, Fiorentino NM, Aoki SK, Anderson AE. Patients with cam-type femoroacetabular impingement demonstrate increased change in bone-to-bone distance during walking: A dual fluoroscopy study. J Orthop Res 2023; 41:161-169. [PMID: 35325481 PMCID: PMC9508282 DOI: 10.1002/jor.25332] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/24/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
Cam-type femoroacetabular impingement (FAI) syndrome is a painful, structural hip disorder. Herein, we investigated hip joint mechanics through in vivo, dynamic measurement of the bone-to-bone distance between the femoral head and acetabulum in patients with cam FAI syndrome and morphologically screened controls. We hypothesized that individuals with cam FAI syndrome would have larger changes in bone-to-bone distance compared to the control group, which we would interpret as altered joint mechanics as signified by greater movement of the femoral head as it articulates within the acetabulum. Seven patients with cam FAI syndrome and 11 asymptomatic individuals with typical morphology underwent dual fluoroscopy imaging during level and inclined walking (upward slope). The change in bone-to-bone distance between femoral and acetabular bone surfaces was evaluated for five anatomical regions of the acetabulum at each timepoint of gait. Linear regression analysis of the bone-to-bone distance considered two within-subject factors (activity and region) and one between-subjects factor (group). Across activities, the change in minimum bone-to-bone distance was 1.38-2.54 mm for the cam FAI group and 1.16-1.84 mm for controls. In all regions except the anterior-superior region, the change in bone-to-bone distance was larger in the cam group than the control group (p ≤ 0.024). An effect of activity was detected only in the posterior-superior region where larger changes were noted during level walking than incline walking. Statement of clinical significance: Patients with cam FAI syndrome exhibit altered hip joint mechanics during the low-demand activity of walking; these alterations could affect load transmission, and contribute to pain, tissue damage, and osteoarthritis.
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Affiliation(s)
- Cara L Lewis
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Keisuke Uemura
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Penny R Atkins
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA
| | - Amy L Lenz
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Niccolo M Fiorentino
- Department of Mechanical Engineering, University of Vermont, Burlington, Vermont, USA
| | - Stephen K Aoki
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
| | - Andrew E Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
- Department of Physical Therapy, University of Utah, Salt Lake City, Utah, USA
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11
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Reine S, Xi Y, Archer H, Chhabra A, Huo M, Wells J. Effects of Depression, Anxiety, and Pain Catastrophizing on Total Hip Arthroplasty Patient Activity Level. J Arthroplasty 2022; 38:1110-1114. [PMID: 36529194 DOI: 10.1016/j.arth.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Improvements in psychological factors are strongly associated with increased physical activity in the general population. The effects of depression, anxiety, and pain catastrophizing on activity level have not been thoroughly explored in patients undergoing total hip arthroplasty (THA). Mental health markedly influences patient perspectives on treatment success and quality of life. We hypothesized that improvements in screenings for depression, anxiety, and catastrophizing correlate with improvements in activity levels after THA. METHODS Two hundred ninety two patients (313 hips) who underwent THA with a minimum 1-year (mean 615 ± 270 days) follow-up completed preoperative and postoperative surveys containing the University of California Los Angeles (UCLA) Activity Score, Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale (PCS), and Depression Anxiety Stress Scale-21 (DASS). Wilcoxon signed-rank tests were performed between preoperative and postoperative times for outcome measures. Partial Spearman's rank-order correlations were performed between the change in UCLA Score and the change in HADS, PCS, and DASS. RESULTS There were significant improvements in UCLA Score (P value < .0001) and every subscale of PCS, HADS, and DASS (P values < .0001). Significant negative correlations existed between change in UCLA Score and change in HADS-anxiety (rs = -0.21, P value < .001), change in HADS-depression (rs = -0.23, P value < .001), and change in DASS-anxiety (rs = -0.22, P value = .004) following THA. Weaker significant negative correlations existed between change in UCLA Score and change in the remaining PCS (P values = .006) and DASS-depression(P value = .037) subscales. CONCLUSION Improvements in patient-reported depression, anxiety, and pain catastrophizing screenings following THA were associated with increased activity levels. Patients who were screened for catastrophizing, depression, and anxiety achieved statistically and clinically meaningful improvements in symptoms following THA. Addressing patient mental health provides another avenue for holistic care of THA patients.
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Affiliation(s)
- Seth Reine
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Holden Archer
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Avnessh Chhabra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael Huo
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joel Wells
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
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12
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Dijkstra HP, Mc Auliffe S, Ardern CL, Kemp JL, Mosler AB, Price A, Blazey P, Richards D, Farooq A, Serner A, McNally E, Mascarenhas V, Willy RW, Oke JL, Khan KM, Glyn-Jones S, Clarke M, Greenhalgh T. Oxford consensus on primary cam morphology and femoroacetabular impingement syndrome: part 2-research priorities on conditions affecting the young person's hip. Br J Sports Med 2022; 57:bjsports-2022-106092. [PMID: 36588402 PMCID: PMC9985764 DOI: 10.1136/bjsports-2022-106092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Primary cam morphology is highly prevalent in many athlete populations, causing debilitating hip osteoarthritis in some. Existing research is mired in confusion partly because stakeholders have not agreed on key primary cam morphology elements or a prioritised research agenda. We aimed to inform a more rigorous, inclusive and evidence-based approach to research on primary cam morphology and its natural history by working towards agreement on a set of research priorities for conditions affecting the young person's hip. METHODS An international expert panel-the Young Athlete's Hip Research (YAHiR) Collaborative-rated research priority statements through an online two-round Delphi exercise and met online to explore areas of tension and dissent. Panellists ranked the prioritised research statements according to the Essential National Health Research (ENHR) ranking strategy. Reporting of results followed REPRISE (REporting guideline for PRIority SEtting of health). RESULTS A diverse Delphi panel (n=65, Delphi rounds 1 and 2; three ENHR strategy surveys: n=49; n=44; n=42) from 18 countries representing six stakeholder groups, prioritised and ranked 18 of 38 research priority statements. The prioritised statements outlined seven research domains: (1) best practice physiotherapy, (2) rehabilitation progression and return to sport, (3) exercise intervention and load management, (4) primary cam morphology prognosis and aetiology, (5) femoroacetabular impingement syndrome prognosis and aetiology, (6) diagnostic criteria, and (7) screening. The panel recommended areas of tension and dissent for the research community to focus on immediately. CONCLUSION While informing more rigorous, inclusive and evidence-based research, this consensus is a roadmap for researchers, policy-makers and funders to implement research dedicated to reducing the cost and burden of hip disease related to primary cam morphology.
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Affiliation(s)
- H Paul Dijkstra
- Department of Medical Education, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Sean Mc Auliffe
- Department of Physical Therapy and Rehabilitation Science, Qatar University, Doha, Qatar
- Department of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Clare L Ardern
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- La Trobe Sport and Exercise Medicine Research Centre; Australian IOC Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre; Australian IOC Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea Britt Mosler
- La Trobe Sport and Exercise Medicine Research Centre; Australian IOC Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Amy Price
- Department of Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
| | - Paul Blazey
- Center for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Abdulaziz Farooq
- FIFA Medical Centre of Excellence, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Andreas Serner
- FIFA Medical, Federation Internationale de Football Association, Zurich, Switzerland
| | | | - Vasco Mascarenhas
- Advanced Imaging Research Consortium UIME, Hospital da Luz, Lisboa, Portugal
| | - Richard W Willy
- School of Physical Therapy, University of Montana, Missoula, Montana, USA
| | - Jason L Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Karim M Khan
- Family Practice & Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sion Glyn-Jones
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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13
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Reine ST, Xi Y, Chhabra A, LaCross J, Kohli A, Wells JE. Does Preoperative Activity Level Affect Postoperative Outcomes Following Total Hip Arthroplasty? J Arthroplasty 2022; 37:1314-1319. [PMID: 35276277 DOI: 10.1016/j.arth.2022.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 03/02/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Many patients electing to undergo total hip arthroplasty (THA) value continuing active lifestyles when considering treatment options. Addressing these concerns requires evaluating the effect of preoperative activity level on patient-reported outcomes and improvement following THA. METHODS Three hundred thirty-five patients (368 hips) who underwent THA with a minimum 6-month (mean 533 ± 271 days) follow-up completed preoperative and postoperative University of California, Los Angeles (UCLA) activity score along with various patient-reported measures of function, pain, and mental state. Preoperative UCLA score divided patients into inactive, mild, and active groups. Analysis of covariance controlling for age, sex, body mass index, surgical approach, implant, bilateral cases, conversions, and follow-up time evaluated differences among groups for postoperative outcomes with subsequent Tukey-Kramer pairwise comparisons. RESULTS Mildly active patients (73:139 male:female) had better postoperative outcomes than inactive patients (40:70 male:female) for UCLA score, EuroQol Visual Analog Scale (EQVAS), Hip Outcome Score (HOS), 12-item Short-Form (SF-12) Physical, and Visual Analog Pain Scale (average/now/worst) (P values <0.001/<0.001/<0.001/<0.001/0.003/<0.001/<0.001). Active patients (32:14 male:female) had better postoperative outcomes than inactive patients for UCLA score, EQVAS, HOS, SF-12 Physical, and Visual Analog Pain Scale Worst (P values <0.001/0.024/0.001/0.001/0.017). No postoperative outcome differences existed between active and mild patients. Inactive patients displayed greater outcome improvements than mildly active patients for UCLA score, Harris Hip Score, and International Hip Outcome Tool (P values <0.001/<0.001/0.013) and active patients for UCLA score, EQVAS, HOS, International Hip Outcome Tool, and SF-12 Physical (P values <0.001/0.008/0.013/0.022/0.004). CONCLUSIONS Inactive patients achieve greater measure improvements following THA. Active patients achieve better absolute outcomes than inactive patients; however, increasing activity levels do not incrementally improve patient-reported outcome measures. Patients similarly improve pain and mental health regardless of activity level.
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Affiliation(s)
- Seth T Reine
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Avneesh Chhabra
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Ajay Kohli
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Joel E Wells
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
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14
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Mentiplay BF, Kemp JL, Crossley KM, Scholes MJ, Coburn SL, Jones DM, de Oliveira Silva D, Johnston RTR, Pazzinatto MF, King MG. Relationship between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome. Clin Biomech (Bristol, Avon) 2022; 92:105587. [PMID: 35123104 DOI: 10.1016/j.clinbiomech.2022.105587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hip muscle weakness and altered hip biomechanics during walking are often observed in people with femoroacetabular impingement syndrome, although little is known about biomechanics during higher impact tasks. The aim of our study was to explore relationships between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome, including exploring sex as an effect-modifier of this relationship. METHODS Forty-two adults with unilateral femoroacetabular impingement syndrome (20 females; age 18-50 years; alpha angle ≥60°) completed assessments of hip muscle strength and hip biomechanics during running. Strength was assessed using a hand-held dynamometer for the hip flexors, extensors, abductors, adductors, internal rotators, and external rotators. Hip biomechanics were assessed during overground running (3-3.5 m/s) using three-dimensional motion capture and a force plate. Linear models assessed the relationships between hip strength and hip biomechanics of the symptomatic limb, controlling for body mass and running velocity along with an interaction term (strength*sex). FINDINGS A significant negative relationship was observed between hip external rotator strength and hip frontal plane range of motion (i.e., excursion), independent of sex (estimate = -0.039, 95%CI -0.071 to -0.008, P = 0.02). Four sex-specific interactions were observed, with a significant positive relationship between hip external rotator strength and peak hip extension moment in women (estimate = -0.413, 95%CI -0.713 to -0.114, P = 0.01) but not in men. INTERPRETATION We found significant relationships between hip external rotator strength and stance phase running biomechanics, providing further understanding on two impaired physical measures that may inform exercise-based management strategies in femoroacetabular impingement syndrome.
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Affiliation(s)
- Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Mark J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Sally L Coburn
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Denise M Jones
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Danilo de Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Richard T R Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Marcella F Pazzinatto
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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15
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Roughead EA, King MG, Crossley KM, Heerey JJ, Lawrenson PR, Scholes MJ, Semciw AI, Mentiplay BF, Kemp JL. Football players with long standing hip and groin pain display deficits in functional task performance. Phys Ther Sport 2022; 55:46-54. [DOI: 10.1016/j.ptsp.2022.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
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16
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Beaupré P, da Silva RA, Chevrette T. The Impact of Pain on Functionality, Postural Control and Fall Risk in Woman Aged 45 to 64 Years Old. Geriatrics (Basel) 2022; 7:10. [PMID: 35076521 PMCID: PMC8788291 DOI: 10.3390/geriatrics7010010] [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: 12/15/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Ageing in women is associated with chronic degenerative pain leading to a functional decrease and therefore increase fall risk. It is therefore essential to detect early functional decreases in the presence of pain related to osteoarthritis. OBJECTIVE This cross-sectional study aimed to assess the impact of pain on functionality, postural control and fall risk in women aged between 45 to 64 years old. METHODS Twenty-one (21) women aged 45 to 64 were evaluated by clinical and functional measures such as a pain questionnaire (Lequesne Index), functional tests (Stair Step Test, 5 times sit-to-stand, 6MWD, Timed-up and Go) and postural performance (under force platform). Women were classified into 2 groups from the Lequesne Pain Index (PI): low pain (score ≤ 9) and strong pain (score ≥ 10) for subsequent comparisons on functionality (physical and postural control performance). RESULTS A significant impact was observed between the pain index (strong PI) and 3 of the 4 functional tests carried out including Stair Step Test (p = 0.001; g = 1.44), walking distance (p = 0.003; g = 1.31) and Timed-up and Go (p = 0.04; g = -0.93). The group with a strong PI score reported further poor postural control under force platform compared to the weak pain group. CONCLUSION Pain and severity based on the PI index negatively modulate physical and postural control performance in women aged 45 to 64 years old.
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Affiliation(s)
- Priscilla Beaupré
- Masters of Biomedical Science Program, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada; (P.B.); (R.A.d.S.)
| | - Rubens A. da Silva
- Masters of Biomedical Science Program, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada; (P.B.); (R.A.d.S.)
- Physical Therapy McGill Program in Extension, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Centre Intersectoriel en Santé Durable, Département des Sciences de la Santé, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Centre Intégré de Santé et Services Sociaux du Saguenay—Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services–La Baie Hospital, Saguenay, QC G7H 7K9, Canada
- BioNR Research Lab, Département des Sciences de la santé, Université du Québec à Chicoutimi (UQAC), Chicoutimi, QC G7H 2B1, Canada
| | - Tommy Chevrette
- Masters of Biomedical Science Program, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada; (P.B.); (R.A.d.S.)
- Centre Intersectoriel en Santé Durable, Département des Sciences de la Santé, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Département des Sciences de la santé, Clinique Universitaire de Kinésiologie, Université du Québec à Chicoutimi (UQAC), Chicoutimi, QC G7H 2B1, Canada
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17
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Nagamoto H, Abe M, Konashi Y, Kimura R, Takahashi M, Oizumi A. Rotation-related sports players demonstrate rotation-type lumbar spondylolysis fracture angle and decreased hip internal rotation range of motion. J Orthop 2021; 28:101-106. [PMID: 34898928 DOI: 10.1016/j.jor.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/21/2021] [Indexed: 11/26/2022] Open
Abstract
Relationship between sports and spondylolysis fracture angle (SFA), and hip internal rotation range of motion (IR ROM) between the sports groups among athletes with spondylolysis were investigated. Sports requiring repeated rotation of the trunk and hips during most aspects of the activity was defined as rotation-related sports (RRS). The SFA was defined as rotation-type or horizontal-type by using the axial view of the CT scan. Percentage of rotation type and SFA of the non-dominant side for RRS group was significantly greater than those of non-RRS group. Hip IR ROM of RRS group was significantly smaller than that of non-RRS group. Level of evidence Level IV.
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Affiliation(s)
- Hideaki Nagamoto
- Department of Orthopaedic Surgery, Tohoku University, Japan.,Department of Orthopaedic Surgery, Kurihara Centeral Hospital, Japan
| | - Masaya Abe
- Department of Physical Medicine and Rehabilitation, Tohoku University Hospital, Japan
| | - Yu Konashi
- Department of Rehabilitation, Kurihara Central Hospital, Japan
| | - Rei Kimura
- Department of Orthopaedic Surgery, Tohoku University, Japan.,Department of Orthopaedic Surgery, Kurihara Centeral Hospital, Japan
| | | | - Akira Oizumi
- Department of Orthopaedic Surgery, Kurihara Centeral Hospital, Japan
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18
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Scholes MJ, Crossley KM, King MG, Schache AG, Kemp JL, Semciw AI, Sritharan P, Heerey JJ, Mentiplay BF. Running biomechanics in football players with and without hip and groin pain. A cross-sectional analysis of 116 sub-elite players. Phys Ther Sport 2021; 52:312-321. [PMID: 34742030 DOI: 10.1016/j.ptsp.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Examine whether football players with hip and/or groin (hip/groin) pain have impaired running biomechanics when compared to pain-free players, analysing men and women independently. DESIGN Cross-sectional. SETTING Biomechanics laboratory. PARTICIPANTS Seventy-eight (62 men, 16 women) football players with >6months of hip/groin pain and a positive flexion-adduction-internal rotation test and 38 (25 men, 13 women) asymptomatic players. MAIN OUTCOME MEASURES Pelvis angles and hip, knee, and ankle joint angles and moments were analysed during the stance phase of overground running at 3-3.5 m⋅s-1. Continuous joint angle and moment data were compared between symptomatic and asymptomatic football players of the same sex using statistical parametric mapping. Joint moment impulses (area under the curve) were compared between groups using linear regression models. RESULTS Symptomatic football players did not display significant differences in pelvis angles or lower-limb joint angles, moments, or moment impulses during the stance phase of running, when compared to asymptomatic players of the same sex. CONCLUSION Our large sample of football players with hip/groin pain who were still participating in competitive sport displayed similar running biomechanics to asymptomatic players. Impaired running biomechanics might exist in people with worse hip/groin pain, warranting future investigation.
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Affiliation(s)
- Mark J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Anthony G Schache
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Adam I Semciw
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Prasanna Sritharan
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Joshua J Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
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19
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Pålsson A, Kostogiannis I, Ageberg E. Physical impairments in longstanding hip and groin pain: Cross-sectional comparison of patients with hip-related pain or non-hip-related groin pain and healthy controls. Phys Ther Sport 2021; 52:224-233. [PMID: 34628337 DOI: 10.1016/j.ptsp.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare physical impairments between patients with hip-related pain and those with non-hip-related groin pain, and to compare both patient groups with healthy controls. DESIGN Cross-sectional. PARTICIPANTS Eighty-one hip and groin pain patients were consecutively included and categorized into having hip-related pain or non-hip-related groin pain. Twenty-eight healthy controls were recruited. SETTINGS Tertiary care. MAIN OUTCOME MEASURES All participants performed physical impairment testing including hip ROM, muscle function, and functional tasks. An analysis of covariates was used for analysis between patients groups and controls. RESULTS Patients with hip-related pain showed reduced hip ROM in internal rotation compared to patients with non-hip-related groin pain and controls (p ≤ 0.026, d -0.65; -0.97). No differences in muscle function or performance in functional tasks were observed between patients with hip-related pain and those with non-hip-related groin pain (p ≥ 0.136, d 0.00; 0.68). Both patient groups had worse muscle function and worse performance in functional tasks compared to controls (p ≤ 0.048, d -0.67; -1.83). CONCLUSIONS Both patients with and without hip-related pain had worse muscle function and worse performance in functional tasks compared to matched controls but no differences were observed between the patient groups. Only patients with hip-related pain had reduced ROM in internal rotation.
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Affiliation(s)
- Anders Pålsson
- Department of Health Sciences, Lund University, Lund, Sweden.
| | | | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden.
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20
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Lewis CL, Halverstadt AL, Graber KA, Perkins Z, Keiser E, Belcher H, Khuu A, Loverro KL. Individuals With Pre-arthritic Hip Pain Walk With Hip Motion Alterations Common in Individuals With Hip OA. Front Sports Act Living 2021; 3:719097. [PMID: 34505057 PMCID: PMC8421535 DOI: 10.3389/fspor.2021.719097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Individuals with hip osteoarthritis (OA) commonly walk with less hip extension compared to individuals without hip OA. This alteration is often attributed to walking speed, structural limitation, and/or hip pain. It is unclear if individuals who are at increased risk for future OA (i.e., individuals with pre-arthritic hip disease [PAHD]) also walk with decreased hip extension. Objectives: (1) Determine if individuals with PAHD exhibit less hip extension compared to individuals without hip pain during walking, and (2) investigate potential reasons for these motion alterations. Methods: Adolescent and adult individuals with PAHD and healthy controls without hip pain were recruited for the study. Kinematic data were collected while walking on a treadmill at three walking speeds: preferred, fast (25% faster than preferred), and prescribed (1.25 m/s). Peak hip extension, peak hip flexion, and hip excursion were calculated for each speed. Linear regression analyses were used to examine the effects of group, sex, side, and their interactions. Results: Individuals with PAHD had 2.9° less peak hip extension compared to individuals in the Control group (p = 0.014) when walking at their preferred speed. At the prescribed speed, the PAHD group walked with 2.7° less hip extension than the Control group (p = 0.022). Given the persistence of the finding despite walking at the same speed, differences in preferred speed are unlikely the reason for the reduced hip extension. At the fast speed, both groups increased their hip extension, hip flexion, and hip excursion by similar amounts. Hip extension was less in the PAHD group compared to the Control group (p = 0.008) with no significant group-by-task interaction (p = 0.206). Within the PAHD group, hip angles and excursions were similar between individuals reporting pain and individuals reporting no pain. Conclusions: The results of this study indicate that kinematic alterations common in individuals with hip OA exist early in the continuum of hip disease and are present in individuals with PAHD. The reduced hip extension during walking is not explained by speed, structural limitation, or current pain.
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Affiliation(s)
- Cara L Lewis
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Anne L Halverstadt
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Kerri A Graber
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Zoe Perkins
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emily Keiser
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Hadwin Belcher
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Anne Khuu
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Kari L Loverro
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States.,U.S. Army Combat Capabilities Development Command Soldier Center, Natick, MA, United States
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21
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Walters V, Coppack RJ, Cassidy RP, Suffield C, Papadopoulou T, Bilzon J, Ladlow P. Use of an isometric mid-thigh pull test during musculoskeletal rehabilitation: can the criterion values from the updated British Army physical employment standards be used to inform UK Defence Rehabilitation practice? BMJ Mil Health 2021; 168:279-285. [PMID: 34417340 DOI: 10.1136/bmjmilitary-2021-001950] [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: 07/21/2021] [Accepted: 08/08/2021] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Objective outcome measures that can quantify the force generating capacity of the lower limb are required to allow clinicians to accurately measure functional status and treatment adaptations over time. The aim of this prospective observational cohort study is to: (1) evaluate the acceptability of the isometric mid-thigh pull (IMTP) test as a measure of functional strength with military personnel undergoing residential hip pain rehabilitation; (2) compare the peak force values recorded against the updated Army physical employment standards (PES) assessment criteria and (3) assess if the minimum PES required of military personnel has the potential to inform clinical decision making and return to duty criteria within UK Defence Rehabilitation. METHODS Acceptability was assessed against patient's adherence to the testing procedures and test burden. Clinician acceptability was assessed against ease of administration and safety of test procedure. Hip pain was recorded before, immediately following and 1 hour after testing. Net peak force was recorded using portable force plates. RESULTS Full patient and clinician acceptability to IMTP testing procedures were demonstrated. Minimal changes in visual analogue scale (VAS) pain scores were demonstrated between baseline values at rest and follow-up. Despite being medically downgraded and functionally compromised due to chronic hip pain, 100% of patients met the PES expected on entry to the British Army and 79% met the PES expected at the end of basic training. CONCLUSION The IMTP provides rehabilitation clinicians with an objective quantifiable measure of maximum muscle strength that can be used early in the rehabilitation care pathway. Based on our finding, it is unclear if the current British Army PES can be used as a criterion standard in Defence Rehabilitation. Therefore, further research focused on generating clinically relevant patient-specific IMTP score criteria, with a larger sample of diverse diagnostic sub-groups is required.
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Affiliation(s)
- Vanessa Walters
- Department for Health, University of Bath, Bath, UK.,Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
| | - R J Coppack
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK.,Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, Department for Health, University of Bath, Bath, UK
| | - R P Cassidy
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK.,Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
| | - C Suffield
- Headquarters, Royal Army Physical Training Corps, Aldershot, UK
| | - T Papadopoulou
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK.,British Association of Sport and Exercise Medicine, Doncaster, UK
| | - J Bilzon
- Department for Health, University of Bath, Bath, UK.,Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, Department for Health, University of Bath, Bath, UK
| | - P Ladlow
- Department for Health, University of Bath, Bath, UK .,Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
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22
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van Klij P, Langhout R, van Beijsterveldt AMC, Stubbe JH, Weir A, Agricola R, Fokker Y, Mosler AB, Waarsing JH, Verhaar J, Tak I. Do hip and groin muscle strength and symptoms change throughout a football season in professional male football players? A prospective cohort study with repeated measures. J Sci Med Sport 2021; 24:1123-1129. [PMID: 33888428 DOI: 10.1016/j.jsams.2021.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/11/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Groin injuries are common in professional male football and result in significant complaints, time-loss and cost. We aimed to study: 1. Normal values of hip muscle strength and self-reported hip and groin function (Hip And Groin Outcome Score (HAGOS)). 2. Changes in these values throughout the season. 3. If previous (groin) injuries, leg dominance or league were associated with these outcome measures. DESIGN Prospective cohort study. METHODS 313 professional male football players (11 clubs) participated. Player characteristics and previous injuries were registered. Hip muscle strength (hand-held dynamometer) and HAGOS measurements were done at the start, middle and end of the season. RESULTS Data from 217 players were analysed. Adduction strength (mean±standard deviation, Nm/Kg) was 3.40±0.72 (start), 3.30±0.65 (mid) and 3.39±0.74 (end) (p=0.186). Abduction strength was 3.45±0.67, 3.14±0.57 and 3.28±0.61 (p<0.001). Adduction/abduction ratio was 1.00±0.21, 1.07±0.22 and 1.05±0.23 (p<0.001). Statistically, the HAGOS-subscale 'Pain' (median [interquartile range]) deteriorated slightly during the season (p=0.005), especially from mid-season (97.5 [90.6-100.0]) to end-of-season (95.0 [87.5-100.0]) (p=0.003). Other subscale scores remained unchanged between time points; 85.7 (symptoms), 100.0 (daily living), 96.9 (sports and recreation) 100.0, (physical activities) and 90.0 (quality of life). Previous injuries were associated with lower HAGOS-scores. Dominant legs had higher abduction strength (p<0.001) and lower adduction/abduction ratio (p<0.001). No differences between leagues were found for hip muscle strength and HAGOS-scores. CONCLUSIONS In Dutch male professional football players, hip muscle strength and HAGOS-scores remained relatively stable throughout the season. Pain increased slightly, which while statistically significant, was not clinically relevant.
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Affiliation(s)
- P van Klij
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands.
| | - R Langhout
- Physiotherapy Dukenburg Nijmegen, Department Manual Therapy and Sports Rehabilitation, The Netherlands; Academic Centre for Evidence Based Sports Medicine (ACES), The Netherlands
| | | | - J H Stubbe
- Codarts, University of the Arts, The Netherlands; Performing Artist and Athlete Research Lab (PEARL), The Netherlands; Department of General Practice, Erasmus MC University Medical Centre Rotterdam, The Netherlands
| | - A Weir
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands; Aspetar Orthopaedic and Sports Medicine Hospital, Qatar; Sports Medicine and Exercise Clinic Haarlem (SBK), The Netherlands
| | - R Agricola
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - Y Fokker
- Amsterdam University of Applied Sciences, Centre for Applied Research in Sports and Nutrition, The Netherlands
| | - A B Mosler
- Aspetar Orthopaedic and Sports Medicine Hospital, Qatar; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Australia
| | - J H Waarsing
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - J Verhaar
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - I Tak
- Academic Centre for Evidence Based Sports Medicine (ACES), The Netherlands; Physiotherapy Utrecht Oost - Sports Rehabilitation and Manual Therapy Clinic, The Netherlands; Amsterdam Collaboration on Health and Safety in Sports (ACHSS)/IOC Research Centre of Excellence, The Netherlands
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23
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Intrarater Test-Retest Reliability of Hip Abduction, Internal Rotation, and External Rotation Strength Measurements in a Healthy Cohort Using a Handheld Dynamometer and a Portable Stabilization Device: A Pilot Study. Arch Rehabil Res Clin Transl 2021; 2:100050. [PMID: 33543077 PMCID: PMC7853325 DOI: 10.1016/j.arrct.2020.100050] [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] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the within-day and between-day test-retest reliability of hip abduction, internal rotation, and external rotation strength measurements taken using a portable device externally stabilizing a handheld dynamometer in healthy participants. Design Observational study. Setting Institute of Technology Carlow, Ireland, a third-level education institute. Participants Healthy participants (N=18; 11 male, 7 female) who participate in a field sport for more than 2 hours per week were recruited via convenience sampling. Interventions Not applicable. Main Outcome Measures Hip abduction, internal rotation, and external rotation peak force during a maximal voluntary isometric contraction (N). The 3 best values recorded for each movement for each day were used to analyze within-day and between-day test-retest reliability. Intraclass correlation coefficients (ICCs), coefficients of variance, standard error of measurement, and minimal detectable change statistics were also calculated. Results External fixation of a handheld dynamometer produced excellent test-retest reliability for within-day (ICC>0.934) and between-day (ICC>0.802) contexts. Conclusions Clinical measurements of hip strength can be performed reliably, efficiently, and cost effectively using the methods described. Furthermore, the use of external fixation eliminates the influence of tester strength on the handheld dynamometry measurements.
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24
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King MG, Schache AG, Semciw AI, Middleton KJ, Heerey JJ, Kemp JL, Sritharan P, Scholes MJ, Mentiplay BF, Crossley KM. Lower-limb work during high- and low-impact activities in hip-related pain: Associations with sex and symptom severity. Gait Posture 2021; 83:1-8. [PMID: 33032182 DOI: 10.1016/j.gaitpost.2020.09.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hip-related pain (HRP) is described as a movement-related disorder. However, little attention is given to the way people with HRP move, especially in populations still participating in sport. Thus, limiting our understanding of movementbased impairments in HRP and their potential relationships with pain/symptoms. RESEARCH QUESTION (1) What are the differences in absolute and relative amounts of positive and negative lower-limb joint work during walking and the single-leg drop jump (SLDJ) in football players with and without HRP? (2) What are the relationships between lower-limb joint work and HRP burden? METHODS 88 football players with HRP and 30 control football players were recruited. Positive and negative work done by the hip, knee, and ankle (and each joint's relative contribution to total work done) were calculated. The effect of sex on the relationship between HRP and work done, as well as the association between work done and International Hip Outcome Tool (iHOT33) scores, were assessed using linear and beta regressions models. RESULTS Walking: No joint work variables were significantly different between groups, nor were any relationships with iHOT33 scores evident. SLDJ: The knee's relative contribution to total lower-limb negative work done was 37.7 % and 42.4 % for women with and without HRP, respectively (P = 0.04). The iHOT33 was significantly associated with positive (P = 0.03 to <0.01) and negative (P = 0.02 to <0.01) work done by the hip as well as negative work done by the ankle (P = 0.03 to 0.01), independent of sex. SIGNIFICANCE Only one significant between-group comparison was revealed, involving the knee in female football players. In addition, football players with a greater selfreported burden of HRP tended to display lower hip joint work during the SLDJ. Rehabilitation programs could be targeted to address these impairments and normalize work done during high impact tasks in the management of HRP.
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Affiliation(s)
- 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
| | - Anthony G Schache
- 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
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Kane J Middleton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, 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
| | - 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
| | - Prasanna Sritharan
- 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
| | - 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
| | - 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.
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25
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Kemp JL, Mosler AB, Hart H, Bizzini M, Chang S, Scholes MJ, Semciw AI, Crossley KM. Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain. Br J Sports Med 2020; 54:1382-1394. [PMID: 32376673 PMCID: PMC7677471 DOI: 10.1136/bjsports-2019-101690] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To report the effectiveness of physiotherapist-led interventions in improving pain and function in young and middle-aged adults with hip-related pain. DESIGN Systematic review and meta-analysis. DATA SOURCES A comprehensive, reproducible search strategy was performed on five databases in May 2019. Reference lists and grey literature were also searched. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Population: people aged ≥18 years with hip-related pain (with or without a diagnosis of femoroacetabular impingement syndrome). INTERVENTION(S) physiotherapist-led interventions for hip pain. Comparators: sham treatment, no treatment or other treatment (eg, hip arthroscopic surgery). OUTCOMES primary outcomes included patient-reported hip pain and function. Secondary outcomes included physical function measures. RESULTS 1722 papers were identified. After exclusion criteria were applied, 14 studies were included for analysis. They had varied risk of bias. There were no full-scale placebo-controlled randomised controlled trials (RCTs) of physiotherapist-led treatment. Pooled effects ranged from moderate effects (0.67 (95% CI 0.07 to 1.26)) favouring physiotherapist-led intervention over no treatment post-arthroscopy, to weak effects (-0.32 (95% CI 0.57 to 0.07)) favouring hip arthroscopy over physiotherapist-led treatment. CONCLUSION Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required. PROSPERO REGISTRATION NUMBER CRD42018089088.
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Affiliation(s)
- Joanne L Kemp
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Andrea B Mosler
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Harvi Hart
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Mario Bizzini
- Schulthess Clinic Human Performance Lab, Zurich, Switzerland
| | - Steven Chang
- La Trobe University Library, La Trobe University, Melbourne, Victoria, Australia
| | - Mark J Scholes
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Adam I Semciw
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia
| | - Kay M Crossley
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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26
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Reiman MP, Agricola R, Kemp JL, Heerey JJ, Weir A, van Klij P, Kassarjian A, Mosler AB, Ageberg E, Hölmich P, Warholm KM, Griffin D, Mayes S, Khan KM, Crossley KM, Bizzini M, Bloom N, Casartelli NC, Diamond LE, Di Stasi S, Drew M, Friedman DJ, Freke M, Glyn-Jones S, Gojanovic B, Harris-Hayes M, Hunt MA, Impellizzeri FM, Ishøi L, Jones DM, King MG, Lawrenson PR, Leunig M, Lewis CL, Mathieu N, Moksnes H, Risberg MA, Scholes MJ, Semciw AI, Serner A, Thorborg K, Virgile A, Wörner T, Dijkstra HP. Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018. Br J Sports Med 2020; 55:115-117. [PMID: 32868314 PMCID: PMC7788225 DOI: 10.1136/bjsports-2020-102219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Michael P Reiman
- Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Rintje Agricola
- Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Joanne L Kemp
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Joshua J Heerey
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Adam Weir
- Department of Orthopaedic Surgery, Erasmus MC Center for Groin Injuries, Erasmus University Medical Centre, Rotterdam, Netherlands.,Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Pim van Klij
- Department of Orthopaedic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Ara Kassarjian
- Elite Sports Imaging, SL, Madrid, Spain.,Musculoskeletal Radiology, Corades, LLC, Brookline, Massachusetts, USA
| | - Andrea B Mosler
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Eva Ageberg
- Health Sciences, Lund University, Lund, Sweden
| | - Per Hölmich
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
| | | | - Damian Griffin
- Warwick Orthopaedics, University of Warwick, Coventry, Warwick, UK.,Orthopaedics Warwick Medical School, University of Warwick, Coventry, Warwick, UK
| | - Sue Mayes
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Karim M Khan
- Family Practice & Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kay M Crossley
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Mario Bizzini
- Research, Schulthess Clinic Human Performance Lab, Zurich, ZH, Switzerland
| | - Nancy Bloom
- Physical Therapy, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
| | - Nicola C Casartelli
- Human Performance Lab, Schulthess Clinic, Zurich, Switzerland.,Laboratory of Exercise and Health, ETH Zurich, Schwerzenbach, Switzerland
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Stephanie Di Stasi
- Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
| | - Michael Drew
- Department of Physiotherapy, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia.,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Daniel J Friedman
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - Matthew Freke
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sion Glyn-Jones
- Department of Orthopaedic Surgery, University of Oxford, Institute of Musculoskeletal Sciences, Oxford, UK
| | - Boris Gojanovic
- Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Geneva, Switzerland.,Sports Medicine, University Hospital of Lausanne, Lausanne, VD, Switzerland
| | - Marcie Harris-Hayes
- Physical Therapy, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
| | - Michael A Hunt
- Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Franco M Impellizzeri
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lasse Ishøi
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
| | - Denise M Jones
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 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
| | - Peter R Lawrenson
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Michael Leunig
- Department of Orthopaedics, Schulthess Klinik, Zurich, Switzerland
| | - Cara L Lewis
- Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Nicolas Mathieu
- Physiotherapy, HES-SO Valais, University of Applied Sciences Western Switzerland, Leukerbad, Valais, Switzerland
| | - Håvard Moksnes
- Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway
| | - May Arna Risberg
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Mark J Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Adam I Semciw
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Andreas Serner
- Research & Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
| | - Adam Virgile
- College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA
| | | | - H Paul Dijkstra
- Sports Medicine, ASPETAR Orthopedic and Sports Medicine Hospital, Doha, Qatar.,Department for Continuing Education, University of Oxford, Oxford, UK
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