Hip Abduction Research Articles

#2786 Effect of intradialytic virtual reality exercise program on lower limb muscle strength in patients on hemodialysis

Abstract Background and Aims In patients on hemodialysis, muscle weakness is highly prevalent and may lead to frailty, limitation of mobility and functional impairment. Moreover, low muscle strength was associated with an increase in mortality risk in these patients. Despite the fact that some studies showed that resistance training improves muscle strength in patients on hemodialysis, the effects of virtual reality (VR) exercise should be confirmed. Therefore, the aim of this study was to evaluate the effects of an intradialytic non-immersive VR exercise program, performed at different times during the hemodialysis session, on lower limb muscle strength in patients on hemodialysis. Method A randomized clinical trial was conducted with patients aged ≥18 years who were undergoing hemodialysis treatment for at least 3 months. Patients were randomized into 2 protocols of exercise at different times during the hemodialysis session (first 2 hours and last two hours) for 3 months. The intradialytic exercise program in both groups consisted of a non-immersive VR game (Treasure Hunting) in which the patients try to catch treasures and avoid bombs by moving their lower limbs (hip flexion, abduction and adduction, and knee flexion and extension), with a progressive duration of 6 to 36 minutes. The difficulty level of the game was graduated according to the characteristics of each patient. The muscle strength of the hip flexion (HF), hip abduction (HA) and ankle extension (AE) was evaluated using a portable handheld dynamometer during hemodialysis session. Patients were advised to perform a 5 s maximum isometric contraction, and the peak values were recorded for 3 repetitions in both lower limbs. The mean muscle strength of 3 trials was recorded. Data were expressed as the median (interquartile range). The Mann‒Whitney U test was used for between-group comparisons. The Friedman test was conducted to evaluate the differences in medians among the muscle strength data at baseline, after 1, 2 and 3 months of exercise program. Results This study included 11 patients in the exercise within the first 2 hours group [50 (55-75) years, 55% male] and 11 patients in the exercise within the last 2 hours group [64 (58-72) years, 64% male]. Table 1 shows that muscle strength of the HA and AE increased significantly in the exercise within the first 2 hours group. Muscle strength of HF, HA and AE improved significantly in the exercise within the last 2 hours group. There were no significant differences between two groups. Conclusion This study suggests that an intradialytic non-immersive VR exercise program can improve lower limb muscle strength in patients on hemodialysis.

#2072 Impact of the GoodRENal platform on lower-limbs muscle strength in a Spanish sample

Abstract Background and Aims People with chronic kidney disease on hemodialysis have low levels of physical activity and low lower-limbs muscle strength, partly due to the sedentary lifestyle, and a big number of hours sitting or in a recumbent position. The GoodRENal project aimed at creating an intradialysis health platform to improve health-related quality of life. The present study focused on the impact of the GoodRENal intradialysis platform on lower-limbs muscle strength. Method People in hemodialysis treatment from Spain were included. Participants were randomized into two groups, the GoodRENal or the usual care group. The participants used the GoodRENal platform for 12 weeks, 3 times a week. Games using non-immersive virtual reality were created aiming at educating on nutritional habits, increasing physical activity during the HD session, improving cognitive skills and increasing psychological well-being. All of them included dual tasks, so that the movement of the legs was used in every game. An Azure Kinect camera was used to capture the movement and all activities were dual, so that movement of lower limbs was promoted in every game. A handheld dynamometer was used to assess hip flexors and abductors muscle strength during the hemodialysis session. This procedure has proven to be reliable and save. An ANOVA mixed model (group and time factors) was used to analyze the results. Results 19 participants were included (Control n = 9; GoodRENal n = 10). Participants’ mean age was 73.4 years for the control and 68.3 years for the GoodRENal group, with a hemodialysis vintage, median 34 months (minimum 3- maximum 277) and 25 months (minimum 5- maximum 48) for the control and GoodRENal groups. Right hip flexor muscles changed in the control group over time: Baseline 124.7 (23.2) N; 4 weeks 121.3 (20.3) N; 12 weeks 119.0 (21.1) N. In the GoodRENal group, the data were: Baseline 116.7 (34.7) N; 4 weeks 124.7 (36.7) N; 12 weeks 142.7 (44.7) N. The ANOVA showed a significant time × group interaction (F = 11.347 p < 0.001) with a significant improvement in the GoodRENal group. Left hip abductor muscles changed in the control group over time: Baseline 124.5 (24.0) N; 4 weeks 123.0 (26.1) N; 12 weeks 122.0 (24.7) N. In the GoodRENal group, the data were: Baseline 111.1 (30.4) N; 4 weeks 119.2 (33.0) N; 12 weeks 138.5 (36.3) N. The ANOVA showed a significant time × group interaction (F = 15.218 p < 0.001) with a significant improvement in the GoodRENal group. Both left hip flexors (F = 19.055 p < 0.001) and abductors (F = 15.036 p < 0.001) showed a significant time per group interaction, with an improvement in the GoodRENal group. Conclusion The GoodRENal platform is a feasible strategy to increase the muscle strength of the hip flexors and abductors muscles. Future studies with bigger samples should confirm these results.

Inclusion of a skeletal model partly improves the reliability of lower limb joint angles derived from a markerless depth camera

A single depth camera provides a fast and easy approach to performing biomechanical assessments in a clinical setting; however, there are currently no established methods to reliably determine joint angles from these devices. The primary aim of this study was to compare joint angles as well as the between-day reliability of direct kinematics to model-constrained inverse kinematics recorded using a single markerless depth camera during a range of clinical and athletic movement assessments.A secondary aim was to determine the minimum number of trials required to maximize reliability. Eighteen healthy participants attended two testing sessions one week apart. Tasks included treadmill walking, treadmill running, single-leg squats, single-leg countermovement jumps, bilateral countermovement jumps, and drop vertical jumps. Keypoint data were processed using direct kinematics as well as in OpenSim using a full-body musculoskeletal model and inverse kinematics. Kinematic methods were compared using statistical parametric mapping and between-day reliability was calculated using intraclass correlation coefficients, mean absolute error, and minimal detectable change. Keypoint-derived inverse kinematics resulted in significantly smaller hip flexion (range = −9 to −2°), hip abduction (range = −3 to −2°), knee flexion (range = −5° to −2°), and greater dorsiflexion angles (range = 6–15°) than direct kinematics. Both markerless kinematic methods had high between-day reliability (inverse kinematics ICC 95 %CI = 0.83–0.90; direct kinematics ICC 95 %CI = 0.80–0.93). For certain tasks and joints, keypoint-derived inverse kinematics resulted in greater reliability (up to 0.47 ICC) and smaller minimal detectable changes (up to 13°) than direct kinematics. Performing 2–4 trials was sufficient to maximize reliability for most tasks. A single markerless depth camera can reliably measure lower limb joint angles, and skeletal model-constrained inverse kinematics improves lower limb joint angle reliability for certain tasks and joints.

Proximal femoral varus osteotomy for Legg–Calvé–Perthes disease: Do age and lateral pillar classifications influence short-to-mid-term clinical and radiological outcomes?

IntroductionProximal femoral varus osteotomy (FVO) is one of the most used treatment methods with acceptable outcomes for Legg–Calvé–Perthes disease (LCPD). We aimed to investigate the influence of age at disease onset and the Lateral Pillar classification on clinical and radiological outcomes of FVO surgery LCPD patients between 6–12years of age. HypothesisProximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up, regardless of preoperative age and Herring type. Material and methodsFifty patients with LCPD (Herring groups B, B/C, and C) who underwent FVO were retrospectively reviewed. We evaluated radiological [center-edge angle, extrusion index, epiphyseal index, acetabular index, articulo-trochanteric distance (ATD)] and clinical [hip abduction range of motion (ROM), Trendelenburg sign, pain, and Harris hip score (HHS)] outcomes with a follow-up of 37.3±10.5months (range: 24–180months). Finally, the overall treatment outcome was assessed using the Stulberg classification. ResultsThe ROC curve analysis did not reveal any significant relationship between age and clinical or radiological outcomes, and there was no predictable age cut-off for surgical outcomes (p=0.13). No significant difference was found in Stulberg classification at the follow-up between patients with type B, B/C, and C of the lateral pillar (p>0.05). DiscussionOur results demonstrated that open-wedge proximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up. Each sample of our study was very small and a lot of variables were measured, making this result not adequately strong enough to draw a robust conclusion. However, FVO surgery remains a possible suggestion for patients in the early fragmentation phase, and age and lateral pillar type may not be limiting factors. Level of evidenceIV; therapeutic retrospective cohort.

Dynamic Gait Analysis in Paediatric Flatfeet: Unveiling Biomechanical Insights for Diagnosis and Treatment.

Flatfeet in children are common, causing concern for parents due to potential symptoms. Technological advances, like 3D foot kinematic analysis, have revolutionized assessment. This review examined 3D assessments in paediatric idiopathic flexible flat feet (FFF). Searches focused on paediatric idiopathic FFF in PubMed, Web of Science, and SCOPUS. Inclusion criteria required 3D kinematic and/or kinetic analysis during posture or locomotion, excluding non-idiopathic cases, adult feet, and studies solely on pedobarography or radiographs. Twenty-four studies met the criteria. Kinematic and kinetic differences between FFF and typical feet during gait were outlined, with frontal plane deviations like hindfoot eversion and forefoot supination, alongside decreased second peak vertical GRF. Dynamic foot classification surpassed static assessments, revealing varied movement patterns within FFF. Associations between gait characteristics and clinical measures like pain symptoms and quality of life were explored. Interventions varied, with orthoses reducing ankle eversion and knee and hip abductor moments during gait, while arthroereisis normalized calcaneal alignment and hindfoot eversion. This review synthesises research on 3D kinematics and kinetics in paediatric idiopathic FFF, offering insights for intervention strategies and further research.

Biomechanical Effects of the Badminton Split-Step on Forecourt Lunging Footwork.

This research investigates the biomechanical impact of the split-step technique on forehand and backhand lunges in badminton, aiming to enhance players' on-court movement efficiency. Despite the importance of agile positioning in badminton, the specific contributions of the split-step to the biomechanical impact of lunging footwork still need to be determined. This study examined the lower limb kinematics and ground reaction forces of 18 male badminton players performing forehand and backhand lunges. Data were collected using the VICON motion capture system and Kistler force platforms. Variability in biomechanical characteristics was assessed using paired-sample t-tests and Statistical Parametric Mapping 1D (SPM1D). The study demonstrates that the split-step technique in badminton lunges significantly affects lower limb biomechanics. During forehand lunges, the split-step increases hip abduction and rotation while decreasing knee flexion at foot contact. In backhand lunges, it increases knee rotation and decreases ankle rotation. Additionally, the split-step enhances the loading rate of the initial ground reaction force peak and narrows the time gap between the first two peaks. These findings underscore the split-step's potential in optimizing lunging techniques, improving performance and reducing injury risks in badminton athletes.

Effects of running-induced fatigue on joint kinematics and kinetics during overground running: a systematic review and meta-analysis.

This study evaluated the acute fatigue-inducing effect of distance running on kinematics and kinetics during overground running. Standardised mean differences (SMD) with 95% confidence intervals (95% CI) were used to pool data across 16 studies. Effects during consistent (pre- and post-fatigue running speed within ± 5%) versus varied speed running (difference of >5% between running speeds) were analysed separately. There was strong evidence that running-induced fatigue significantly increases ground contact times at consistent running speeds (SMD 0.52 [95% CI 0.22, 0.82]) and moderate evidence that step length shortens at varied running speeds (SMD -1.27 [95% CI -1.79, -0.75]). There was strong evidence that fatigue does not change peak: hip and knee flexion angles, hip adduction angle, hip and knee internal rotation angles, hip and knee extension moments, hip and knee abduction moments, knee abduction angle, knee flexion and extension moments, knee adduction moment, rearfoot eversion angle, and plantarflexion moments, or knee flexion and plantarflexion range of motion during stance. Running-induced fatigue increases contact times and reduces step length, whereas lower-body joint angles and moments are unchanged. Minimising changes in stride parameters could provide a mechanism for reducing the effects of fatigue on running performance.

A Step Forward Understanding Directional Limitations in Markerless Smartphone-Based Gait Analysis: A Pilot Study.

The progress in markerless technologies is providing clinicians with tools to shorten the time of assessment rapidly, but raises questions about the potential trade-off in accuracy compared to traditional marker-based systems. This study evaluated the OpenCap system against a traditional marker-based system-Vicon. Our focus was on its performance in capturing walking both toward and away from two iPhone cameras in the same setting, which allowed capturing the Timed Up and Go (TUG) test. The performance of the OpenCap system was compared to that of a standard marker-based system by comparing spatial-temporal and kinematic parameters in 10 participants. The study focused on identifying potential discrepancies in accuracy and comparing results using correlation analysis. Case examples further explored our results. The OpenCap system demonstrated good accuracy in spatial-temporal parameters but faced challenges in accurately capturing kinematic parameters, especially in the walking direction facing away from the cameras. Notably, the two walking directions observed significant differences in pelvic obliquity, hip abduction, and ankle flexion. Our findings suggest areas for improvement in markerless technologies, highlighting their potential in clinical settings.

Females Present Different Single-Leg Squat Kinematics and Muscle Activation Strategies than Males Even after Hip Abductor Fatigue

Background: Despite the potential connection between hip and knee muscle control, there is limited research on the effects of hip abductor fatigue on the hip and knee neuromuscular responses in both males and females. This study aimed to investigate the influence of sex on the hip and knee frontal plane kinematics and the EMG responses of the hip abductors and knee extensor muscles during the single-leg squat before and after hip abductor fatigue. Methods: A total of 30 participants (males, n = 15; females, n = 15) performed single-leg squats before and immediately after a hip abductor fatigue protocol (10° hip abduction position while bearing a 20% load of their estimated 1RM until exhaustion). The frontal plane kinematics (hip adduction and knee frontal plane projection angle) and EMG parameters (amplitude and median frequency) of the gluteus medius (GMed), tensor fascia latae (TFL), vastus lateralis (VL) and vastus medialis (VM) were measured during the single-leg squat. Results: We did not find any effects of hip abductor fatigue or interaction between fatigue and sex on the evaluated parameters (p > 0.05). However, compared to males, females had greater values for the hip and knee frontal plane kinematics (p = 0.030), GMed EMG amplitude (+10.2%, p = 0.012) and median frequency (+10.3%; p = 0.042) and lower VL median frequency (−9.80%; p = 0.007). Conclusions: These findings establish sex-related differences in the kinematics and hip and knee EMG parameters during the single-leg squat, which were not influenced by the hip abductor fatigue protocol.

How reliable are femoropelvic kinematics during deep squats? The influence of subject-specific skeletal modelling on measurement variability

BackgroundBiplanar radiography displays promising results in the production of subject-specific (S.specific) biomechanical models. However, the focus has predominantly centred on methodological investigations in gait analysis. Exploring the influence of such models on the analysis of high range of motion tasks linked to hip pathologies is warranted. The aim of this study is to investigate the effect of S.Specific modelling techniques on the reliability of deep squats kinematics in comparison to generic modelling. Methods8 able-bodied male participants attended 5 motion capture sessions conducted by 3 observers and performed 5 deep squats in each. Prior to each session a biplanar scan was acquired with the reflective-markers attached. Inverse kinematics of pelvis and thigh segments were calculated based on S.specific and Generic model definition. Agreement between the two models femoropelvic orientation in standing was assessed with Bland-Altman plots and paired t- tests. Inter-trial, inter-session, inter-observer variability and observer/trial difference and ratio were calculated for squat kinematic data derived from the two modelling approaches. ResultsCompared to the Generic model, the S.Specific model produced a calibration trial that is significantly offset into more posterior pelvis tilt (–2.8±2.7), hip extension (–2.2±3.8), hip abduction (–1.2±3.6) and external rotation (–13.8±11.4). The S.specific model produced significantly different squat kinematics in the sagittal plane of the pelvis (entire squat cycle) and hip (between 40 % and 60 % of the squat cycle). Variability analysis indicated that the error magnitude between the two models was comparable (difference<2°). The S.specific model exhibited a lower variability in the observer/trial ratio in the sagittal pelvis and hip, the frontal hip, but showed a higher variability in the transverse hip. SignificanceS.specific modelling appears to introduce a calibration offset that primarily translates into an effect in the sagittal plane kinematics. However, the clinical added value of S.specific modelling in terms of reducing experimental sources of kinematic variability was limited.

REAL-TIME HIP RANGE OF MOVEMENT MEASUREMENT IN TELEREHABILITATION; COMPARISON OF HUMAN POSE ESTIMATION TOOL, PHYSIOROM, VS 3D MOTION CAPTURE SYSTEM

INTRODUCTION AND AIMS Telerehabilitation is widely acknowledged, but its adoption in musculoskeletal cohorts has been restricted due to challenges in accurately measuring objective parameters such as range of movement (ROM). This research assesses the accuracy of a human pose estimation tool utilising two-dimensional (2D) video (PhysioROM, Coviu) for evaluating active hip flexion and abduction ROM during common rehabilitation exercises, compared to three-dimensional (3D) motion capture. METHODS Fifty participants (18 to 80 years) were recruited, each performing three common hip movements; standing hip flexion, standing hip abduction and a sit-to-stand. The motions were captured using the 12-camera, 3D Vicon motion capture system in conjunction with simultaneous 2D video, simulating a home telehealth consultation scenario. Joint kinematics were computed using either the Vicon Plug-in Gait model (3D Vicon) or the human pose estimation tool integrated into the PhysioROM algorithm (2D PhysioROM). RESULTS No significant differences were observed in peak hip ROM measurements during the tasks undertaken. Mean peak hip flexion was 2.4° (p=1.0) less for 3D Vicon versus 2D PhysioROM in standing hip flexion, though 2.1° (p=0.46) greater during sit-to-stand movement. Hip abduction was 5.3° (p&amp;lt; 0.001) less for 3D Vicon versus 2D PhysioROM in standing hip abduction. Statistical parametric mapping revealed significant differences (p&amp;lt;0.001) in hip flexion between Vicon 3D and 2D PhysioROM for 32% of timepoints for both standing hip flexion and sit-to-stand movements, clustered around full hip extension. During standing hip abduction, significant differences (p&amp;lt;0.001) were found at 58% of timepoints clustered around neutral postures. Overall mean absolute deviation was 10.1°, 9.7° and 9.0° for hip flexion/extension, sit-to-stand, and hip abduction respectively. CONCLUSION Validity of PhysioROM to accurately measure peak hip flexion and peak hip abduction was high. PhysioROM may provide an effective method of accurately and objectively quantifying hip movement during a telerehabilitation session using 2D video.

Impact of model geometry and joint center locations on inverse kinematic/dynamic predictions: A comparative study of sexually dimorphic models

This work illustrates the sensitivity of demographically characteristic body segment inertial properties and subject-specific customization on model performance. One characteristic demographic, gender, and one subject-specific characteristic, hip joint center location, were represented with musculoskeletal modeling to evaluate how design decisions may alter model outputs. Generic sexually dimorphic musculoskeletal models were developed from the commonly used Rajagopal model using male and female data adapted by Dumas et al. Hip joint centers of these models were adjusted based on functional joint center testing. The kinematics and dynamics of 40 gait cycles from four subjects are predicted using these models. Two-way analysis of variance (ANOVA) was performed on the continuous time series data using statistical parametric mapping (SPM) to assess changes in kinematics/dynamics due to either choice in model (Rajagopal vs Dumas) or whether joint center adjustment was performed. The SPM based two-way ANOVA of the inverse dynamics found that differences in the Rajagopal and Dumas models resulted in significant differences in sagittal plane moments during swing (0.115 ± 0.032 Nm/kg difference in mean hip flexion moment during initial swing and a 0.077 ± 0.041 Nm/kg difference in mean hip extension moment during terminal swing), and differences between the models with and without hip joint center adjustment resulted in significant differences in hip flexion and abduction moments during stance (0.217 ± 0.055 Nm/kg increased mean hip abductive moment). By comparing the outputs of these differently constructed models with each other, the study finds that dynamic predictions of stance are sensitive to positioning of joint centers, and dynamic predictions of swing are more sensitive to segment mass/inertial properties.

Resistance training in women with myotonic dystrophy type 1: a multisystemic therapeutic avenue

Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been reported in men with DM1, but its impact on women remains unknown. We evaluated the effects of a 12-week supervised strength training on physical and neuropsychiatric health. Women with DM1 performed a twice-weekly supervised resistance training program (3 series of 6–8 repetitions of squat, leg press, plantar flexion, knee extension, and hip abduction). Lower limb muscle strength, physical function, apathy, anxiety and depression, fatigue and excessive somnolence, pain, and patient-reported outcomes were assessed before and after the intervention, as well as three and six months after completion of the training program. Muscle biopsies of the vastus lateralis were also taken before and after the training program to assess muscle fiber growth. Eleven participants completed the program (attendance: 98.5 %). Maximal hip and knee extension strength (p < 0.006), all One-Repetition Maximum strength measures (p < 0.001), apathy (p = 0.0005), depression (p = 0.02), pain interference (p = 0.01) and perception of the lower limb function (p = 0.003) were significantly improved by training. Some of these gains were maintained up to six months after the training program. Strength training is a good therapeutic strategy for women with DM1.

A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty.

The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation. A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period. All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals. Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.

The Relationship Between Functional Movement Screening and Joint Range of Motion, Y-Balance Test and Countermovement Jump in Amateur Soccer Players

This study aimed to investigate the relationship between a functional movement screening (FMS) test and joint range of motion (ROM), balance (YBT), and countermovement jump (CMJ) performance in amateur soccer players. A study was conducted with 25 male amateur soccer players to assess their physical abilities using various tests. The tests included FMS, YBT, CMJ, ROM for shoulder extension, hip abduction, hip external rotation, and ankle dorsi/plantar flexion. Pearson’s correlation test was used to examine the association between the variables. A significant positive correlation between the FMS and CMJ (r=0.424, p

Hip Abductor Muscle Strength Recovery: A Comparison Between Joint Replacement Surgery and Internal Fixation Surgery.

Introduction Proximal femoral fractures are common fractures of the hip that are considered a major healthcare concern globally; these include subtrochanteric, intertrochanteric, and theneck of the femur fractures. Internal fixation surgery and joint replacement surgery are the two most common intervention techniques used to treat these fractures. Consequently, weakness in the hip abductor muscle post-surgery may lead to implant loosening, necessitating revision of the surgery. In light of this, this study aimed to compare hip abductor strength recovery outcomes between joint replacement surgery and internal fixation surgery. Methodology A comparative study was performed over six months at the Department of Orthopaedics and Physiotherapy. Based on the inclusion and exclusion criteria and anticipating potential dropouts, a total of 56 patients were included in thestudy, and their hip abductor strength was measured using a sphygmomanometer. The patients were classified into two groups: Group A or Group B as per the type of hip surgery. Group A included 29 patientswho underwent joint replacement surgeries involving either cemented or uncemented total hip arthroplasty (THA) or hip hemiarthroplasty (HHA). Group B comprised 27 patientswho were operated on using either proximal femoral nail (PFN) or dynamic hip screw (DHS). Results The cohort consisted of 36 males and 20 females, with a mean age of51.71 years. The overall mean value of hip abductor muscle strength at postoperative day (POD) three in the internal fixation group was 65.06 ±5.98, which progressed to 107.51 ±24.76 after six months; in the joint replacement surgery group, it was 70.03 ±12.46 at POD three, which progressed to 113.11 ±21.27 after six months. The age-wise distribution demonstrated that the patients in the age group of 18-50 years demonstrated progressive results: from 65.33 ±4.9 at POD three to 105.95 ±22.71 after six months in the internal fixation group;from 66.82 ±7.72 at POD three to 109.59 ±22.54 after six months in the joint replacement group. Moreover, patients aged above 50 yearsshowed progression from 64.80 ±6.98 at POD three to 103.33 ±27.30 after six months in the internal fixation group, and from 69.58 ±14.75 at POD three to 108.22 ±20.62 after six months in the joint replacement group. Conclusions Our findings revealed thatjoint replacement surgery resulted in greater improvements in the hip abductor muscle strength compared to internal fixation surgery in the immediate postoperative period and during follow-ups. Additionally, younger patients exhibited better strength-related outcomes in comparison to the elderly population regardless of the type of surgery.

No sign of weakness: a systematic review and meta-analysis of hip and calf muscle strength after anterior cruciate ligament injury

ObjectiveWe aimed to determine hip and lower-leg muscle strength in people after ACL injury compared with an uninjured control group (between people) and the uninjured contralateral limb (between limbs).DesignSystematic review...

Observe, Practice, and Improve? Enhancing Sidestep Cutting Execution in Talented Female Soccer Players: A Four-Week Intervention Program With Video Instruction.

Nijmeijer, EM, Kempe, M, Elferink-Gemser, MT, and Benjaminse A. Observe, practice and improve? Enhancing sidestep cutting (SSC) execution in talented female soccer players: A four-week intervention program with video instruction. J Strength Cond Res 38(8): e430-e439, 2024-Implicit learning has the potential to improve movement execution and reduce injury risk. Previous research showed beneficial effects of short-term interventions with implicit learning in male athletes. However, research on long-term interventions in female athletes is lacking. The aim of this study was to examine the effects of a 4-week intervention with video instruction on movement execution of SSC, a task that is highly related with anterior cruciate ligament (ACL) injury risk, in female athletes. Twenty talented adolescent female soccer players were part of the control (CTRL, n = 10) or video instruction (VIDEO, n = 10) group. All subjects practiced 4 weeks and received general task instructions. In addition, the VIDEO group received expert video instruction during practice. Lower extremity kinematics and kinetics and vertical ground reaction force of SSC were examined during baseline, immediate post, and 1-week retention tests. After nonlinear registration, differences between each subject and the expert she had seen were determined. These differences were analyzed with SPM1D 2-way ANOVA. No interaction effects between time and group were found ( p > 0.05). Main effects of time were found in the frontal plane. In particular, smaller deviations of subjects compared with the seen expert of the knee adduction ( p = 0.005, 97.9-100% stance phase [SP]) and hip abduction ( p = 0.005, 11.5-13.8% SP) and adduction ( p < 0.001, 33.4-87.7% SP) moments were found in immediate post compared with baseline. These frontal plane short-term improvements, replicating earlier findings in both sexes, may lower ACL injury risk. The large observed interindividual differences over time may have concealed the long-term effects of video instruction at the group level.

Gait Compensation among Children with Non-Operative Legg-Calvé-Perthes Disease: A Systematic Review.

A systematic electronic search was performed using MEDLINE, CINAHL, Embase, BIOSIS, and the Cochrane Library to identify studies published from inception up until December 2023. An adapted Downs and Black checklist was utilised to assess methodological quality and project risk of bias. Percentage agreement and nominal kappa statistics with bootstrapped bias-corrected 95% confidence intervals (CIs) were used. A comprehensive literature search revealed 277 citations for review, of which 210 studies entered full-text screening. In total, eight studies met the inclusion criteria for quality assessment by two independent reviewers. The results revealed variations in data quality, with scores ranging from 12 to 17 due to missing information related to subject characteristics, biomechanical model, and power calculation. This review reveals common compensation strategies associated with walking among non-operative children with Perthes disease such as Trendelenburg gait due to weakness of the hip abductor muscle.

Dependence on visual information in patients with ACL injury for multi-joint coordination during single-leg squats: a case control study.

The influence of vision on multi-joint control during dynamic tasks in anterior cruciate ligament (ACL) deficient patients is unknown. Thus, the purpose of this study was to establish a new method for quantifying neuromuscular control by focusing on the variability of multi-joint movement under conditions with different visual information and to determine the cutoff for potential biomarkers of injury risk in ACL deficient individuals. Twenty-three ACL deficient patients and 23 healthy subjects participated in this study. They performed single-leg squats under two different conditions: open eyes (OE) and closed eyes (CE). Multi-joint coordination was calculated with the coupling angle of hip flexion, hip abduction and knee flexion. Non-linear analyses were performed on the coupling angle. Dependence on vision was compared between groups by calculating the CE/OE index for each variable. Cutoff values were calculated using ROC curves with ACL injury as the dependent variable and significant variables as independent variables. The sample entropy of the coupling angle was increased in all groups under the CE condition (P < 0.001). The CE/OE index of coupling angle variability during the descending phase was higher in ACL deficient limbs than in the limbs of healthy participants (P = 0.036). The CE/OE index of sample entropy was higher in the uninjured limbs of ACL deficient patients than in the limbs of healthy participants (P = 0.027). The cutoff value of the CE/OE index of sample entropy was calculated to be 1.477 (Sensitivity 0.957, specificity 0.478). ACL deficient patients depended on vision to control multiple joint movements not only on the ACL deficient side but also on the uninjured side during single leg squat task. These findings underscore the importance of considering visual dependence in the assessment and rehabilitation of neuromuscular control in ACL deficient individuals.