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Abd-Eltawab AE, Elbandrawy AM, Ghanem HB, Farhana A. Three dimensional analysis of ground reaction force during level walking correlates with sacrum displacement. Int J Health Sci (Qassim) 2023; 17:31-38. [PMID: 37692994 PMCID: PMC10484067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Objective We determined the association between sacrum displacement and ground reaction force (GRF) during walking on a level surface and identify the sub-phase of gait cycle most affected by GRF. The kinematic parameters of angular displacement of sacrum bone in three directions were measured and a correlation was derived to integrate the effect of GRF to sacrum displacement. Furthermore, gender variation in the sacrum bone configuration that induces the GRF to shift in one direction was determined. Methods Forty healthy university students were evaluated for a normal gait pattern using the Qualysys motion capture system or a motion analysis system (MAS). The synchronization between MAS and force plate was done through computer software for the three-dimensional analysis (3D) of the force and angular displacement. Results A positive correlation in the vertical direction was observed in the early and late phases of the stance phase in females. In males, a positive correlation was demonstrated in the middle and late phase of the stance phase. However, a positive correlation in the anteroposterior direction during the middle part of the stance phase was found only among the male group. Conclusion Incorporation of strength training exercises help to increase the rotator muscle strength of the trunk and lower extremities in both genders. In the male group, flexors and extensors of the trunk and lower extremities in the middle part need to be focused during strength training, especially for athletes. This would be useful in decreasing the incidence of sports injuries.
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Affiliation(s)
- Amany E. Abd-Eltawab
- Department of Physical Therapy and Health Rehabilitation, Faculty of Applied Medical Sciences, Jouf University, P. O. Box 2014 Sakaka, KSA
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Asmaa M. Elbandrawy
- Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Al-Salam University, Gharbia, Egypt
| | - Heba B. Ghanem
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University,Sakaka, Aljouf, Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Aisha Farhana
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University,Sakaka, Aljouf, Saudi Arabia
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2
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Riczo DB. What You Need to Know About Sacroiliac Dysfunction. Orthop Nurs 2023; 42:33-45. [PMID: 36702094 DOI: 10.1097/nor.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Low back pain is the leading cause of disability worldwide, and sacroiliac dysfunction is estimated to occur in 15%-30% of those with nonspecific low back pain. Nurses are in the unique position to support and provide education to patients who may be experiencing sacroiliac dysfunction or possibly apply this knowledge to themselves, as low back pain is a significant problem experienced by nurses. A patient's clinical presentation, including pain patterns and characteristics, functional limitations, common etiologies and musculoskeletal system involvement, current diagnostic tools, and realm of treatments, are discussed along with their respective efficacy. Distinction is made between specific diagnosis and treatment of joint involvement and that of sacroiliac regional pain, as well as other factors that play a role in diagnosis and treatment for the reader's consideration.
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Affiliation(s)
- Deborah B Riczo
- Deborah B. Riczo, DPT, MEd, PT, Guest Faculty, Cleveland State University Doctor of Physical Therapy Program, and Founder, Riczo Health Education, Seven Hills, OH
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3
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Rodríguez-Pastor JA, Caro-Puértolas B, Caña-Pino A, Sánchez-Preciado AM, Garrido-Ardila EM, Apolo-Arenas MD. Effect of osteopathic manipulation of the sacroiliac joint vs electrotherapy on pain and functional disability in patients with low back pain: A pilot study. J Back Musculoskelet Rehabil 2022; 35:1219-1226. [PMID: 35599463 DOI: 10.3233/bmr-210120] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND One of the main problems faced by physiotherapists in primary care is low back pain with or without radiation to lower limbs. There are many different treatment approaches for the management of low back pain. Despite the large amount of published studies, the evidence remains contradictory. OBJECTIVE To evaluate the influence of the osteopathic manipulation of the sacroiliac joint on low back pain with or without radiation to lower limbs. METHOD Single-blind randomized clinical controlled trial. Participants with low back pain with or without lower limb radiation were randomized to osteopathic manipulation of the sacroiliac joint group (intervention, 6 sessions) or to an electrotherapy group (control, 15 sessions) for 3 weeks. Measures were taken at baseline (week 0) and post-intervention (week 4). The primary outcome measures were pain (Visual Analogue Scale), functional disability (Oswestry disability index and Roland Morris questionnaire). The secondary outcome measure was pain threshold at muscular tender points in the quadratus lumborum, pyramidal, mayor gluteus, and hamstrings. RESULTS In all, 37 participants completed the study. The results of the intragroup comparisons showed statistically significant improvements in both groups in the visual analogue scale (Osteopathic manipulation group, P= 0.000; Electrotherapy group, P= 0.005) and Oswestry disability index (Osteopathic manipulation group, P= 0.000; Electrotherapy group- P= 0.026) but not in the Roland Morris questionnaire (P= 0.121), which only improved in the intervention group (P= 0.01). The osteopathic manipulation was much more effective than electrotherapy improving to pain and functional disability. CONCLUSION Osteopathic manipulation of the sacroiliac joint improves pain and disability in patients with sacroiliac dysfunction after three weeks of treatment.
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Affiliation(s)
- José Antonio Rodríguez-Pastor
- Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain
| | - Berta Caro-Puértolas
- Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain
| | - Alejandro Caña-Pino
- Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain
| | | | - Elisa María Garrido-Ardila
- ADOLOR Research group, Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain
| | - Ma Dolores Apolo-Arenas
- Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Extremadura University, Badajoz, Spain
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O'Sullivan L, Preszler J, Tanaka M. Hamstring Injury Rehabilitation and Prevention in the Female Athlete. Int J Sports Phys Ther 2022; 17:1184-1193. [PMID: 36262421 PMCID: PMC9528714 DOI: 10.26603/001c.38254] [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: 03/17/2022] [Accepted: 07/25/2022] [Indexed: 11/12/2022] Open
Abstract
Hamstring injuries (HSIs) are common in female athletes and are associated with a lengthy recovery period and a high rate of reinjury. Currently, the majority of existing literature investigating HSI rehabilitation has been conducted using male participants. However, female athletes display intrinsic anatomical and biomechanical differences compared to males that influences the way this population experiences HSIs and HSI rehabilitation. HSI rehabilitation and injury prevention guidelines for female athletes must take these differences into account. Female athletes display anatomical differences such as increased anterior pelvic tilting, gluteus maximus weakness, an increased pelvic width-to-femoral length ratio, and an increased degree of femoral anteversion, all of which can predispose females to HSIs. Maneuvers designed to strengthen the gluteal musculature and transverse abdominis can overcome these risk factors. Females show increased joint laxity and a greater range of motion of hip flexion and internal rotation compared to males. Females have lower passive hamstring stiffness than males, therefore hamstring flexibility exercises may not be as necessary during rehabilitation for females as in the male athlete population. Female athletes may instead benefit from trunk stabilization exercises and agility training due to neuromuscular control deficits that arise from the maturation and growth of the female pelvis. Existing literature on hamstring injury prevention shows consistent use of the Nordic Hamstring Exercise and balance exercises may reduce the risk of sustaining an HSI in both males and females, though more studies are needed to ascertain the optimal regimen for injury prevention in the female athlete population specifically. The goal of this clinical commentary is to discuss sex-specific anatomic and biomechanical differences of the lumbar, pelvic, and hip regions with the aim of providing guidelines for rehabilitation and injury prevention of HSIs in female athletes. Level of Evidence 5.
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Affiliation(s)
| | | | - Miho Tanaka
- Women's Sports Medicine Program, Massachusetts General Hospital
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5
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Jeong ED, Kim CY, Kim NH, Kim HD. Immediate effects of static and proprioceptive neuromuscular facilitation stretching of hamstring muscles on straight leg raise, craniovertebral angle, and cervical spine range of motion in neck pain patients with hamstring tightness: A prospective randomized controlled trial. J Back Musculoskelet Rehabil 2022; 35:429-438. [PMID: 34151831 DOI: 10.3233/bmr-201840] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle's flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.
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Affiliation(s)
- Eun-Dong Jeong
- Department of Physical Therapy, College of Health Sciences, Korea University, Seoul, Korea
| | - Chang-Yong Kim
- Pharma and Bio Pharma Industry Team, Department of Pharmaceutical and Bio-Pharmaceutical Industry, Korea Health Industry Development Institute, Cheongju-si, Korea
| | - Nack-Hwan Kim
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy, School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea
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6
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Harris-Hayes M, Spitznagle T, Probst D, Foster SN, Prather H. A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain. PM R 2019; 11 Suppl 1:S73-S82. [PMID: 31233286 DOI: 10.1002/pmrj.12209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this narrative review is to present the evidence relating to musculoskeletal impairments found in people with nonspecific chronic pelvic pain (CPP). The musculoskeletal impairments assessed in this review include pelvic floor muscle: performance, resting state, strength, activation, posture and movement patterns. A search was performed systematically using PubMed, Cochrane, CINAHL, Embase, and Web of Science databases from 1998 to 2018 to identify studies reporting the relationship between nonspecific CPP and musculoskeletal impairments of the hip, pelvis, and trunk. The search resulted in 2106 articles that were screened by two authors. Remaining articles were screened by an additional two authors for inclusion in this review. Thirty-one articles remained after initial screening. Full-text publications were reviewed and an additional 25 articles were excluded. Six additional articles were located through review of the reference lists of included articles. The final review included 12 publications. Seven of these studies were cross-sectional cohorts or case-control comparing patients with CPP to asymptomatic controls. The level of evidence for the studies included in this review was low at Levels 4 and 5. We were unable to draw clear conclusions regarding the relationships of musculoskeletal impairments and CPP because validity and use of terms and assessments were inconsistent. Further research is needed with standardized definitions and measurements to better understand the musculoskeletal system as it relates to nonspecific CPP.
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Affiliation(s)
- Marcie Harris-Hayes
- Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Theresa Spitznagle
- Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Probst
- Division of Physical Medicine and Rehabilitation, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Stefanie N Foster
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Heidi Prather
- Division Physical Medicine and Rehabilitation, Departments of Orthopaedic Surgery and Neurology, Washington University School of Medicine, St. Louis, Missouri
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Hori M, Hasegawa H, Takasaki H. Comparisons of hamstring flexibility between individuals with and without low back pain: systematic review with meta-analysis. Physiother Theory Pract 2019; 37:559-582. [PMID: 31317831 DOI: 10.1080/09593985.2019.1639868] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: There is no robust evidence on the contribution of reduced hamstring flexibility to the development of low back pain (LBP) in cohort studies.Purpose: To investigate whether individuals with LBP have impaired hamstring flexibility and stiffness and what measures have been used to compare hamstring flexibility and stiffness between individuals with and without LBP.Methods: A systematic literature search was undertaken in PubMed, EMBASE, MEDLINE, CINAHL, SCOPUS, and Cochrane databases from inception to April 2018. The GRADE system was used to determine the quality of evidence for each measure evaluated in meta-analysis.Results: Respectively, seventeen and two studies having acceptable methodological quality were analyzed with regard to hamstring flexibility and stiffness. Four measures were identified for hamstring flexibility and five for stiffness. Meta-analyses were undertaken in straight leg raising (SLR), sit and reach and knee extension in 90° hip flexion for hamstring flexibility and for hamstring stiffness measures of stiffness at 50° SLR and gradient of stiffness from 20° to 50° SLR (Me-grad). Significantly reduced hamstring flexibility or increased stiffness (P < .05) was detected in SLR, 90/90 knee extension and Me-grad. However, the validity of measures for hamstring flexibility was problematic and GRADE scores for all measures in the meta-analyses were very low.Conclusion: There have been four measures for hamstring flexibility and five for stiffness to evaluate individuals with and without LBP. It was impossible to conclude whether individuals with LBP have impaired hamstring flexibility and stiffness due to very low quality of evidence for meta-analyses.
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Affiliation(s)
- Masataka Hori
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan.,Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | | | - Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan
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8
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Shamsi M, Mirzaei M, Khabiri SS. Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle. BMC Sports Sci Med Rehabil 2019; 11:4. [PMID: 30949343 PMCID: PMC6431043 DOI: 10.1186/s13102-019-0116-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/15/2019] [Indexed: 12/13/2022]
Abstract
Background Both universal goniometer and electro-goniometer are used for measuring joint range of motion in physiotherapy. Active knee extension test is a way to assess hamstring shortness in patients with chronic low back pain. The aim of this study was to assess universal goniometer and electro-goniometer reliability in measuring knee angle during active knee extension test. Methods This was an intra-examiner reliability study between three measurements of knee extension angle that conducted on 45 patients with chronic low back pain having short hamstring muscle that referring to Kermanshah University of Medical Sciences clinic from 2016 to 2017. Knee extension angle was measured three times during active knee extension test with both universal goniometer and electro-goniometer. The measurement of knee extension angle was done at the beginning, middle and the end of one single session by one experienced physiotherapist. The intra-class correlation coefficient (ICC) and standard error of measurements (SEM) were used to quantify intra-examiner reliability. Results For both methods, the reliability test values were found to be greater than 0.7 in the range of 0.92 to 0.99 (CI 95% ranged over = 0.94 to 0.99), which are classified as good reliability. The SEMs ranged from 1.04° to 2.16° for both scales. Conclusion Universal goniometer in clinical evaluations of patients (as they are easy to be employed) and electro-goniometer in laboratory studies (as they are more accurate) are reliable.
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Affiliation(s)
- MohammadBagher Shamsi
- 1Department of Rehabilitation and Sport Medicine, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mirzaei
- 1Department of Rehabilitation and Sport Medicine, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyyed Saeed Khabiri
- 2Department of Orthopedic Surgery, Taleghani Hospital, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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9
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Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study. Sci Rep 2018; 8:15980. [PMID: 30374032 PMCID: PMC6206162 DOI: 10.1038/s41598-018-34387-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/15/2018] [Indexed: 11/16/2022] Open
Abstract
The sacroiliac joint (SIJ) is a well-known source of low back pain, with increasing interest for both conservative and surgical treatment. Alterations in pelvis kinematics are hypothesized as a contributor to SIJ pain and pelvic orthoses one treatment option, but their effects on the pelvis are poorly understood. Alterations in movement patterns induced by the application of pelvic orthoses were determined in five human cadaveric pelvises. Deformations were obtained from the lumbosacral transition and the bilateral SIJ, using digital image correlation and a customized routine to compute the movements within the pelvis. Significant alterations were found for the movements at the SIJ, in particular a vast increase in axial (x-axis) rotation, accompanied by increased inferior (y-) translation of the sacrum relative to the ilium. Movement patterns at the lumbosacral transition changed, causing increases in axial rotation and decreased inferior translation of L5 relative to S1. Using a physiologic mode of load application gives novel insights into the potential effects of pelvic orthoses. The results of these in-vitro experiments vary markedly from previous experiments with loading limited to two or less axes. Furthermore, the influence of pelvic orthoses on the lumbosacral transition warrants further investigation.
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10
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Lee DK, Oh JS. Relationship between hamstring length and gluteus maximus strength with and without normalization. J Phys Ther Sci 2018; 30:116-118. [PMID: 29410579 PMCID: PMC5788788 DOI: 10.1589/jpts.30.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study assessed the relationship between hamstring length and gluteus maximus (GM) strength with and without normalization by body weight and height. [Subjects and Methods] In total, 34 healthy male subjects volunteered for this study. To measure GM strength, subjects performed maximal hip joint extension with the knee joints flexed to 90° in the prone position. GM strength was normalized for body weight and height. [Results] GM strength with normalization was positively correlated with hamstring length, whereas GM strength without normalization was negatively correlated with hamstring length. [Conclusion] The normalization of GM strength by body weight and height has the potential to lead to more appropriate conclusions and interpretations about its correlation with hamstring length. Hamstring length may be related to GM strength.
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Affiliation(s)
- Dong-Kyu Lee
- Department of Physical Therapy, Graduate School, Inje University, Republic of Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University: 607 Obang-dong, Gimhae-si, Gyeongsangnam-do 621-749, Republic of Korea
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Han HI, Choi HS, Shin WS. Effects of hamstring stretch with pelvic control on pain and work ability in standing workers. J Back Musculoskelet Rehabil 2016; 29:865-871. [PMID: 27197706 DOI: 10.3233/bmr-160703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hamstring tightness induces posterior pelvic tilt and decreased lumbar lordosis, which can result in low back painOBJECTIVE: We investigated effects of hamstring stretch with pelvic control on pain and work ability in standing workers. METHODS One hundred adult volunteers from a standing workers were randomly assigned to pelvic control hamstring stretching (PCHS) (n = 34), general hamstring stretching (GHS) (n = 34), control (n = 32) groups. The control group was performed self-home exercise. All interventions were conducted 3 days per week for 6 weeks, and included in the hamstring stretching and lumbopelvic muscle strengthening. Outcomes were evaluated through the visual analog scale (VAS), straight leg raise test (SLR), sit and reach test (SRT), Oswestry disability index (ODI), and work ability index (WAI). RESULTS Significant difference in VAS, SLR, SRT, ODI, and WAI were found in the PCHS and GHS groups. The control group was a significant difference only in ODI. The PCHS group showed a greater difference than the GHS group and control group in VAS, SLR, SRT, and ODI. CONCLUSIONS The pelvic control hamstring stretch exercise would be more helpful in back pain reduction and improvement of work ability in an industrial setting.
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Affiliation(s)
- Hyun-Il Han
- Department of Physical Therapy, Graduate School of Daejeon University, Daejeon, Korea
| | - Ho-Suk Choi
- Department of Physical Therapy, Graduate School of Daejeon University, Daejeon, Korea
| | - Won-Seob Shin
- Department of Physical Therapy, Graduate School of Daejeon University, Daejeon, Korea.,Department of Physical Therapy, Collage of Health and Medical Science, Daejeon University, Daejeon, Korea
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12
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Keep H, Luu L, Berson A, Garland SJ. Validity of the Handheld Dynamometer Compared with an Isokinetic Dynamometer in Measuring Peak Hip Extension Strength. Physiother Can 2016; 68:15-22. [PMID: 27504043 DOI: 10.3138/ptc.2014-62] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether the handheld dynamometer (HHD) is an appropriate tool to assess and quantify peak hip extension strength in prone standing position by (1) evaluating the concurrent validity of the HHD versus an isokinetic dynamometer (IKD), (2) establishing the minimal detectable change (MDC), and (3) determining the validity of single-trial versus multi-trial measures. METHOD A convenience sample of 20 healthy adults was recruited for this cross-sectional study. Measures of peak hip extension strength were collected in prone standing position with both the HHD and the IKD and in supine position with the IKD. RESULTS Values of r were 0.37 for HHD versus IKD prone standing and 0.51 for HHD versus IKD supine. MDC was 14.8 Nm for the HHD, 25.6 Nm for IKD prone standing, and 41.5 Nm for IKD supine. High correlations (r values of 0.92-0.94) were observed between trial 1 and the mean of three trials. CONCLUSIONS The HHD has moderate concurrent validity in measuring peak hip extension strength in the prone standing position in healthy adults. MDC for hip extension strength was lowest using the HHD. Single-trial values showed a high correlation with three-trial mean values.
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Affiliation(s)
- Heather Keep
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - Levana Luu
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - Ayli Berson
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - S Jayne Garland
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
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13
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Skorupska E, Keczmer P, Łochowski RM, Tomal P, Rychlik M, Samborski W. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers. PLoS One 2016; 11:e0159587. [PMID: 27459688 PMCID: PMC4961367 DOI: 10.1371/journal.pone.0159587] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/06/2016] [Indexed: 01/21/2023] Open
Abstract
AIM Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP) and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects. METHOD Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images. RESULTS Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (p<0.001), gluteus minimus (p<0.01) and piriformis (p<0.05)). The ICC values indicated that the inter-rater reproducibility was greater than 0.90 for all measurements (LBLP and healthy subjects), except for the measurement of the right gluteus medius muscle in LBLP patients, which was equal to 0.848. CONCLUSION More than 50% of LBLP subjects presented symptomatic gluteus maximus, gluteus minimus and piriformis muscle atrophy. 3-D manual segmentation reliably measured muscle volume in all the measured pelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required.
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Affiliation(s)
- Elżbieta Skorupska
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Keczmer
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Rafał M. Łochowski
- Department of Mathematics and Mathematical Economics, Warsaw School of Economics, Warsaw, Poland
| | - Paulina Tomal
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Rychlik
- Department of Virtual Engineering, Poznan University of Technology, Poznan, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
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14
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Medeiros DM, Cini A, Sbruzzi G, Lima CS. Influence of static stretching on hamstring flexibility in healthy young adults: Systematic review and meta-analysis. Physiother Theory Pract 2016; 32:438-445. [PMID: 27458757 DOI: 10.1080/09593985.2016.1204401] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of the current study was to investigate the influence of static stretching on hamstring flexibility in healthy young adults by means of systematic review and meta-analysis. The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, EMBASE, LILACS, and manual search from inception to June 2015. Randomized and controlled clinical trials studies that have compared static stretching to control group, and evaluated range of motion (ROM), were included. On the other hand, studies that have worked with special population such as children, elderly people, athletes, and people with any dysfunction/disease were excluded, as well as articles that have used contralateral leg as control group or have not performed static stretching. The meta-analysis was divided according to three types of tests. Nineteen studies were included out of the 813 articles identified. In all tests, the results favored static stretching compared to control group: passive straight leg raise (12.04; 95% CI: 9.61 to 14.47), passive knee extension test (8.58; 95% CI: 6.31 to 10.84), and active knee extension test (8.35; 95% CI: 5.15 to 11.55). In conclusion, static stretching was effective in increasing hamstring flexibility in healthy young adults.
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Affiliation(s)
- Diulian M Medeiros
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Anelize Cini
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Graciele Sbruzzi
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Cláudia S Lima
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
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Yoo WG. Effects of bridging plus exercises with heel lift on lower extremity muscles. J Phys Ther Sci 2016; 28:1582-3. [PMID: 27313376 PMCID: PMC4905915 DOI: 10.1589/jpts.28.1582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 02/02/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of the bridging plus exercise with heel
lift on lower extremity muscles. [Subjects and Methods] Nine healthy males participated.
The subjects performed bridging exercises under two conditions. Surface electromyography
was used to measure the electrical activities of the medial hamstring (MH) and the gluteus
maximus (GM) muscles. [Results] Activation of the MH muscle during bridging with heel lift
decreased, and activation of the GM muscle during bridging with heel lift increased
compared to those with the bridging exercise. [Conclusion] This result showed that
bridging plus exercises with heel lift could be an effective exercise for patients with
compensatory mechanisms during bridging exercises, such as weak GM with hamstring
tightness.
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Affiliation(s)
- Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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16
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Abstract
OBJECTIVE To compare the effects of stretching the hamstrings with the ankle in either a plantar-flexed (PF) or dorsiflexed (DF) position for improving straight leg hip flexion range of motion (ROM) over a 4-week period. DESIGN Randomized, single-blinded, pretest, posttest design. SETTING Athletic training facility. PARTICIPANTS Each limb of 34 asymptomatic individuals (15 males, 19 females) was randomly assigned to one of the 3 groups. Twenty-four limbs received hamstring stretches with the ankle in DF, 24 limbs received hamstring stretches with the ankle in PF, and 20 limbs received no stretch (control). INDEPENDENT VARIABLES Ankle position (PF, DF) during hamstring stretching. MAIN OUTCOME MEASURES We measured pretest and posttest passive straight leg hip flexion ROM with the test ankle in a neutral position. For the intervention groups, the test limb was passively stretched with the ankle held in end range DF or PF for their respective group. Each stretch was held for 30 seconds for a total of 3 applications. Two treatment sessions were completed per week for a total of 4 weeks. The control limbs received no stretching during the 4-week period. We conducted 1-way analyses of covariance to determine significant changes in ROM between groups (P < 0.05). RESULTS There was no significant difference between treatment groups (P = 0.90), but a significant difference was found for both the PF (P = 0.04) and DF (P = 0.01) groups when compared with the control group. CONCLUSIONS Our findings indicate that both stretching the hamstrings in either PF or DF improve straight leg hip ROM compared with a control group. CLINICAL RELEVANCE The results of this study should be considered by clinicians when determining the optimal stretching techniques aimed at increasing hamstring length.
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Kang SY, Choung SD, Jeon HS. Modifying the hip abduction angle during bridging exercise can facilitate gluteus maximus activity. ACTA ACUST UNITED AC 2016; 22:211-5. [PMID: 26778602 DOI: 10.1016/j.math.2015.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 12/23/2015] [Accepted: 12/26/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate how the erector spinae (ES) and gluteus maximus (GM) muscle activity and the anterior pelvic tilt angle change with different hip abduction angles during a bridging exercise. METHODS Twenty healthy participants (10 males and 10 females, aged 21.6 ± 1.6) voluntarily participated in this study. Surface electromyography (EMG) signals were recorded from the ES and GM during bridging at three hip abduction angles: 0°, 15°, and 30°. Simultaneously, the anterior pelvic tilt angle was measured using Image J software. RESULTS The EMG amplitude of the GM muscle and the GM/ES EMG ratio were greatest at 30° hip abduction, followed by 15° and then 0° hip abduction during the bridging exercise. In contrast, the ES EMG amplitude at 30° hip abduction was significantly lesser than that at 0° and 15° abduction. Additionally, the anterior pelvic tilt angle was significantly lower at 30° hip abduction than at 0° or 15°. CONCLUSIONS Bridging with 30° hip abduction can be recommended as an effective method to selectively facilitate GM muscle activity, minimize compensatory ES muscle activity, and decrease the anterior pelvic tilt angle.
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Affiliation(s)
- Sun-Young Kang
- Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Kangwon-do, Republic of Korea
| | - Sung-Dae Choung
- Department of Physical Therapy, Baekseok University, Anseo-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - Hye-Seon Jeon
- Department of Physical Therapy, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Kangwon-do, Republic of Korea.
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Cho BY, Yoon JG. The effect of gait training with shoe inserts on the improvement of pain and gait in sacroiliac joint patients. J Phys Ther Sci 2015; 27:2469-71. [PMID: 26357428 PMCID: PMC4563292 DOI: 10.1589/jpts.27.2469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/24/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the current research was to identify how gait training with shoe inserts affects the pain and gait of sacroiliac joint dysfunction patients. [Subjects and Methods] Thirty subjects were randomly selected and assigned to be either the experimental group (gait training with shoe insert group) or control group. Each group consisted of 15 patients. Pain was measured by Visual Analogue Scale, and foot pressure in a standing position and during gait was measured with a Gateview AFA-50 system (Alpus, Seoul, Republic of Korea). A paired sample t-test was used to compare the pain and gait of the sacroiliac joint before and after the intervention. Correlation between pain and walking after gait training with shoe inserts was examined by Pearson test. The level of significance was set at α=0.05. [Results] It was found that application of the intervention to the experimental group resulted in a significant decrease in sacroiliac joint pain. It was also found that there was a significant correlation between Visual Analogue Scale score and dynamic asymmetric index (r= 0.796) and that there was a negative correlation between Visual Analogue Scale score and forefoot/rear foot peak pressure ratio (r=-0.728). [Conclusion] The results of our analysis lead us to conclude that the intervention with shoe inserts had a significant influence on the pain and gait of sacroiliac joint patients.
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Affiliation(s)
- Byung-Yun Cho
- Department of Physical Therapy, Incheon City Jung Hospital, Republic of Korea
| | - Jung-Gyu Yoon
- Department of Physical Therapy, Namseoul University, Republic of Korea
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Pelvic Belt Effects on Health Outcomes and Functional Parameters of Patients with Sacroiliac Joint Pain. PLoS One 2015; 10:e0136375. [PMID: 26305790 PMCID: PMC4549265 DOI: 10.1371/journal.pone.0136375] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 07/31/2015] [Indexed: 02/07/2023] Open
Abstract
Introduction The sacroiliac joint (SIJ) is a common source of low back pain. However, clinical and functional signs and symptoms correlating with SIJ pain are widely unknown. Pelvic belts are routinely applied to treat SIJ pain but without sound evidence of their pain-relieving effects. This case-control study compares clinical and functional data of SIJ patients and healthy control subjects and evaluates belt effects on SIJ pain. Methods 17 SIJ patients and 17 healthy controls were included in this prospective study. The short-form 36 survey and the numerical rating scale were used to characterize health-related quality of life in patients in a six-week follow-up and the pain-reducing effects of pelvic belts. Electromyography data were obtained from the gluteus maximus, biceps femoris, rectus femoris and medial vastus. Alterations of muscle activity, variability and gait patterns were compared in patients and controls along with the belts’ effects in a dynamic setting when walking. Results Significant improvements were observed in the short-form 36 survey of the SIJ patients, especially in the physical health subscores. Minor declines were also observed in the numerical rating scale on pain. Belt-related changes of muscle activity and variability were similar in patients and controls with one exception: the rectus femoris activity decreased significantly in patients with belt application when walking. Further belt effects include improved cadence and gait velocity in patients and controls. Conclusions Pelvic belts improve health-related quality of life and are potentially attributed to decreased SIJ-related pain. Belt effects include decreased rectus femoris activity in patients and improved postural steadiness during locomotion. Pelvic belts may therefore be considered as a cost-effective and low-risk treatment of SIJ pain. Trial Registration ClinicalTrials.gov NCT02027038
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20
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Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J 2015; 9:535-40. [PMID: 26240711 PMCID: PMC4522442 DOI: 10.4184/asj.2015.9.4.535] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 12/16/2014] [Accepted: 12/18/2014] [Indexed: 12/12/2022] Open
Abstract
STUDY DESIGN Cross-sectional study. PURPOSE To verify the association of hamstring tightness and range of motion in anterior pelvic tilt (PT), lumbar motion (LM), and trunk flexion (TF) during forward bending. OVERVIEW OF LITERATURE Increased hamstring stiffness could be a possible contributing factor to low back injuries. Clinical observations have suggested that hamstring tightness influences lumbar pelvic rhythm. Movement restrictions or postural asymmetry likely lead to compensatory movement patterns of the lumbar spine, and subsequently to increased stress on the spinal soft tissues and an increased risk of low back pain (LBP). METHODS Hamstring muscle tightness was measured using the self-monitored active knee extension (AKE) test. A bubble inclinometer was used to determine the range of motion of PT, LM, and TF during forward bending. Statistical analysis included descriptive statistics, comparisons between groups and a correlation between hamstring tightness (AKE) and anterior PT, TF, and regional LM with p≤0.05. RESULTS The LBP group was composed of 36 participants, and the asymptomatic group consisted of 32 participants. The mean for PT in the control group was 66.7°, 64.5° for LM and 104.6° for TF. Respective values in the symptomatic group were 57.0°, 79.8°, and 82.2°. CONCLUSIONS Participants with LBP showed restriction in the pelvis and TF range of motion, but had higher amplitudes in the lumbar spine during forward bending.
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Affiliation(s)
- Felipe Jose Jandre Reis
- Department of Physiotherapy, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Ribeiro Macedo
- Department of Physiotherapy, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil
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21
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Soisson O, Lube J, Germano A, Hammer KH, Josten C, Sichting F, Winkler D, Milani TL, Hammer N. Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction. PLoS One 2015; 10:e0116739. [PMID: 25781325 PMCID: PMC4364533 DOI: 10.1371/journal.pone.0116739] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 12/14/2014] [Indexed: 12/02/2022] Open
Abstract
Introduction The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application. Methods Morphometric and functional data pertaining to pelvic belt effects were compared in 17 SIJ patients and 17 controls. Lumbar spine and pelvis morphometries were obtained from 3T magnetic resonance imaging. Functional electromyography data of pelvis and leg muscles and center of pressure excursions were measured in one-leg stance. The numerical rating scale was used to evaluate immediate pain-reducing effects. Results Pelvic morphometry was largely unaltered in SIJ patients and also by pelvic belt application. The angle of lumbar lateral flexion was significantly larger in SIJ patients without belt application. Muscle activity and center of pressure were unaffected by SIJ pain or by belt application in one-leg stance. Nine of 17 patients reported decreased pain intensities under moderate belt application, four reported no change and four reported increased pain intensity. For the entire population investigated here, this qualitative description was not confirmed on a statistical significant level. Discussion Minute changes were observed in the alignment of the lumbar spine in the frontal plane in SIJ patients. The potential pain-decreasing effects of pelvic belts could not be attributed to altered muscle activity, pelvic morphometry or body balance in a static short-term application. Long-term belt effects will therefore be of prospective interest.
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Affiliation(s)
- Odette Soisson
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Juliane Lube
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Andresa Germano
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | | | - Christoph Josten
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Freddy Sichting
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | - Dirk Winkler
- Department of Neurosurgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Thomas L. Milani
- Institute of Applied Kinesiology, Technische Universität Chemnitz, Chemnitz, Germany
| | - Niels Hammer
- Institute of Anatomy, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- Department of Trauma and Reconstructive Surgery, University of Leipzig, Faculty of Medicine, Leipzig, Germany
- * E-mail:
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Choi SA, Cynn HS, Yi CH, Kwon OY, Yoon TL, Choi WJ, Lee JH. Isometric hip abduction using a Thera-Band alters gluteus maximus muscle activity and the anterior pelvic tilt angle during bridging exercise. J Electromyogr Kinesiol 2014; 25:310-5. [PMID: 25262160 DOI: 10.1016/j.jelekin.2014.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/03/2014] [Accepted: 09/01/2014] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to investigate the effects of bridging with isometric hip abduction (IHA) using the Thera-Band on gluteus maximus (GM), hamstring (HAM), and erector spinae (ES) muscle activity; GM/HAM and GM/ES ratios; and the anterior pelvic tilt angle in healthy subjects. Twenty-one subjects participated in this study. Surface EMG was used to collect EMG data of GM, HAM, and ES muscle activities, and Image J software was used to measure anterior pelvic tilt angle. A paired t-test was used to compare GM, HAM, and ES muscle activity; the GM/HAM and GM/ES ratios; and the anterior pelvic tilt angle with and without IHA during the bridging exercise. GM muscle activity increased significantly and the anterior pelvic tilt angle decreased significantly during bridging with IHA using the Thera-Band (p < 0.05). However, there were no significant differences in the activity of the HAM and ES and the GM/HAM and GM/ES ratios between bridging with and without IHA (p > 0.05). The results of this study suggest that bridging with IHA using the Thera-Band can be implemented as an effective method to facilitate GM muscle activity and reduce the anterior pelvic tilt angle.
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Affiliation(s)
- Sil-Ah Choi
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Heon-Seock Cynn
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Chung-Hwi Yi
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Oh-Yun Kwon
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Tae-Lim Yoon
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Woo-Jeong Choi
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
| | - Ji-Hyun Lee
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do 220-710, South Korea.
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Diagnosis and Current Treatments for Sacroiliac Joint Dysfunction: A Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2014. [DOI: 10.1007/s40141-013-0037-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hammer N, Steinke H, Lingslebe U, Bechmann I, Josten C, Slowik V, Böhme J. Ligamentous influence in pelvic load distribution. Spine J 2013; 13:1321-30. [PMID: 23755919 DOI: 10.1016/j.spinee.2013.03.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 01/03/2013] [Accepted: 03/20/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The influence of the posterior pelvic ring ligaments on pelvic stability is poorly understood. Low back pain and sacroiliac joint (SIJ) pain are described being related to these ligaments. Computational approaches involving finite element (FE) modeling may aid to determine their influence. Previous FE models lacked in precise ligament geometries and material properties, which might have influence on the results. PURPOSE AND STUDY DESIGN The aim of this study is to investigate ligamentous influence in pelvic stability by means of FE using precise ligament material properties and morphometries. METHODS An FE model of the pelvis bones was created from computer tomography, including the pubic symphysis joint (PSJ) and the SIJ. Ligament data were used from 55 body donors: anterior (ASL), interosseous (ISL), and posterior (PSL) sacroiliac ligaments; iliolumbar (IL), inguinal (IN), pubic (PL), sacrospinous (SS), and sacrotuberous (ST) ligaments; and obturator membrane (OM). Stress-strain data were gained from iliotibial tract specimens. A vertical load of 600 N was applied. Pelvic motion related to altered ligament and cartilage stiffness was determined in a range of 50% to 200%. Ligament strain was investigated in the standing and sitting positions. RESULTS Tensile and compressive stresses were found at the SIJ and the PSJ. The center of sacral motion was at the level of the second sacral vertebra. At the acetabula and the PSJ, higher ligament and cartilage stiffnesses decrease pelvic motion in the following order: SIJ cartilage>ISL>ST+SS>IL+ASL+PSL. Similar effects were found for the sacrum (SIJ cartilage>ISL>IL+ASL+PSL) but increased ST+SS stiffnesses increased sacral motion. The influence of the IN, OM, and PL was less than 0.1%. Compared with standing, total ligament strain was reduced to 90%. Increased strains were found for the IL, ISL, and PSL. CONCLUSIONS Posterior pelvic ring cartilage and ligaments significantly contribute to pelvic stability. Their effects are region- and stiffness dependent. While sitting, load concentrations occur at the IL, ISL, and PSL, which goes in coherence with the clinical findings of these ligaments serving as generators of low back pain.
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Affiliation(s)
- Niels Hammer
- Faculty of Medicine, Institute of Anatomy, University of Leipzig, Liebigstraße 13, 04103 Leipzig, Germany; Department of Trauma and Reconstructive Surgery, Faculty of Medicine, University of Leipzig, Liebigstraße 13, 04103 Leipzig, Germany.
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Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 2012; 221:537-67. [PMID: 22994881 PMCID: PMC3512279 DOI: 10.1111/j.1469-7580.2012.01564.x] [Citation(s) in RCA: 283] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2012] [Indexed: 12/28/2022] Open
Abstract
This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure.
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Affiliation(s)
- A Vleeming
- Department of Anatomy, University of New England College of Osteopathic Medicine, Biddeford, ME, USA
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