Abductor Muscle Strength Research Articles

Woman with dyspnea after skin rash.

Woman with dyspnea after skin rash.

Outcomes After Abductor Reattachment to Proximal Femur Endoprosthesis After Tumor Resection

Resection of the proximal femur raises several challenges including restoration of the abductor mechanism. Few evaluated the outcomes of different techniques of abductor fixation to the proximal femur endoprosthesis. A retrospective review of patients who underwent proximal femoral arthroplasty with a minimum follow-up of 12 months was conducted. Patients were divided into two groups: (1) those with preserved greater trochanter (GT) reattached to the implant and (2) those with direct abductor muscle reattachment. Both groups were compared for surgical and functional outcomes. Group 1 patients were subdivided into those who received GT reinsertion using grip and cables and those reattached using sutures. Fifty-three patients were included with a mean follow-up of 49 months. There were 22 patients with reinserted GT and 31 patients with soft-tissue repair. The endoprosthesis revision rate was comparable between groups (P = 0.27); however, the incidence of dislocations was higher in group 2 (0/22 versus 6/31; P = 0.035). Trendelenburg gait (77% versus 74%), use of walking aids (68% versus 81%), and abductor muscle strength were comparable between both groups (P > 0.05). In group 1, 15 patients had GT reinsertion with grip and cables. Of those, five patients (33%) had cable rupture within 13 months of follow-up. GT displacement reached 12 mm at 12 months of follow-up in patients with grip and cables compared with 26 mm in patients with GT suture reinsertion (P < 0.05). Although GT preservation did not improve functional outcomes, it was associated with a lower dislocation rate despite frequent cable failure. Less displacement was observed when GT reattachment used grip and cables.

Effectiveness of Manual Therapy and Specific Exercise Conditioning on Clinical Outcome Measures among Participants with Subacromial Impingement Syndrome

Shoulder subacromial impingement syndrome (SIS) is a mechanical disturbance caused by a multifactorial aetiology, and conservative treatment is the first choice. This study aims to investigate the combined short-term effect of manual therapy and eccentric exercise conditioning on clinical outcomes in the acute phase. We recruited 126 subjects with a SIS of 3 months' duration and divided them into two groups of 63 people each. The experimental group received manual therapy and eccentric exercise; the control group received concentric exercise, spread over 3 weeks, followed by a home program for another 9 weeks. Pain intensity, shoulder elevation range, abductor and external rotator muscle strength, and regional function were obtained at baseline, after 10 sessions of treatment and follow-up at 12 weeks. After the first session and by the end of 3 weeks, a global rating of change (GRC) questionnaire was administered to determine self-perceived improvement. An analysis of variance with repeated measures was applied, and the results showed that there were statistically significant differences in both groups; all outcomes improved after treatment and during follow-up (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.005). However, on intergroup analysis, significant improvement was observed with pain intensity (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.0005), elevation range of motion (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.05) and external rotator muscle strength (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.016) after treatment, and external rotator muscle strength and SPADI score (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.0005) at follow-up by 12 weeks in the experimental group. The between-group comparison revealed that pain reduction by 3 weeks, external rotator muscle strength by 3 and 12 weeks, had resulted in a large effect size. Manual therapy and eccentric exercise can reduce pain intensity, improve shoulder elevation range, and gleno-humeral muscle strength after 12 weeks of training better than concentric exercises. The improvement in shoulder function with the experimental group exceeded the MCID of 13 points, resulting in a large and significant effect size (d &amp;#61; 1.08). The self-perceived improvement (GRC) was significant in the experimental group (&lt;i&gt;P&lt;/i&gt; &amp;#60; 0.001) with a clinically significant change greater than the MCID (3 points).

Influence of Motor Imagery Training on Hip Abductor Muscle Strength and Bilateral Transfer Effect

Influence of Motor Imagery Training on Hip Abductor Muscle Strength and Bilateral Transfer Effect

Abductor recovery after muscle-sparing periacetabular osteotomy using a lateral approach.

To decrease hip abductor dysfunction after periacetabular osteotomy using a lateral/trochanteric approach, we aimed to modify transposition osteotomy of the acetabulum (TOA) to not cut the greater trochanter and abductor-iliac crest detachment. We subsequently compared abductor muscle strength recovery between TOAs with [conventional TOA (C-TOA)] and without [modified TOA (M-TOA)] trochanteric osteotomy. C-TOA and M-TOA were performed in 27 and 34 hips, respectively. Hip abduction, flexion and knee extension muscle strength were measured preoperatively and at 3, 5, 10, 24 and 52 weeks postoperatively. The muscle strength ratio of the affected and contralateral lower limbs was compared between the C-TOA and M-TOA groups. Neither the mean Merle d'Aubigné-Postel score at the final follow-up nor the postoperative center-edge angle showed significant differences between the M-TOA and C-TOA groups (15.7 versus 16.4 points; P = 0.25 and 38.5° versus P = 0.62 and 39.8°, respectively). The mean muscle strength ratios of hip abduction at 5, 12 and 24 weeks postoperatively were significantly higher in the M-TOA group than in the C-TOA group (0.62 versus 0.39, 0.76 versus 0.59 and 0.94 versus 0.70; P = 0.03, 0.04 and 0.01, respectively). There were no significant differences between groups at Postoperative Week 52 (P = 0.36). Discomfort at the greater trochanter was observed in 18 hips (66.7%) in the C-TOA group but only in 4 hips (11.2%) in the M-TOA group. In conclusion, M-TOA is less invasive than C-TOA and allows an earlier recovery of abductor muscle strength without significant correction loss.

Contribution of Hip Abductors Muscles on Bone Mineral Density and Functionality in Older Women

Background: Despite the well-established role of muscle in maintaining bone mass and physical performance, there are still few studies that assess the relationship between muscle groups and specific bone sites and its contribution to physical function in older people. The aim of the study is to verify the association between hip and knee's muscle strength and bone mineral density of the femoral neck (BMD-FN) and investigated which muscle strength that are related with BMD-FN is associated with physical function in older women. Methodology: This is a cross-sectional study of 94 women over the age of 60 years, physically independent. Muscle strength of the hip and knee was evaluated using an isokinetic dynamometer (Biodex, USA) to obtain peak torque (PT). The BMD-FN was obtained using dual-energy x-ray absorption densitometry (DXA). Physical function was evaluated by the Timed Up and Go (TUG), gait speed (GS), five times stand to sit (5TSS) and single-leg stance (SS). To verify the association between muscle strength (independent variable) and the BMD-FN (dependent variable) and the relationship between muscle strength (independent variable) and clinical tests (dependent variable), the multiple linear regression was carried out, adjusted for age, time of menopause, height and level of physical activity. All of the analyses were carried out by the SPSS 17.0 software, with a level of p < 0.05 significance. Results: We found an association between the hip abductors PT and the BMD-FN and between hip abductors PT and all clinical tests. Conclusion: We observe that hip abductor muscle strength contributes to BMD-FN and to performance in several clinical tests in older women. These findings reinforce the importance of this musculature not only for improving balance and gait, but also it can be a strategy to maintain/improve bone mass in the femoral neck in this population.

Frontal plane projection angle predicts patellofemoral pain: Prospective study in male military cadets

BackgroundPatellofemoral pain (PFP) is a major source of knee pain. Identifying who may develop PFP is of paramount importance. PurposeTo assess whether Frontal plane projection angles (FPPA) and hand held dynamometry (HHD) strength measures can predict development of PFP. Study designProspective evaluation of individuals undertaking a military training programme. MethodsMale military recruits were enrolled and prospectively followed up from enrolment to completion of 12-weeks training. Lower limb kinematics (FPPA, Q-angle, hip adduction angle, knee flexion, ankle dorsiflexion, and rearfoot eversion angle) measured during running, single leg squatting (SLS), and single leg landing (SLL) and isometric muscle strength of hip abductors and knee extensors. ResultsBody mass, hip abductor muscle strength, Q-angle during SLS and SLL, FPPA during SLL all significantly different between the PFP and non-injured groups and predicted PFP, highest predictor variable was FPPA during SLL (Odds Ratio = 1.13, P = 0.01). A FPPA≥5.2° during SLL predicting PFP with a sensitivity of 70% and a specificity of 70%. ConclusionParticipants who developed PFP had a number of physical factors significantly different than the non-injured group, most predictive was a larger FPPA during SLL, with angles greater than 5.2° associated with a 2.2x greater risk. Clinical relevanceAssessing FPPA during SLL could be used to determine who was predisposed to PFP.

Comparison of shoulder muscle strength, shoulder range of motion and scapular motion in men with ankylosing spondylitis and healthy men: a case-controlled study

Background/Aims Ankylosing spondylitis mainly affects the vertebral column, meaning that the assessment of the physical function of the upper extremity and scapulothoracic region in ankylosing spondylitis is often overlooked. Therefore, the aim of this study was to investigate shoulder muscle strength, shoulder active range of motion and three-dimensional scapular motion in patients with ankylosing spondylitis. Methods The study included 18 men with ankylosing spondylitis, and 16 age-matched typically healthy men as the control group. Muscle strength, active range of motion, and three-dimensional scapular motion were assessed with a digital hand-held dynamometer, an inclinometer, and an electromagnetic tracking device respectively. Results A decrease in shoulder flexion and abduction muscle strength on both the dominant side (P&lt;0.001, P=0.001) and non-dominant side (P&lt;0.001, P&lt;0.001) was found in the ankylosing spondylitis group compared to the control group. A decrease in shoulder flexion, abduction, and external and internal rotation active range of motion on both the dominant side (P=0.001, P&lt;0.001, P=0.015, P&lt;0.001, respectively) and non-dominant side (P=0.001, P&lt;0.001, P=0.017, P&lt;0.001 respectively) was observed in the ankylosing spondylitis group. There was an increase in the upward rotation of the scapula on the non-dominant side at 30, 60, and 90° humeral elevations in the ankylosing spondylitis group compared to the control group (P=0.018, P=0.003, P=0.001 respectively). The other parameters of the scapular motion did not differ between groups (P&gt;0.05). Conclusions This study showed that shoulder muscle strength and active range of motion were lower, and the upward rotation of the scapula was greater in men with ankylosing spondylitis compared to typically healthy men. The kinetics and kinematics parameters of the shoulder and scapula should be considered when assessing the physical function of patients with ankylosing spondylitis.

Eight-week virtual reality training improves lower extremity muscle strength but not balance in adolescents with intellectual disability: A randomized controlled trial.

Purpose: This study aims to assess the effects of 8-week virtual reality (VR) training on balance and lower extremity muscle strength in adolescents with intellectual disability (ID). Methods: Thirty adolescents with intellectual disability were randomly divided into the virtual reality group and control group. The participants in the virtual reality group and the control group received the virtual reality training and the physical education (PE) course, respectively, for 8weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test and lower extremity muscle strength were measured before and after the training. Results: The between-group results showed that the participants in the virtual reality group increased the muscle strength of hip flexors (p < 0.001), hip extensors (p = 0.002), hip abductors (p < 0.001), knee flexors (p < 0.001), knee extensors (p = 0.002) and ankle plantar flexors (p = 0.042) significantly after training, compared to the control group. However, no significant improvement was found in the berg balance scale and timed up and go scores between the virtual reality group and control group after training (p > 0.05). The within-group results showed that the strength of all the muscle groups significantly increased after training in the virtual reality group (p < 0.05) compared to the baseline. However, no significant difference was found in the muscle strength in the control group before and after training. The within-group berg balance scale and timed up and go scores showed no significant improvements in both groups. Conclusion: Virtual reality training intervention might be effective in improving the lower extremity muscle strength, but no significant improvement was found on balance ability in adolescents with intellectual disability.

Effects of perioperative exercise therapy combined with nutritional supplementation on functional recovery after fast-track total hip arthroplasty

BackgroundThe combination of exercise therapy combined with nutritional supplementation (Nutr) is widely used for frail or sarcopenic older persons. However, the effects of Nutr in elderly patients after fast-track total hip arthroplasty (THA) are unknown. This study examined the effects of perioperative Nutr on muscle strength, functional performance, and quality of life (QOL) in frail elderly women after fast-track THA. MethodsA total of 58 frail elderly women aged 65–80 years scheduled for unilateral primary THA were randomly allocated to two groups: the physical exercise (Ex) combined with Nutr (Ex + Nutr; n = 29) group, and the Ex alone (Ex; n = 29) group. Protein and vitamin D supplements were provided daily from 4 weeks preoperatively to 8 weeks postoperatively (12 weeks) to the patients in the Ex + Nutr group, whereas the Ex group did not receive any supplements. Surgery and postoperative rehabilitation programmes during intervention were identical in both groups.Hip abductor and knee extensor muscle strength, functional performance (Timed Up & Go test, Harris Hip Score), and QOL (Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire) were assessed at baseline and at 12 weeks (8 weeks postoperatively). ResultsAfter the intervention, hip abductor muscle strength on the contralateral leg and knee extensor muscle strength on both sides significantly improved in the Ex + Nutr group compared to the Ex group (p = 0.03, 0.01, and 0.01, respectively). However, hip abductor muscle strength on the operated side did not differ significantly between the groups (p = 0.23). There were no significant differences in functional performance and QOL. ConclusionEx + Nutr does not have an additional effect on the improvement of hip abductor strength, functional performance, and QOL compared to Ex alone after fast-track THA. However, significant improvements were observed in the strength of some muscles after fast-track THA. Trial registrationUMIN 000042964. The IRB approvalThis study was approved by the Mirai Iryo Reesearch Center (approval number TGE1602-115).

Relationship between Hip Abductor Muscle Strength and Frontal Plane Kinematics: A Cross-Sectional Study in Elite Handball Athletes

Frontal plane kinematics of the lower limb could be especially relevant in the risk of injuries in handball (HB) athletes. An association between lower limb frontal plane kinematics and hip abductor muscles strength has been investigated in different populations. However, the relationship between pelvis, hip, and knee frontal plane kinematics and the hip abductor strength in HB athletes has not been considered. Therefore, the objective of this study was to evaluate the relationship between hip abductor muscles strength and frontal plane kinematics (contralateral pelvic drop, femoral adduction, and knee valgus) in elite HB athletes using 2D analysis. Design: Cross-sectional and correlational study. Methods: Thirty-four male professional HB athletes were recruited. Athletes had to perform a deep single-leg squat. The frontal plane was recorded using the Camera app on iPhone (5SE). The clinical variables were hip abductor muscles strength assessed using a Lafayette hand-held dynamometer version 01165, and frontal plane kinematics measured with Kinovea 2D software version 0.9.4. Both variables were measured independently by two different examiners. Results: The correlation analysis showed a statistically significant negative correlation between the hip abductor muscles strength and the pelvic drop angle (p &lt; 0.001; PCC: −0.873). A statistically significant positive correlation was found between the hip abductor muscles strength and the femoral adduction angle (p &lt; 0.001; PCC: 0.767) and between the hip abductor muscles strength and the knee valgus angle (p &lt; 0.001; PCC: 0.855). Conclusion: Hip abductor muscles strongly correlate with frontal plane kinematics in HB athletes.

Evaluation of the dynamics of electrotensodynamometry indicators during the implementation of the physical therapy program for children aged 5–6 years with the consequences of hip dysplasia

Purpose: to investigate and evaluate the indicators of electrotensiodynamometry in the process of implementing a program of physical therapy for children aged 5–6 years with the consequences of hip dysplasia (HD). Material &amp; Methods: 131 children were examined, from which two groups were subsequently formed: the HD group (n=68) - a group of children with the consequences of HD; comparison group (n=63) – healthy children. The HD group was divided into control (n=33) and main (n=35). To evaluate the results, the method of electrotension dynamometry of the thigh muscles was used. Results: there is an asymmetry in the development of the strength capacity of the muscles of the lower limbs (the tone of the adductor muscles exceeds the tone of the hip abductor muscles, there is an asymmetry in the muscle tone of the hip flexors and extensors when compared with an intact limb) in children with HD. A program of physical therapy (basic and variable component) for children 5-6 years old with the consequences of HD on the level of function and activity/participation of the ICF-CY was developed. The effectiveness of the program was confirmed by the dynamics of electrotensiodynamometry indicators, where the strength of the hip abductor muscles of the affected limb did not have statistically significant (p&gt;0,05) differences (intact – 86,42±6,63, affected – 83,21±6,34), in contrast to the control group, where the parameters of the affected group were statistically significantly (p &lt;0,05) higher (intact – 82,14±7,41, affected – 57,25±7,53). Conclusions: the dynamics of electrotensiodynamometry indicators of the thigh muscles during the implementation of the physical therapy program for children aged 5-6 years with the consequences of HD shows the advantages of the developed physical therapy program, which was tested in the main group. Positive changes were noted in the control group, which were determined by increasing indicators of the moment of strength of the thigh muscles of the affected limb, but they did not have a confirmed statistically significant (p&gt;0.05) positive effect.

Hip Adductor, Abductor Muscles Strength, and Performance in Participants with and without Low Back Pain

Introduction: Weakness of hip muscles is common in individuals with chronic non- specific low back pain (CNSLBP). Also, hip joint performance can be influenced by the weakness of hip muscles. This study aimed to compare the strength and performance of hip adductor and abductor muscles between subjects with and without CNSLBP and to investigate their association with disability level.&#x0D; Materials and Methods: This case-control study included 41 participants with CNSLBP and 41 healthy participants. The strength of hip abductor and adductor muscles were measured using a dynamometer and their performance was assessed using the one-leg hop test. The disability level in the CNSLBP group was assessed using the oswestry disability index (ODI). Data were analyzed using an independent sample t test and Pearson correlation coefficient.&#x0D; Results: No significant differences were observed between groups for hip muscle strength. One-leg hop test scores of the left lower extremity in the lateral direction were significantly higher in the CNSLBP group compared to the control group. Also, no significant relationships were observed between the total score of ODI and hip muscle strength or performance in the CNSLBP group.&#x0D; Conclusion: It’s recommended that evaluation and exercise therapy of participants with CNSLBP be performed during functional performance tasks.

Rapid Spike in Hip Adduction Strength in Early Adolescent Footballers: A Study of 125 Elite Male Players From Youth to Senior.

To investigate the differences in hip adductor and abductor muscle strength in elite male footballers from youth to senior level. We tested 125 players from the under-13-years (U'13) to senior squads of a Danish male professional football club in this cross-sectional design study. Hip adductor and abductor force (in newtons), torque (in newton meters), normalized torque (in newton meters per body mass), and adduction-to-abduction ratio were measured using handheld dynamometry. Between U'13 and senior level, adductor force increased by 104%, torque by 127%, and normalized torque by 21%. Abductor force increased by 78%, torque by 126%, and normalized torque by 17%. For incremental differences between age groups, significant increases were observed between the ages of U'13 to U'14 (18%-39%) and U'14 to U'15 (19%-33%) for all strength measures (P ≤ .021). No incremental difference was observed for adductor-to-abductor ratio. The large increases in hip adductor and abductor strength occurring between the ages of U'13 and U'15 offer insight into the strength capabilities and stress demands in these players, which may relate to injury vulnerability, and facilitate clinicians in selecting best-suited exercise interventions.

The influence of mat Pilates training adherence on strength and flexibility parameters in breast cancer survivors undergoing hormone therapy.

The aim of this study was to evaluate the influence of adherence to mat Pilates training on lower and upper body strength and flexibility in breast cancer survivors. Breast cancer survivors (≥40 years) with cancer stages 0–III undergoing hormone therapy participated in this study. For this secondary investigation only the intervention group was analyzed, divided into low and high training adherence. Participants performed a 60-min session of mat Pilates, 3 times/wk, for 24 weeks. Concentric, eccentric, and isometric hip flexor-extensor muscle peak torque, and isometric maximal strength parameters of the shoulder abductors, trunk extensors, and handgrip were assessed. Physical activity level was analyzed as a control variable. The results showed that high training adherence improved (P<0.05) left shoulder abductor strength parameters and lower and upper body flexibility compared to baseline. The low training adherence group improved (P<0.05) trunk extensors, right and left shoulder abductor strength parameters, handgrip strength, and extensor-flexor peak torque compared to baseline. There were no differences (P>0.05) between high and low adherence for physical activity level before and after the intervention. Therefore, it appears that higher training adherence most influences some strength parameters and flexibility, while fewer sessions enable the achievement of significant results for shoulder abductor and hip extensor-flexor muscle strength parameters.

Effect of fascia iliaca compartment block on anterolateral small incision total hip arthroplasty

To compare the effects of simple intraspinal anesthesia and combined fascia iliaca compartment block(FICB) on total hip arthroplasty(THA) through anterior lateral small incision (orthop dische chirurgie München, OCM). From January 2019 to October 2020, patients undergoing unilateral total hip arthroplasty were treated with intraspinal anesthesia combined with ultrasound-guided fascia iliaca compartment block(30 cases in group A) and simple intraspinal anesthesia(30 cases in group B). Two groups were treated with the same intravenous analgesia after operation. The operation time, the amount of bleeding, the peeling degree of middle gluteal muscle, the splitting of greater trochanter of femur, the visual analysis scale (VAS) of hip joint after operation, the abductor muscle strength of quadriceps femoris and hip joint before and 48 hours after operation, and the Harris score of hip joint function after operation were observed and compared between two groups. All patients were followed up for 48 to 62 weeks with an average of (54.2±4.0) weeks. The incision length, operation time and intraoperative bleeding in group A were significantly lower than those in group B (P<0.05). The level of hemoglobin 24 hours after operation in group A was significantly higher than that in group B (P<0.05). The abductor muscle strength of hip joint in group A was significantly higher than that in group B 48 hours after operation (P<0.05). The degree of middle gluteal muscle dissection in group A was significantly lower than that in group B (P<0.05). The VAS of group A at 8, 12 and 24 hours after operation was significantly lower than that of group B (P<0.05);The Harris score in group A was significantly higher than that in group B at 2 and 8 weeks after operation (P<0.05). The application of ultrasound-guided fascia iliaca compartment block in lateral position OCM approach THA can significantly shorten the operation time, reduce the amount of bleeding, reduce the perihip trauma such as the peeling of middle gluteal muscle during operation, and improve the early postoperative pain of patients, which is conducive to the clinical operation of OCM approach and the rapid postoperative recovery of patients.

The effectiveness of the comprehensive corrective exercise program on kinematics and strength of lower extremities in males with dynamic knee valgus: a parallel-group randomized wait-list controlled trial

BackgroundDynamic knee valgus (DKV) is a prevalent movement impairment widely regarded as a risk factor for lower extremity disorders such as patellofemoral pain syndrome. The present study aimed to investigate the effectiveness of the comprehensive corrective exercise program (CCEP) on kinematics and strength of lower extremities in males with DKV.MethodsThirty asymptomatic young men with DKV between the ages of 18 and 28 years participated in this study. They were randomly assigned to the intervention (n = 15) and control groups (n = 15). The intervention group performed the CCEP for three sessions per week for eight weeks, while the control group only did activities of daily living. Hip external rotator and abductor muscle strength and three-dimensional lower extremity kinematics consisting of knee varus/valgus, femur adduction/abduction, femur medial/lateral rotation, and tibial medial/lateral rotation were measured at the baseline and post-test. The data were analyzed using the analysis of covariance (ANCOVA).ResultsThere were significant improvements in all kinematics variables in the intervention group after the 8-week CCEP. Moreover, the strength of abductor and external rotator muscle improved in the intervention group (P < 0.05).ConclusionsThe CCEP led to substantial improvements in the selected variables of lower extremity kinematics and muscle strength in participants with DKV during a single-leg squat. These results imply that practitioners should adopt a comprehensive approach to pay simultaneous attention to both proximal and distal segments for improving DKV.Trial registrationThe protocol has been approved in the Registry of Clinical Trials (Registration N: IRCT20180821040843N1) on 2018-12-30.

Is there a correlation between isometric muscle strength and the kinematics of the pelvis, hip and knee during functional tasks in women with patellofemoral pain?

ObjectivesTo evaluate the correlation between isometric muscle strength of the hip abductors (HABD) and lateral rotators (HLR) with the range of motion (ROM) of the pelvis/hip in the frontal/transverse planes, respectively, and between the strength of the knee extensors (KExt) with the ROM of the knee in the sagittal plane during seven tasks. DesignCross-sectional study. SettingLaboratory. ParticipantsThirty-five women with patellofemoral pain. Main outcome measuresMaximum isometric muscle strength of the HABD, HLR, and KExt was measured using a manual dynamometer, and pelvis and lower limbs kinematics were evaluated using 3D optical system during gait, ascending and descending stairs, the forward and lateral step down tests, and the propulsion and landing phases of the single leg hop test (SLHT). ResultsA weak correlation was found between KExt strength and knee ROM in the sagittal plane (p = 0.05; r = −0.33) during SLHT landing, and a moderate correlation between HABD strength and ROM of pelvic obliquity (p < 0.01; r = 0.50) during ascending stairs. ConclusionsThe lower strength of KExt has a weak correlation with higher knee flexion during the landing phase of the SLHT, and the lower strength of HABD has a moderate correlation with lower pelvis ROM in the frontal plane when ascending stairs.

Combined and Modified Gibson and Ilioinguinal Approaches in Type II + III Internal Hemipelvectomy for Periacetabular Tumors.

BackgroundThe routine iliofemoral approach and its modifications in type II+III resection require extensive skin incision and massive periacetabular muscle detachment, leading to prolonged hospital stay, increased complication incidence, and impaired lower limb function. Under the management of an enhanced recovery after surgery (ERAS) protocol, a combined and modified Gibson and ilioinguinal (MGMII) approach was used to avoid unnecessary soft tissue trauma during tumor resection and therefore advantageous to patients’ return to normal life.MethodsTwenty-five patients with type II + III (including type II) periacetabular tumors who underwent reconstruction with 3D printed customized endoprostheses at our center between January 2017 and March 2019 were included in this study. There were 13 cases using MGMII approach and 12 cases using iliofemoral approach. The operation duration and blood loss were assessed by chart review. The surgical margin was evaluated by the histopathological studies. The reconstruction accuracy, the abductor muscle strength, the 1993 version of the Musculoskeletal Tumor Society (MSTS-93), the Harris Hip scores (HHS), and the limp score were evaluated. Complications were recorded after reviewing the patients’ records.ResultsThe operative duration and blood loss in MGMII group were shorter than those in the iliofemoral group, but the postoperative hemoglobin was slightly higher than that in the iliofemoral group. The MGMII group had stronger postoperative hip abductors, better functional restoration, and relatively fewer patients with higher limp scores. No complication was observed in the MGMII group. In the iliofemoral group, three patients encountered wound healing delay, and one patient suffered deep infection.ConclusionsThe MGMII approach can better expose the posterior column of the acetabulum, especially the ischial tuberosity, which is beneficial for avoiding tumor rupture during resection. The MGMII approach also helps to preserve residual muscle function, such as the origin of the gluteus medius, while ensuring the extent of resection.

Hip Abductor Muscle Fatigue Induces Different Strategies During Disrupted Postural Control.

BackgroundAnkle sprain is one of the most common injuries in sport, and hip abductor muscle weakness has recently been reported as a predisposing factor. Currently, the influence of hip abductor muscle fatigue on ankle joint control has not been elucidated during an ankle disturbed balance exercise. This study aimed to determine the influence of hip abductor muscle fatigue on ankle joint control during a disturbed balance task, and to consider inter-individual variability in the kinematic and neuromuscular reorganizations implemented.MethodsTwenty-six healthy subjects (13 males; 13 females) performed a unipedal postural balance task with eyes closed before and after a fatiguing exercise (up to a 50% decrease in strength) of the hip abductor muscles. Subjects completed balance task while equipped with an ankle destabilization device that allows inversion/eversion movements. Electromyographic (EMG) activity of the gastrocnemius lateralis (GastL), peroneus longus (PL) and brevis, tibialis anterior, and gluteus medius were recorded during task. Kinematics (e.g., frontal foot angulation) of the ankle complex were determined using inertial measurement units.ResultsIn the overall group, no significant time, sex or interaction effect was observed for kinematic and EMG variables. However, when considering individual responses to hip fatigue, 14 subjects decreased the standard deviation of frontal angulation (−30%) suggesting enhancement of ankle joint control, while 12 subjects increased it (+46%). Normalized EMG for PL and GastL muscles changed with fatigue for both these groups. However, variations were significantly different between groups (p = 0.027 for PL and p = 0.006 for GastL). Indeed, the contribution of ankle muscles increased for the enhanced-stability group while no change for the impaired-stability group.ConclusionThese results highlight that subject adopt different neuromuscular and kinematic ankle strategies to control ankle destabilization in response to hip abductor muscle fatigue. Frontal foot angulation variability seemed to be a valuable marker to detect the type of strategy employed. The strategy adopted by the impaired-stability group might have important implications when analyzing risk factors for ankle sprains. Further studies should consider individual responses to fatigue, to understand which factor could predispose athletes to use of one or other strategy.