Abduction Exercise Research Articles

Sex-differences in neuromuscular control of hip abductors during isometric submaximal tasks

BackgroundOne key focus in the literature is the need to better understand how males and females perform neuromuscular control, which requires consideration of muscle morphology, as it may change neural drive during force production. Although previous studies focused on muscles around the knee and ankle, it is crucial to explore the behavior of other muscles, such as the hip abductors, since many lower limb conditions more common in females have been associated with alterations in hip muscles. Research questionsAre electromyography (EMG) variables (amplitude and low- and high frequency bands) of hip abductors during submaximal isometric tasks different between males and females? How is muscle size associated with EMG responses during these tasks? MethodsThirty-six participants (males, n = 18; females, n = 18) had muscle and subcutaneous thickness of gluteus medius (GMed) and tensor fascia latae (TFL) measured. They then performed an estimated one-repetition maximum (1RM) test in a side-lying hip abduction exercise, followed by two 10-s submaximal tasks: (i) side-lying hip abduction with 50 % 1RM and (ii) with 20 % 1RM. GMed and TFL EMG amplitude and frequency bands (low and high frequency components) were analyzed. ResultsFemales had higher GMed EMG amplitude, lower low-frequency, and higher high-frequency components than males in both tasks (p = 0.001–0.040). No differences were observed in TFL EMG variables. Greater GMed thickness was associated with lower amplitudes in the 50 % 1RM task (r = − 0.35; p = 0.03), while greater TFL thickness was associated with lower low-frequency [20 % 1RM: r = − 0.70; p = 0.002; 50 %-1RM: r = − 0.65; p = 0.005] and higher high-frequency components [20 % 1RM: r = 0.74; p = 0.001; 50 %-1RM: r = 0.76; p < 0.001] only in females. SignificanceMales and females employ different neuromuscular control strategies, which vary among the synergists for hip abduction.

Shoulder Rotation Affects Trapezius Muscle Activity During Shoulder Horizontal Abduction.

Shoulder horizontal abduction exercise in the prone position is effective for strengthening the lower trapezius muscle. However, this exercise is difficult for patients with acute pain or those undergoing initial rehabilitation because of the postural characteristics of the exercise. This study aimed to (1) investigate the effect of a shoulder horizontal abduction exercise when performed with a different amount of shoulder rotation on the trapezius muscle activation and scapular anterior/posterior tilt angle and (2) evaluate the effect of shoulder rotation on the acromiohumeral distance while sitting. Fifteen healthy men performed shoulder horizontal abduction exercise in three shoulder positions (internal rotation, neutral rotation, and external rotation). During exercises, we measured trapezius muscle activity using an electromyography system and scapular anterior/posterior tilt angle using an inclinometer application. We also measured the acromiohumeral distance using real-time ultrasonography before the exercises. Increases in lower trapezius and middle trapezius muscle activities and a decrease in scapular anterior tilt occurred in shoulder external rotation compared with other positions (p<0.001). Shoulder external rotation also significantly increased acromiohumeral distance in the sitting position (p<0.05). We propose that shoulder external rotation effectively and safely increases middle and lower trapezius muscle activities during the sitting shoulder horizontal abduction exercise.

Voluntary Contraction of the Abdominal Muscles Increases Hip Muscle Activation During Lower-Extremity Exercises: A Critically Appraised Topic.

Existing studies have posited that incorporating abdominal enhancement techniques during lower-extremity exercises might mitigate compensatory pelvic motions and enhance the engagement of specific hip muscles. Does performing lower-extremity exercises with abdominal enhancement techniques increase hip muscle activation levels in healthy individuals? Summary of Key Finding: After the literature review, 4 cross-sectional studies met the inclusion criteria and were included in this critically appraised topic. There is moderate evidence to support that prone hip extension with abdominal enhancement may increase gluteus maximus and hamstring muscle activity. Gluteus medius activity may not be affected by abdominal enhancement during hip abduction exercises. Strength and Recommendation: The collective findings from the 4 cross-sectional trials indicate that the incorporation of abdominal enhancement techniques during lower-extremity exercises may have the potential to enhance targeted muscle activation levels in healthy individuals. Further research is recommended to establish more robust conclusions.

Joint angle estimation during shoulder abduction exercise using contactless technology

BackgroundTele-rehabilitation, also known as tele-rehab, uses communication technologies to provide rehabilitation services from a distance. The COVID-19 pandemic has highlighted the importance of tele-rehab, where the in-person visits declined and the demand for remote healthcare rises. Tele-rehab offers enhanced accessibility, convenience, cost-effectiveness, flexibility, care quality, continuity, and communication. However, the current systems are often not able to perform a comprehensive movement analysis. To address this, we propose and validate a novel approach using depth technology and skeleton tracking algorithms.MethodsOur data involved 14 participants (8 females, 6 males) performing shoulder abduction exercises. We collected depth videos from an LiDAR camera and motion data from a Motion Capture (Mocap) system as our ground truth. The data were collected at distances of 2 m, 2.5 m, and 3.5 m from the LiDAR sensor for both arms. Our innovative approach integrates LiDAR with the Cubemos and Mediapipe skeleton tracking frameworks, enabling the assessment of 3D joint angles. We validated the system by comparing the estimated joint angles versus Mocap outputs. Personalized calibration was applied using various regression models to enhance the accuracy of the joint angle calculations.ResultsThe Cubemos skeleton tracking system outperformed Mediapipe in joint angle estimation with higher accuracy and fewer errors. The proposed system showed a strong correlation with Mocap results, although some deviations were present due to noise. Precision decreased as the distance from the camera increased. Calibration significantly improved performance. Linear regression models consistently outperformed nonlinear models, especially at shorter distances.ConclusionThis study showcases the potential of a marker-less system, to proficiently track body joints and upper-limb angles. Signals from the proposed system and the Mocap system exhibited robust correlation, with Mean Absolute Errors (MAEs) consistently below 10∘\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$10^\\circ$$\\end{document}. LiDAR’s depth feature enabled accurate computation of in-depth angles beyond the reach of traditional RGB cameras. Altogether, this emphasizes the depth-based system’s potential for precise joint tracking and angle calculation in tele-rehab applications.

Feasibility of 3D Body Tracking from Monocular 2D Video Feeds in Musculoskeletal Telerehabilitation.

Musculoskeletal conditions affect millions of people globally; however, conventional treatments pose challenges concerning price, accessibility, and convenience. Many telerehabilitation solutions offer an engaging alternative but rely on complex hardware for body tracking. This work explores the feasibility of a model for 3D Human Pose Estimation (HPE) from monocular 2D videos (MediaPipe Pose) in a physiotherapy context, by comparing its performance to ground truth measurements. MediaPipe Pose was investigated in eight exercises typically performed in musculoskeletal physiotherapy sessions, where the Range of Motion (ROM) of the human joints was the evaluated parameter. This model showed the best performance for shoulder abduction, shoulder press, elbow flexion, and squat exercises. Results have shown a MAPE ranging between 14.9% and 25.0%, Pearson's coefficient ranging between 0.963 and 0.996, and cosine similarity ranging between 0.987 and 0.999. Some exercises (e.g., seated knee extension and shoulder flexion) posed challenges due to unusual poses, occlusions, and depth ambiguities, possibly related to a lack of training data. This study demonstrates the potential of HPE from monocular 2D videos, as a markerless, affordable, and accessible solution for musculoskeletal telerehabilitation approaches. Future work should focus on exploring variations of the 3D HPE models trained on physiotherapy-related datasets, such as the Fit3D dataset, and post-preprocessing techniques to enhance the model's performance.

Effects of Band-Resisted Abduction on Muscle Activity between the Barbell Hip Thrust and Barbell Glute Bridge

The importance of hip extensor and abductor muscles for sport performance and injury reduction is well-documented. To target these muscle groups, the barbell hip thrust and barbell glute bridge are used to load the posterior kinetic chain while band-resisted abduction exercises, like band-resisted side stepping, target the lateral kinetic chain. However, combining band-resisted hip abduction with barbell hip-extension dominant exercises has not yet been investigated. In this study, ten male subjects underwent a two-part research protocol with surface electromyography (sEMG) measured during a 5-repetition maximum (5-RM) load performance to determine differences in peak and mean muscular activity between band-resisted barbell hip thrust (BBHT) and barbell hip thrust (BHT), and between band-resisted barbell glute bridge (BBGB) and barbell glute bridge (BGB). The results indicated three significant differences between the pairs, with both banded conditions eliciting greater sEMG activity in the Upper Gluteus Maximus compared to non-banded conditions. However, BGB unexpectedly elicited greater sEMG activity in the Gluteus Medius compared to BBGB. The differences in muscle activity could potentially be explained by reciprocal inhibition and synergistic dominance. Further research is needed to make definitive statements on the superiority of band-resisted barbell exercises over non-banded barbell exercises and transferability to sport performance.

Effect of Scapular Retraction on Lower Trapezius, Infraspinatus, and Deltoid Muscle Electromyographic Activity During the Side-Lying Abduction Exercise.

The lower trapezius (LT) muscle, which stabilizes the scapula posteriorly during arm elevation, has been interesting to both clinicians and researchers for its importance in throwing-related shoulder rehabilitation and injury prevention. The purpose of this study was to investigate the electromyographic activity of the LT and other relevant muscles during scapular and shoulder activities in the side-lying position. Twenty collegiate baseball players volunteered to participate in this study. Electromyographic (EMG) output of the lower trapezius, infraspinatus, posterior deltoid, middle deltoid, serratus anterior, and upper trapezius muscles were collected. All the subjects performed isometric resistance exercises in four arm positions: 0° horizontal abduction from the coronal plane (NEUT) with protraction (NEUT-PRO), 15° horizontal adduction from the coronal plane (HADD) with protraction (HADD-PRO), and NEUT with retraction (NEUT-RET), and HADD-RET in a side-lying isometric abduction exercise with two external loads: a 9.1 kg dumbbell and 40% of the manual muscle test (MMT). The subjects also performed two more isometric resistance exercises: supine protraction and side-lying external rotation (ER) of the glenohumeral (GH) joint in GH adduction at 90° of GH ER or with as much ER as possible. All raw EMG data were normalized to maximal voluntary isometric contraction (% MVIC) of the corresponding muscle. LT activity was significantly greater in HADD-RET with 9.1 kg than that of HADD-PRO (p < 0.001) (55 vs 21% MVIC) while middle deltoid muscle activity was significantly decreased in both NEUT and HADD-RET compared to that of NEUT and HADD-PRO (p < 0.001). In contrast, IS muscle activity was significantly increased in HADD-RET with 9.1 kg compared with that 40% MMT (p < 0.001) (41 vs 22% MVIC). LT activity was modulated by changes in scapulothoracic and glenohumeral joint positioning during a side-lying isometric abduction exercise. These findings may help clinicians to select exercises to improve scapular muscle balance ratios during rehabilitation of the shoulder complex. Level 3b, Controlled laboratory study.

Motion Analysis of Core Stabilization Exercise in Women: Kinematics and Electromyographic Analysis

As core stabilization exercise is essential for maintaining a stable spine and improving functional performance, understanding the activation of core muscles and the stabilization of the trunk and pelvis during such exercise is crucial. The purpose of this study was to investigate the muscle activation and stabilization of the lumbar-pelvic region during core stabilization exercise, with a specific focus on analyzing EMG and 3D motion kinematic data. The study aimed to understand how different tension settings on the reformer affect muscle activation and hip motion, as well as how these factors impact pelvic and trunk stability during the exercise. The reformer consists of a carriage that slides back and forth on rails, with springs providing resistance. The springs can be adjusted to vary the resistance level. Twenty-eight healthy women participating in this study were asked to perform 'side splits', a hip abduction exercise, on the reformer in both heavy and light tension settings. Activation of the internal oblique (IO), rectus abdominis (RA), multifidus (MU), costal lumbosacral (IL), gluteus medius (GM), and adductor muscles (AL) were measured using electromyography (EMG) and 3D motion. Kinematic data using an assay were also measured during exercise. GM, IO, and MU muscles were more active when heavy springs were used, and AL muscles were more active when light springs were used. Hip motion was more symmetrical when lighter springs were used with a greater range of hip motion. There was less pelvis and torso weight transfer and more torso and pelvis stability when the heavier springs were used. In this study, we confirmed that core stabilization exercise on an unstable surface activates the deep muscles of the abdomen and back and is effective for pelvic and trunk stabilization training.

再発性腰痛者における視覚的フィードバックが腰椎骨盤の運動制御に与える影響

[Purpose] The purpose of this study was to clarify the immediate effects of motor control training with visual feedback on lumbopelvic motion during an active hip abduction test in subjects with recurrent low back pain. [Participants and Methods] Thirty patients were divided into two groups: one group received visual feedback on pelvic motion and performed hip abduction exercise, and the other group performed hip abduction exercise without visual feedback. [Results] The visual feedback group showed an increase in contralateral oblique abdominal muscle activity and a decrease in pelvic elevation during hip abduction after the intervention. [Conclusion] The results suggest that the motor control training with visual feedback immediately inhibited excessive pelvic movement.

Kinematic Strategies for Sustainable Well-Being in Aging Adults Influenced by Footwear and Ground Surface.

Falls are an inescapable problem influencing the health and threatening the safety of older adults. Exploring the kinematic strategies of aging adults can help reduce the risk of falls. To study kinematic strategies of aging adults in response to footwear (flat shoes, toe spring shoes, rocker sole shoes) and ground surfaces (level ground, grassland and rock road), a 3D motion capture system and subjective stability evaluation, with 14 female participants, were performed. Results indicated that footwear and ground surfaces significantly impacted joint dynamics during walking. Compared with young adults, aging adults tended to adopt a more conservative walking pattern. Wearing different shoes on the three ground surfaces mainly reduced the ROM (range of motion) of the ankle (p &lt; 0.05). By analyzing the objective and subjective results, rocker sole shoes gave aging adults a stronger sense of instability, so they controlled the movement of ankle joint initiatively. When walking on grassland and rock road, aging adults adjusted the movements of hip, knee and ankle joints to maintain gait stability. Aging adults are recommended to strengthen flexibility training of the ankle joint, perform hip adduction and abduction exercises, and wear rocker sole shoes to improve their balance ability and sustainable well-being.

Open reduction and internal fixation of Ideberg type IA glenoid fractures: Tricks, pearls, and potential pitfalls based on a retrospective cohort of 33 patients focusing on the rehabilitation protocol.

The standard treatment of anterior glenaoid fractures carrying > 20% of the glenoid fossa is open reduction and internal fixation (ORIF). In the herein study, we report our outcomes in a retrospective cohort of anterior and anteroinferior glenoid rim fractures using an accelerated postoperative rehabilitation protocol. A secondary aim is to describe the surgical steps for ORIF of anterior and anteroinferior glenoid rim fractures using the anterior axillary approach, describing the tricks, pearls, and pitfalls of this surgical technique. A retrospective cohort of skeletally mature patients treated for an anterior glenoid rim fracture carrying > 20% of the glenoid fossa during a 10-year period were operated on using a vertical axillary incision, osteosynthesis with 2.0-mm cortical screws, and labral repair with small diameter metallic anchors and non-absorbable sutures. Rehabilitation began on the first postoperative day, including passive external rotation exercises and active-assisted flexion, adduction, and abduction exercises as tolerated. The exercises are performed with the patient sitting or lying down. Phase 1 is continued for 6-10weeks until the patient regains painless, normal, or near-normal ROM. Usually by 10weeks, the fracture and labrum are healed, so phase 2 rehabilitation begins with strengthening and ROM exercises. Radiologic and clinical outcomes, including active range of motion (ROM), glenohumeral stability, and visual analogue scale (VAS) were measured. About 33 patients (35 fractures) had complete medical records and pre- and post-operative imaging exams available for further analysis regarding the surgical protocol, with a mean of 4.8years. The mean DASH questionnaire was 3.75 ± 9.0 and the mean CM score was 62.5 ± 0.1. Active flexion and internal rotation were recovered in all patients, while external rotation presented an average loss of 8° (p = 0.12) and abduction of 5° (p = 0.33). The mean VAS was 1.1 ± 0.8. No patient reported major or disabling symptoms, or great difficulty or inability to perform daily or recreational activities. No patient presented residual instability of the glenohumeral joint. In this retrospective cohort, ORIF using a vertical axillary incision, osteosynthesis with 2.0-mm screws, and labral repair with small diameter metallic anchors and non-absorbable sutures was a safe approach, with a minimal risk of complications and residual instability. The accelerated postoperative rehabilitation protocol, allowing immediate passive external rotation of the operated shoulder, resulted in a non-significant loss of ROM compared to the contralateral side. Therefore, we recommend this management strategy for anterior glenoid rim fractures in patients with unstable shoulder joint after traumatic glenohumeral dislocation. Therapeutic Study (Surgical technique and Retrospective cohort).

The influence of exercise on clinical pain and pain mechanisms in patients with subacromial pain syndrome.

BackgroundFew studies have investigated the underlying mechanisms for unilateral subacromial pain syndrome (SAPS). Therefore, this study examined (1) if 8‐weeks of exercise could modulate clinical pain or temporal summation of pain (TSP), conditioned pain modulation (CPM), and exercise‐induced hypoalgesia (EIH) and (2) if any of these parameters could predict the effect of 8‐weeks of exercise in patients with unilateral SAPS.MethodsThirty‐seven patients completed a progressive abduction exercise program every other day for 8‐weeks. Worst shoulder pain in full abduction was rated on a numeric rating scale (NRS). Pain pressure thresholds (PPTs), TSP, CPM, EIH, Shoulder Pain and Disability Index (SPADI), Pain Catastrophizing Scale (PCS), PainDETECT questionnaire (PD‐Q), Pain Self‐Efficacy Questionnaire (PSE‐Q) and Pittsburgh Sleep Quality Index (PSQI) were assessed before and after intervention.ResultsThe intervention improved worst pain intensity (p < 0.001), increased the CPM (p < 0.001), improved the sleep scores (p < 0.005) and reduced the PainDETECT ratings (p < 0.001). No changes were observed in PPT, TSP, EIH, SPADI, PCS and PSE‐Q (all p > 0.05). In a linear regression, the combination of all baseline parameters predicted 23.2% variance in absolute change in pain after 8 weeks. Applying backwards elimination to the linear regression yielded that baseline pain intensity combined with TSP predicted 33.8% variance.ConclusionThis explorative study suggested reduction in pain, improved sleep quality and increased CPM after 8‐weeks of exercise. Furthermore, the results suggests that low pain intensity and high TSP scores (indicative for pain sensitisation) may predict a lack of pain improvement after exercise.

Effect of side-sling plank exercise on trunk and hip muscle activation in subjects with gluteus medius weakness.

The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear. To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness. Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles. The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L. SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL.

Effects of Isometric Hip Abduction using an Elastic-band on Muscle Activation in the Gluteus Maximus, Hamstring, and Erector Spinae during Forward Bending and Return Task

Background : Trunk bending requires coordination of the pelvis and hip joints and activation of the gluteal and lower extremity muscles. The gluteus maximus (GM) is an important muscle for trunk bending task and repeated trunk extension increases erector spinae (ES) muscle activity, and these extensors exhibit muscle activity opposite that of the gluteal muscles at a given lumbo-pelvic angle. Elastic band placed around the legs was found to increase GM muscle activity during exercise. Previous studies have compared GM, ES, and HS muscle activities during flexion movements. However, there is no study that applies elastic band during trunk forward bending and compared the activity of the GM, ES and HS muscles. Objectives : The purpose of this study was to investigate muscle activity in the gluteus maximus (GM), erector spinae (ES), and hamstring (HS), as well as hip joint angle during trunk forward bending in a hip abduction exercise using an elastic band. Methods Fourteen healthy women were recruited. Surface electromyographic activity was recorded from the GM, HS, and ES muscles, and hip joint angle was measured using Image J during trunk forward bending while performing a hip abduction exercise using an elastic band. Results : The hip joint angle during the forward bending movement increased significantly when an elastic band was used compared to when it was not. Muscle activity in the GM increased significantly, whereas that in the HS decreased significantly, with the elastic-band intervention. No significant change in ES muscle activity was observed with the band. Conclusions : During trunk forward bending with isometric hip abduction using an elastic band could be beneficial to promote hip joint movement and GM muscle relative to HS muscle activity.

Is it appropriate to use external loads during side-lying hip abduction exercise for weakened gluteus medius?

Side-lying hip abduction exercise could be beneficial to improve the neuromuscular control of the hip abductor; however, there has been limited information available to determine the exercise load during the exercise. This study aimed to demonstrate the effects of using external loads on the hip abductor muscles during side-lying hip abduction exercises in females with gluteus medius (GM) weakness. This study enrolled 24 females with weakness in the GM. Electromyographic (EMG) data of the quadratus lumborum (QL) and GM muscles were recorded during the exercise under three load conditions: no-load, external load-1 (3% of body weight), and external load-2 (5% of body weight). During the exercise, the EMG activities of the QL were significantly different under all three conditions (p< 0.05), with greater activity observed in the external load-2 condition (92.05 ± 65.93% maximal voluntary isometric contraction [MVIC]) as compared to the others, and in the external load-1 condition (82.47 ± 57.36% MVIC) as compared to the no-load condition (48.94 ± 45.09% MVIC). Furthermore, the GM/QL ratios showed significant differences between no-load (1.78 ± 1.47) and external load-1 conditions (0.93 ± 0.60), and between no-load and external load-2 (0.85 ± 0.45) conditions (p< 0.05). These findings suggest that greater load could be a factor to increase the QL activity during the exercise in females with weakened GM.

Design, manipulability analysis and optimization of an index finger exoskeleton for stroke rehabilitation

Rehabilitation medicine studies have indicated that occupational therapy has a positive effect on the recovery of hand function. However, few wearable hand exoskeletons can assist in performing the adduction and abduction exercises of occupational therapy. Therefore, the wearable index finger rehabilitation exoskeleton (WIFRE) is studied in this paper. First, a WIFRE is proposed to realize the index joint’s independent actuation, including adduction and abduction movements. Second, the local/global kinematic and dynamic manipulability measures are proposed and analyzed to evaluate the performance of the WIFRE. The analysis results show that the dimensional parameters of the WIFRE have a significant effect on its global manipulability measures. The global kinematic and dynamic manipulability measures can be improved by 13%–15% compared with the corresponding minimums. Third, a multi-parameter multi-objective optimization method is proposed to simultaneously enhance the three global manipulability measures. Finally, experiments are performed to verify the effectiveness of the index finger exoskeleton and the global manipulability measures.

In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

A further increase in the number of total hip arthroplasty (THA) is predicted, in particular the number of young THA patients has raised and with it their demands. There is no standardized evidence-based rehabilitation program and no reliable guidelines for sports activities after THA. Stretching and strengthening gymnastics are routinely performed in rehabilitation and aerobics as a sport after THA. The aim of the investigation was to determine the in vivo force and moments acting on the hip prosthesis during gymnastics and aerobic exercises to provide a source for evidence-based recommendations. Hip joint loads were measured in six patients with instrumented hip implants. The resulting force FRes, bending moment MBend at the neck and torsional moment MTors at the stem were examined during seven strengthening (with two different resistance bands) and four stretching gymnastic exercises and seven aerobic exercises with and without an aerobic step board compared to the loads during the reference activity walking. The stretching and strengthening gymnastics exercises and the aerobic exercises with and without a board demonstrated in their median peak force and moments mostly lower or similar values compared to walking. Significantly increased loads were recorded for the flexor stretching exercise in monopod stand (Fres and MBend), the strengthening abduction exercise on the chair (MTors) and the strengthening flexion exercise with the stronger resistance band (MTors). We also found a significant increase in median peak values in aerobic exercises with a board for the "Basic Step" (ipsilateral started Fres and MTors; contralateral started MTors), "Kickstep ipsilateral started" (Fres and MTors) and "Over the Top contralateral started" (Fres). The in vivo loads in THA patients during frequently performed stretching, strengthening and aerobic exercises were demonstrated for the first time. It was proved that stretching gymnastic exercises are safe in terms of resulting force, bending and torque moments for THA patients, although an external assistance for stabilization may be considered. Strengthening gymnastics exercises are reliable in terms of Fres, MBend and MTors, but, based on our data, we recommend to adhere to the communicated specific postoperative restrictions and select the resistance bands with lower tension. Aerobic exercises without an aerobic board can be considered as reliable activity in terms of force and moments for THA patients. Aerobic exercises with a board are not recommended for the early postoperative period and in our opinion need to be adapted to the individual muscular and coordinative resources.

The feasibility of ultrasound Graf method in screening infants and young children with congenital hip dysplasia and follow-up of treatment effect.

BackgroundCongenital hip dysplasia is a common limb deformity in infants and young children. This study aimed to clarify the feasibility of ultrasound Graf method in screening congenital hip dysplasia of infants and young children, and its application value in follow-up treatment.MethodsA total of 1,313 infants and young children with clinically suspected congenital hip dysplasia in our hospital from December 2016 to January 2018 were selected as the participants and were examined by ultrasound Graf method. The acetabulum shape and the measured values of α and β angles of the participants were observed. The development of the hip joint and distribution of congenital hip dysplasia were analyzed, and the treatment effect was followed up.ResultsAmong 1,313 infants and young children with suspected congenital hip dysplasia, the positive rate of congenital hip dysplasia was 6.02% (79/1,313). The lesions were located on both sides in 14 cases, on the left side in 67 cases, and on the right side in 26 cases. The α angle of cases with congenital hip dysplasia was significantly lower than that of normal cases, and the β angle was significantly higher than that of normal cases (P<0.05). Ultrasound follow-up results showed that out of 24 cases who underwent hip abduction exercises, 22 (91.67%) returned to normal, and the remaining 2 returned to normal after Pavlik sling treatment. Among 46 cases treated with Pavlik sling, 42 (91.30%) returned to normal, and the remaining 4 cases returned to normal after closed reduction and plaster fixation. A total of 9 participants underwent plaster fixation after closed reduction, all of which returned to normal.ConclusionsUltrasound Graf method can be used as the first choice for screening infants and young children with congenital hip dysplasia. It can be followed up to observe the clinical treatment effect, and it has high clinical application value.

Kinect-based integrated physiotherapy mentor application for shoulder damage

With the increasing rate of disabled people in the world, the number of people in need of physiotherapy is increasing. Most of the disabled persons with shoulder damaged should do physiotherapy exercises. The telerehabilitation systems using developed technologies have advantages over conventional physiotherapy methods. Such systems have the potential to improve communication between patients and physiotherapists. They also allow for easier information and medical data sharing. In this study, a telerehabilitation system based on Kinect Sensor (Kinect 2) was developed to observe and evaluate shoulder damaged patient exercises by using the Kinect skeletal monitoring feature. The proposed system consists of two basic components: the web application that enables the communication between patients and physiotherapists, allows the physiotherapist to observe/update patient exercise data, patients information, and the console application which enables the patients to perform their exercises correctly. This console app was developed for patients with shoulder damage. Abduction, flexion, internal rotation, external rotation, extension exercises can be performed correctly thanks to the developed application. The proposed system was evaluated in Bilecik State Hospital for 29 shoulder damaged volunteers. 14 of the volunteers were treated with the conventional methods and 15 of them were treated with the proposed system. The recovery of the volunteers was analyzed for each intragroup and intergroup comparison was made. Statistically, significant decreases were observed in the limitations of the patients treated with the proposed system. For abduction, flexion, internal rotation, and external rotation exercises, the Kinect-based physiotherapy mentor application was more successful than conventional method, while all volunteers treated by the proposed method had no limitations in extension exercise. As a result, the Kinect-based physiotherapy mentor application can be used as an alternative telerehabilitation method for patients with shoulder damaged.

Examining Muscle Activity Differences During Single and Dual Vector Elastic Resistance Exercises.

BackgroundElastic resistance exercise is a common part of rehabilitation programs. While these exercises are highly prevalent, little information exists on how adding an additional resistance vector with a different direction from the primary vector alters muscle activity of the upper extremity.PurposeThe purpose of this study was to examine the effects of dual vector exercises on torso and upper extremity muscle activity in comparison to traditional single vector techniques.Study DesignRepeated measures design.MethodsSixteen healthy university-aged males completed four common shoulder exercises against elastic resistance (abduction, flexion, internal rotation, external rotation) while using a single or dual elastic vector at a fixed cadence and standardized elastic elongation. Surface electromyography was collected from 16 muscles of the right upper extremity. Mean, peak and integrated activity were extracted from linear enveloped and normalized data and a 2-way repeated measures ANOVA examined differences between conditions.ResultsAll independent variables differentially influenced activation. Interactions between single/dual vectors and exercise type affected mean activation in 11/16 muscles, while interactions in peak activation existed in 7/16 muscles. Adding a secondary vector increased activation predominantly in flexion or abduction exercises; little changes existed when adding a second vector in internal and external rotation exercises. The dual vector exercise in abduction significantly increased mean activation in lower trapezius by 25.6 ± 8.11 %MVC and peak activation in supraspinatus by 29.4 ± 5.94 %MVC (p<0.01). Interactions between single/dual vectors and exercise type affected integrated electromyography for most muscles; the majority of these muscles had the highest integrated electromyography in the dual vector abduction condition.ConclusionMuscle activity often increased with a second resistance vector added; however, the magnitude was exercise-dependent. The majority of these changes existed in the flexion and abduction exercises, with little differences in the internal or external rotation exercises.Level of Evidence3b