Abduction Strength Research Articles

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations.

To investigate the efficacy of hip strengthening on pain, disability, and hip abductor strength in musculoskeletal conditions of the trunk and lower limbs, we searched eight databases for randomized controlled trials up to 8 March 2022 with no date or language restrictions. Random-effect models estimated mean differences (MDs) with 95% confidence intervals (CIs), and the quality of evidence was assessed using the GRADE approach. Very low quality evidence suggested short-term effects (≤3 months) of hip strengthening on pain intensity (MD of 4.1, 95% CI: 2.1 to 6.2; two trials, n = 48 participants) and on hip strength (MD = 3.9 N, 95% CI: 2.8 to 5.1; two trials, n = 48 participants) in patellofemoral pain when compared with no intervention. Uncertain evidence suggested that hip strengthening enhances the short-term effect of the other active interventions on pain intensity and disability in low back pain (MD = -0.6 points, 95% CI: 0.1 to 1.2; five trials, n = 349 participants; MD = 6.2 points, 95% CI: 2.6 to 9.8; six trials, n = 389 participants, respectively). Scarce evidence does not provide reliable evidence of the efficacy of hip strengthening in musculoskeletal conditions of the trunk and lower limbs.

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.

Comparing the effects of hopping and strength-balance exercises on the selected muscles strength and balance in male athletes with chronic ankle instability

Background and Aims: The present study aims to compare the effects of two types of hopping and strength-balance exercises on the balance and strength of selected muscles in athletes with chronic ankle instability. Methods: Participants were 30 male athletes with chronic ankle instability, who were selected using a purposive sampling method and randomly divided into two groups of hopping and strength-balance exercise. A questionnaire was used to record demographic characteristics and the information about the history of sports. To measure strength, a dynamometer was used. The Standing stork test and Y balance test were used to measure static and dynamic balances, respectively. Analysis of covariance and the Least Significant Difference post hoc test were used to compare the means. Results: There was a significant difference in the static balance (P&lt;0.001) and the total dynamic balance between the two groups (P&lt;0.001). The strength-balance exercise group in all directions of the Y balance test performed better than the hopping exercise group. Moreover, hip abduction strength (P=0.02) and the inversion (P=0.005) and eversion strengths (P=0.002) of ankle were significantly different between the two groups after training, where the strength-balance group had higher scores. There was no significant difference between the two groups in other factors. Conclusion: Both hopping and strength-balance exercises can be effective in improving the balance and strength of male athletes with chronic ankle instability, where the strength -balance exercise program seems to be more useful due to its comprehensiveness and given that it emphasizes the improvement of balance, proprioception, trunk strength, and lower limb strength, and can have a greater effect on the fast recovery of athletes.

Intrinsic and extrinsic factors contributing to running-related lower limb injuries among adolescent runners

ABSTRACT The purpose of this study was to assess which combination of intrinsic and extrinsic factors contribute to running-related injury (RRI)among adolescent cross-country, track, and long-distance runners. We conducted a retrospective study at a hospital-affiliated sports injury prevention centre of 130 adolescent runners (F: 62.1%, M: 37.9%; cross-country: 34.1%, track: 56.1%, long-distance running: 9.8%) who underwent an Injury Prevention Evaluation between 2013 and 2021. The evaluation included a questionnaire on personal and training factors, and standardised physical assessments. We used a binomial logistic regression to assess the influence of demographics, lower extremity strength and alignment, training (running volume and intensity, weight training), and dietary factors on RRIs. There were 38 adolescent runners who reported RRIs (ankle sprains: N = 16, shin splints: N = 9, stress fractures: N = 13). Female sex (odds ratio [OR]: 4.58 [1.37, 15.37]; p = 0.01), reduced weekday hours of sleep (OR: 1.75 [1.04, 2.95]; p = 0.04), reduced hip abduction strength (OR: 1.02 [1.00, 1.04]; p = 0.05), and intention to lose weight to improve athletic performance (OR: 4.58 [1.00, 21.28]; p = 0.05) were associated with RRIs. These intrinsic and extrinsic risk factors may represent targets for injury prevention for adolescent runners.

Association of Core Muscle Endurance with Weekly Workout Time, Speed, and the Symmetry of Frontal Core Motion during Indoor Walking and Cycling

This study investigated the factors that influence core muscle endurance, i.e., the symmetry of frontal core motion during indoor walking and cycling, the symmetry of lateral core muscle endurance, the symmetry of the hip abductor strength, the weekly workout time and fast walking and cycling speeds, while controlling for gender. Seventy-nine healthy young adults participated in this study. In a regression analysis, the core muscle endurance time was the dependent variable. The independent variables were the symmetry of frontal core motion (measured using a wireless earbud sensor during walking and cycling), the symmetry of side plank time and of hip abductor strength, the weekly workout time and fast walking and cycling speeds. In the multiple regression analysis, weekly workout time, fast walking speed, symmetry of frontal core motion during fast cycling and symmetry of lateral side plank time predicted core muscle endurance (adjusted R2 = 0.42). Thus, clinicians and fitness personnel should consider the association of core muscle endurance with the symmetry of frontal core motion during cycling and the symmetry of side plank holding time, as well as with the weekly workout time and a fast walking speed, when designing core muscle exercise programmes.

Impact of age on shoulder range of motion and strength.

Total shoulder arthroplasty (TSA) is a surgical technique commonly used to treat patients with arthritis and rotator cuff deficiency. Its purpose is to reduce pain and improve shoulder function, namely range of motion (ROM) and strength. While shoulder ROM and strength have been studied extensively in patients with various shoulder pathologies, there is a dearth of knowledge with regard to the asymptomatic population. A cross-sectional study was conducted in the outpatient orthopaedic clinic following institutional review board approval. Patients 18 years of age and older with at least one asymptomatic and healthy shoulder with no prior history of shoulder surgery, injury, or pain were enrolled in the study. Demographic information, ROM, and strength measurements were collected for 256 shoulders, evenly stratified into groups by age and sex. A goniometer was used to measure forward elevation, abduction, and external rotation, and a handheld dynamometer was utilized for measuring strength. Statistical evaluation was conducted using Pearson correlations, analysis of variance, and Bonferroni and Mann-Whitney post hoc tests, with P<.01 indicating a significant difference. Abduction strength (P<.001), external rotation strength (P<.001), and internal rotation strength (P<.001) were negatively correlated with age when viewing the data as a whole and after stratification of males and females. Age and shoulder ROM, namely abduction (P<.001) and forward elevation (P<.001), were also significantly negatively correlated, although internal rotation decreased with age as well. When comparing across age groups, abduction (P=.001) and forward elevation (P=.001) were significantly higher in group 1 (18-35) when compared to group 4 (66+), but external rotation was not significantly different between these groups. External rotation (P=.001) was only significantly different between groups 2 (36-50) and 4. Variation in external rotation strength was also found. Group 4 was found to have significantly less strength than all 3 of the other groups. Shoulder strength significantly decreased with age, with abduction strength and external rotation strength displaying the strongest negative correlations. Decreases in strength were most prominent in patients 66 years of age and above. Shoulder ROM was not as tightly correlated with age, although abduction, forward elevation, and internal rotation were found to generally decrease over time. Differences in external rotation were not clinically significant. These correlations provide useful controls for patients of various ages regarding their clinical outcomes when presenting with shoulder pathology. Variations in current literature allow this study to verify the impact of age on shoulder ROM and strength.

Impacto clínico en el hombro luego del uso de clavos endomedulares para tratamiento de fracturas diafisarias de húmero

BackgroundIntramedullary fixation is a frequently used option for the management of proximal and diaphyseal humeral fractures. The biomechanical advantages of this fixation method are known, in addition to the preservation of soft tissues and periosteal irrigation. However, in clinical practice, the postoperative follow-up reveals that some patients develop symptoms associated with shoulder pathology, such as subacromial pain, decreased flexion and abduction strength. MethodsA retrospective descriptive observational study was conducted, evaluating 25 adult patients with humeral shaft fractures treated with antegrade intramedullary nailing. Follow-up was performed 12 months after the procedure, assessing functional range of motion and DASH score, pain by visual analog scale (VAS) and subacromial impingement tests (Yocum, Neer, and Hawkins–Kennedy). ResultsAll patients achieved adequate antegrade flexion with a mean arc of 145° (±31), a DASH score with a mean of 6.1 (±8.5), and a VAS score of 2 (±2.6). 64% of the patients did not present any clinical sign of subacromial impingement. ConclusionWe conclude that in this group of patients, osteosynthesis with humeral intramedullary nails did not have a significant clinical impact on the shoulder in terms of range of motion and symptoms of impingement.

Comparison of hip strength in football players with hip and/or groin-related pain and healthy controls

Introduction: Muscle weakness and atrophy have been associated with longstanding joint pathology, and strength testing is often recommended during the physical examination of patients with hip/groin pain. The aim of this study was to compare peak strength in football players (soccer and Australian football) presenting with hip and/or groin-related pain with healthy controls. Methods: Male and female football players were recruited across Melbourne and Brisbane, Australia. Demographic information and two questionnaires; the Copenhagen Hip and Groin Outcome Score (HAGOS) and the International Hip Outcome Tool 33 (iHOT) were collected. Hand-held dynamometry was utilised to test isometric hip muscle strength across flexion, extension, abduction, adduction, internal and external rotation planes. Peak strength (N) and torque (Nm) were normalised to body mass and linear mixed effects models were used to investigate the relationship between strength and symptomatic hips. Results: 191 football players with hip and/or groin-related pain (mean [+/- SD] age, 27.8 ± 6.3 years) and 69 controls (mean [+/- SD] age, 27.3 ± 5.6 years) were include in this study. Of this, 293 symptomatic hips and 138 control hips were used for analyses. Results demonstrated peak adduction (-0.18 Nm/kg: 95% CI -0.27 to -0.08, P 0.001), external rotation (-0.06 Nm/kg: 95% CI -0.09 to -0.02, P 0.003) and internal rotation strength (-0.06 Nm/kg: 95% CI -0.10 to -0.03, P 0.001) were lower in symptomatic hips than control hips. Abduction strength was lower in symptomatic Australian football players hips than controls (-0.20 Nm/kg: 95% CI -0.33 to -0.06, P 0.004) but this was not observed in symptomatic soccer players hips (-0.05 Nm/kg: 95% CI -0.15 to 0.06, P 0.382). No difference was found between peak flexion strength (0.07 Nm/kg: 95% CI -0.15 to 0.01, P 0.103) or peak extension strength (-0.07 Nm/kg: 95% CI -0.18 to 0.05, P 0.249) in symptomatic hips and control hips. Discussion: The findings from this research suggest that hip adduction, internal and external rotation are lower in footballers with hip and/or groin related pain than controls irrespective of the sport played. Hip abduction strength was lower in symptomatic Australian Rules football players but not observed in soccer. Impact:•Findings from this research suggest common impairments are found in hip adduction, internal and external rotation in football players with hip and/or groin related pain than controls regardless of sport played.•Hip abduction strength was lower in symptomatic Australian Rules football players but not observed in soccer. My co-authors and I acknowledge this research was supported by an Australian National Health and Medical Research Council (NHMRC) project grant 1088683.

Sports Participation After Reverse Total Shoulder Replacement.

Reverse total shoulder replacement (RTSR) is becoming a popular and reliable treatment for rotator cuff arthropathy. However, little is known about the ability to participate in sports after surgery. To determine to what extent RTSR will allow patients to participate in sporting activities and identify the associated factors that could affect postoperative sports participation. Case series; Level of evidence, 4. Data were collected prospectively from patients who underwent RTSR over a 10-year period from April 2009 to May 2019. Patients were assessed before surgery, at 6 months after surgery, and at the final follow-up. Patients were asked within a validated shoulder questionnaire to rank their current highest level of sports participation, overall shoulder status, frequency of pain, level of pain, and functional levels. Their shoulder range of motion and strength were assessed before surgery and at 6 months after surgery. The study included 108 shoulders (106 patients). The mean age was 74 years (range, 51-88 years), with 44 men and 64 women. The mean follow-up was 4 years. Overall shoulder satisfaction, frequency and levels of pain, and shoulder function improved significantly at 6 months and 4 years (P < .0001). External rotation, abduction, and forward flexion range of motion improved significantly at 6 months (P < .05 for all). The strength of internal rotation, external rotation, abduction, and adduction improved significantly at 6 months (P < .001 for all). The rate of return to sports was 67% at 6 months and 48% at 4 years. Multiple significantly associated factors were identified with return to sports at 6 months, including sex and age. The rate of return to sports after RTSR is high. Around two-thirds of patients can return to sports at 6 months postoperatively, although the results slightly deteriorate over time (48% at 4 years).

Hip strength, quadriceps strength and dynamic balance are lower in people with unilateral knee osteoarthritis compared to their non-affected limb and asymptomatic controls

BackgroundThere is insufficient literature on multi-directional hip strength differences and dynamic balance between people with knee osteoarthritis (KOA) and healthy controls. ObjectiveIn people with unilateral KOA, determine if hip/knee strength and dynamic balance differs (i) between sides, and (ii) compared to controls. MethodsThirty-six participants (17 women; 65.5 ± 8.9 years) with unilateral KOA and 36 age- and sex-matched controls were included in a cross-sectional study. Outcomes included hip strength, quadriceps strength, and dynamic balance (three directions) during the Star Excursion Balance Test. Mixed ANOVA analysis was completed to investigate differences between Limbs and Groups. Mean differences (MD) and 95% confidence intervals (CI) were calculated. ResultsQuadriceps and hip adduction strength were 16% (95%CI:10, 22) and 9% [95%CI: 3, 16) lower on the affected compared to non-affected side. Quadriceps and hip abduction, adduction, flexion, and extension strength (MD varying from 16%, 95%CI: 8, 25; to 34%, 95%CI: 17, 50) were weaker bilaterally in individuals with KOA compared to control. Posteromedial balance was 4% (95%CI: 2, 6) lower for affected compared to non-affected limbs in those with KOA and 13% (95%CI: 6, 21) lower in the affected limb compared to controls. Individuals with KOA had lower balance bilaterally in the anterior 11% (95%CI: 7, 15) and posterolateral 21% (95%CI: 13, 30) directions. ConclusionHip/knee strength (especially in the sagittal and frontal planes) and dynamic balance are lower bilaterally in people with KOA compared to controls. Hip adduction strength is lower on the affected than non-affected limbs of people with KOA. Clinicians should consider that knee extension strength, hip strength, and dynamic balance are lower bilaterally in people with unilateral KOA.

Dynamic hip screw with stabilization plate in unstable intertrochanteric fractures: a case series

Background: Unstable intertrochanteric fractures represent about 60% of all trochanteric fractures. Dynamic hip screw alone in an unstable fracture pattern has a high failure rate of about 50%. Proximal femoral nail is technically a difficult surgery and has complications including nail failure, femoral shaft fracture, malreduction, screw cut-out, and nonunion. Putting a buttress like a trochanteric-stabilization plate acts as a support to the dynamic hip screw and gives good lateral wall buttress, which prevents excessive shaft medialization. Methods: Twenty-one patients with closed unstable trochanteric fractures were treated by dynamic hip screw with trochanteric stabilization plate. Results: According to the modified Harris Hip Scoring system, 11 patients had excellent results, five patients had good results, four patients had fair results, and one patient had a poor result. Conclusions: The dynamic hip screw with trochanteric stabilization plate provides a stable construct for unstable intertrochanteric fractures as it gives a good lateral wall buttress which prevents excessive fracture collapse, femoral shaft medialization, and consecutive limb shortening. It effectively supports the unstable greater trochanteric fragment and can maintain the lever arm with adequate abductor strength. Level of Evidence: Level IV.

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).

Double Fascicular Nerve Transfer to Restore Elbow Flexion Following Neuralgic Amyotrophy: A Case Report

Double fascicular nerve transfer (DFNT) involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion. We performed this procedure on a patient who was diagnosed with neuralgic amyotrophy (NA) 2 years previously. We aimed to investigate the short-term outcomes and feasibility of DFNT applied to non-traumatic neuropathy. A 63-year-old, right-handed man presented to us with persistent right elbow flexion weakness 24 months after receiving the diagnosis of NA. On examination, biceps strength was 0/5, and shoulder abduction strength was 3/5. Magnetic resonance neurography demonstrated muscle atrophy in the upper trunk. DFNT was considered to restore elbow flexion. The donor and recipient fascicles were then coapted (flexor digitorum superficialis to biceps brachii, flexor carpi ulnaris to brachialis). Postoperatively, paresthesia was reported in the area of ulnar innervation, and the patient complained of hand clumsiness. From postoperative day 10 onward, biceps muscle contracture was identified and on the 14th day, grade 3 elbow flexion strength was observed. We suggest that DFNT may be a safe and effective method to restore elbow flexion in patients with NA.

Quantifying Donor Deficits Following Nerve Transfer Surgery in Tetraplegia

Nerve transfer (NT) surgery can improve function in people with cervical spinal cord injury (SCI). However, the impact of donor nerve deficits remains unclear. The purpose of this study was to quantify donor deficits experienced by individuals with cervical SCI following NT. This prospective single-arm, comparative study included people with SCI undergoing upper extremity NTs. Myometry was used to assess muscle strength at baseline and follow-up. The Spinal Cord Independence Measure was used to measure the ability to perform activities of daily living. Ten individuals underwent 20 NTs to restore elbow extension (donor, posterior deltoid; n= 2), hand opening (donor, supinator; n= 7), and hand closing (donor, brachialis; n= 11). Shoulder abduction strength decreased (-5.6% at early and-4.5% late follow-up) in the elbow extension NT. Wrist extension strength decreased at early (-46.9% ± 30.3) and increased by late (76.4% ± 154.0) follow-up in the hand opening NT. No statistically significant change in elbow flexion strength was noted in the hand closing NT. Spinal Cord Independence Measure scores did not change significantly between baseline and early postoperative follow-up; they improved at late follow-up. Use of expendable donor nerves with redundant function to perform NT surgery has relatively little impact on strength or capacity to perform activities of daily living, even in the unique and highly vulnerable SCI population. Early, temporary loss in wrist extension strength can be seen after the supinator to posterior interosseous nerve transfer. This study offers quantitative data about possible diminution of donor function after NT, enabling hand surgeons to better counsel individuals contemplating upper extremity reconstruction. Prognostic I.

Biomechanical Asymmetry of Strength and Dynamic Balance Kinetics in Middle-Ages with Adhesive Capsulitis of the Hip.

The representative clinical features of adhesive capsulitis of the hip (ACH) are restricted range of motion (ROM) and pain. However, reports on kinetics such as strength and dynamic balance that explain physical functions are rare. This study compared subjective hip scores using Copenhagen Hip and Groin Outcome Score (HAGOS) and ROM using a manual goniometer as well as strength using isokinetic equipment, and dynamic balance through the Y-balance test, between patients with ACH and healthy individuals. Data of 193 middle-aged participants (men: 99 and women: 94) were analyzed. The ACH group scored significantly lower in all six HAGOS sub-sections. Hip joint flexion, abduction, internal and external rotation ROM were significantly lower in ACH compared to healthy group. These results were the same for men and women. In the strength of men and women, flexion, adduction, and abduction, and dynamic balance in all three directions were significantly decreased in ACH. Meanwhile, there were no significant between-group differences in the functional decrease in extension and adduction of ROM, and extension strength. In conclusion, subjective evaluation and dynamic balance of patients with ACH were decreased in the all parts. In ROM, flexion, abduction, internal rotation, and external rotation were restricted except for extension and adduction. Men and women with ACH maintained extensor strength, but had weakened strength in flexion, adduction and abduction. This information will be useful for therapists to understand the biomechanical properties of ACH and to design effective rehabilitation programs.

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.

Hip adduction and abduction strength in youth male soccer and basketball players with and without groin pain in the past year.

The objectives of this study were to 1) assess the differences between youth soccer and basketball players with and without past year groin pain (GP) in hip adduction and abduction strength and several training characteristics (age at the start of regular training, weekly training frequency, warm-up and training duration, use of stretching and/or stabilisation exercises during warm-up, use of resistance training); 2) present strength reference values for youth soccer and basketball players. 227 players participated (age 16.9 ± 1.4 years; height 184.2 ± 8.5 cm; mass 75.5 ± 11.9 kg). Hip adduction and abduction strength was measured in supine position (hip, knee and ankle in neutral position) using a MuscleBoard dynamometer. Interlimb asymmetries and hip adduction:abduction ratios were calculated. Past year GP and training characteristics were assessed with a retrospective questionnaire. 11.9% of players reported past year GP (16.9% in soccer and 6.4% in basketball). The only significant difference between the past year GP and the control groups was found in the age of the players at the start of regular training (7.2 ± 1.8 years for the GP group vs. 8.5 ± 2.6 years for the control group). Additionally, soccer players without past year GP have significantly higher hip adduction strength (1.1 ± 0.2 Nm/kg vs. 1.0 ± 0.2 Nm/kg) and adduction:abduction strength ratio (1.10 ± 0.18 vs. 1.03 ± 0.16) compared to basketball players. Our results show that hip adduction and abduction strength, interlimb asymmetry and hip adduction:abduction ratio do not differentiate between players with and without past year GP (p = 0.29–0.90), which means that their adduction or abduction strength can be analysed regardless of the GP presence in the past year. Additionally, players with past year GP started regularly training at significantly lower age, which could indicate the problematic nature of early/premature sports specialisation.

The effect of hip abductor fatigue on knee kinematics and kinetics during normal gait.

ObjectiveTo investigate the effect of hip abductor fatigue on the kinematics and kinetics of the knee joint during walking in healthy people to provide a new approach for the prevention and treatment of knee-related injuries and diseases.MethodsTwenty healthy participants, ten females, and ten males, with a mean age of 25.10 ± 1.2 years, were recruited. Isometric muscle strength testing equipment was used to measure the changes in muscle strength before and after fatigue, and the surface electromyography (SEMG) data during fatigue were recorded synchronously. The Vicon system and an AMTI© force platform were used to record the kinematic parameters and ground reaction force (GRF) of twenty participants walking at a self-selected speed before and after fatigue. Visual 3D software was used to calculate the angles and torques of the hip and knee joints.ResultsAfter fatigue, the muscle strength, median frequency (MF) and mean frequency (MNF) of participants decreased significantly (P < 0.001). The sagittal plane range of motion (ROM) of the knee (P < 0.0001) and hip joint (P < 0.01) on the fatigue side was significantly smaller than before fatigue. After fatigue, the first and second peaks of the external knee adduction moment (EKAM) in participants were greater than before fatigue (P < 0.0001), and the peak values of the knee abduction moment were also higher than those before fatigue (P < 0.05). On the horizontal plane, there is also a larger peak of internal moment during walking after fatigue (P < 0.01).ConclusionHip abductor fatigue affects knee kinematics and kinetics during normal gait. Therefore, evaluating hip abductor strength and providing intensive training for patients with muscle weakness may be an important part of preventing knee-related injuries.

The Effect of Blood Flow Restriction Therapy on Shoulder Function Following Shoulder Stabilization Surgery: A Case Series.

Traumatic shoulder instability is a common injury in athletes and military personnel. Surgical stabilization reduces recurrence, but athletes often return to sport before recovering upper extremity rotational strength and sport-specific abilities. Blood flow restriction (BFR) may stimulate muscle growth without the need for heavy resistance training post-surgically. To observe changes in shoulder strength, self-reported function, upper extremity performance, and range of motion (ROM) in military cadets recovering from shoulder stabilization surgery who completed a standard rehabilitation program with six weeks of BFR training. Prospective case series. Military cadets who underwent shoulder stabilization surgery completed six weeks of upper extremity BFR training, beginning post-op week six. Primary outcomes were shoulder isometric strength and patient-reported function assessed at 6-weeks, 12-weeks, and 6-months postoperatively. Secondary outcomes included shoulder ROM assessed at each timepoint and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), the Upper Extremity Y-Balance Test (UQYBT), and the Unilateral Seated Shotput Test (USPT) assessed at the six-month follow-up. Twenty cadets performed an average 10.9 BFR training sessions over six weeks. Statistically significant and clinically meaningful increases in surgical extremity external rotation strength (p < 0.001; mean difference, .049; 95% CI: .021, .077), abduction strength (p < 0.001; mean difference, .079; 95% CI: .050, .108), and internal rotation strength (p < 0.001; mean difference, .060; CI: .028, .093) occurred from six to 12 weeks postoperatively. Statistically significant and clinically meaningful improvements were reported on the Single Assessment Numeric Evaluation (p < 0.001; mean difference, 17.7; CI: 9.4, 25.9) and Shoulder Pain and Disability Index (p < 0.001; mean difference, -31.1; CI: -44.2, -18.0) from six to 12 weeks postoperatively. Additionally, over 70 percent of participants met reference values on two to three performance tests at 6-months. While the degree of improvement attributable to the addition of BFR is unknown, the clinically meaningful improvements in shoulder strength, self-reported function, and upper extremity performance warrant further exploration of BFR during upper extremity rehabilitation. 4, Case Series.

Comparative study of 145° onlay curved stem versus 155° inlay straight stem reverse shoulder arthroplasty: clinical and radiographic results with a minimum 2-year follow-up.

Lateralized onlay reverse shoulder arthroplasty (RSA) is designed to ensure better clinical functional recovery and lower rate of complications compared with Grammont medialized inlay RSA. The purpose of the present study was to compare the clinical and radiographic outcomes between these 2 different designs. Eighty-five consecutive patients who underwent RSA were retrospectively analyzed. Nine patients were lost to follow-up, 34 received a curved onlay with a 145° neck-shaft angle (Ascend Flex group), and 42 received a long straight inlay stem with a 155° neck-shaft angle (Delta Xtend group). Patients were reviewed at an average follow-up of 46.8±13.2 months (Ascend Flex group) and 36±10.8 months (Delta Xtend group). Clinical outcome measures included active range of motion, strength, visual analog scale, Constant-Murley score, and the American Shoulder and Elbow Surgeons score. Radiographic evaluation at the final follow-up was performed to assess scapular notching, stress shielding, acromial or scapular fractures, heterotopic ossification, and radiolucent lines or implant loosening. No differences emerged between the 2 groups in terms of visual analog scale, American Shoulder and Elbow Surgeons and Constant-Murley scores, pain, function, strength, mobility, active forward elevation, active internal rotation, active external rotation at 0° and 90° of abduction, abduction, forward elevation, and external rotation strength (P=n.s.). Statistically superior active abduction was observed in the Delta Xtend group (P=.0017). Scapular notching was observed in 12 shoulders (35.2%) in the Ascend Flex group (a grade 1) and in 10 shoulders (23.8%) in the Delta Xtend group (P=n.s.). No differences emerged between the 2 groups in terms of humeral or glenoid radiolucency (P=n.s.). Higher rate of humeral stress shielding rate was observed in the Ascend flex cohort (P=n.s.). No statistically significant difference emerged between the 145° onlay curved stem vs. the 155° inlay straight stem according to most of the evaluated parameters. Statistically superior active abduction was observed in the 155° group although it did not affect patients' satisfaction.