Abduction Strength Research Articles

Influence of motor imagery training on hip abductor muscle strength and bilateral transfer effect.

Motor imagery training could be an important treatment of reduced muscle function in patients and injured athletes. In this study, we investigated the efficacy of imagery training on maximal force production in a larger muscle group (hip abductors) and potential bilateral transfer effects. Healthy participants (n = 77) took part in two experimental studies using two imagery protocols (∼30min/day, 5days/week for 2 weeks) compared either with no practice (study 1), or with isometric exercise training (study 2). Maximal hip abduction isometric torque, electromyography amplitudes (trained and untrained limbs), handgrip strength, right shoulder abduction (strength and electromyography), and imagery capability were measured before and after the intervention. Post intervention, motor imagery groups of both studies exhibited significant increase in hip abductors strength (∼8%, trained side) and improved imagery capability. Further results showed that imagery training induced bilateral transfer effects on muscle strength and electromyography amplitude of hip abductors. Motor imagery training was effective in creating functional improvements in limb muscles of trained and untrained sides.

Gluteus maximus tendon transfer as a salvage option for painful chronic hip abductor insufficiency: clinical and MRI results with a minimum follow-up of 24 months.

Chronic hip abductor insufficiency is a rare debilitating condition. In cases refractory to conservative treatment and not amenable to direct repair an augmentation becomes necessary. The preferred salvage method at our institution is augmentation with the anterior third of the gluteus maximus tendon. The aim of this study is to describe the results of 8 patients, treated for painful chronic hip abductor insufficiency with gluteus maximus muscle transfer, after a minimal follow-up of 24 months including a full clinical and MRI evaluation of the hip abductors pre- and postoperatively. We retrospectively reviewed a consecutive series of 8 patients who were surgically managed for painful chronic hip abductor insufficiency. All patients had a Trendelenburg sign, impaired muscle strength (M ⩽ 3) as well as a complete avulsion of the hip abductors with marked fatty degeneration (⩾3). Pain levels, muscle strength, functional scores as well as a postoperative MRI was obtained after a minimal follow-up of 24 months. The mean age of the patients was 69 years, mean follow-up was 35 (26-54) months. Pain was significantly reduced postoperatively to VAS 2.5 from VAS 5 (p = 0.046). Trendelenburg sign remained positive in all patients and hip abductor strength did not improve significantly from 2.4 to 3.1 (p = 0.19). Complete healing of the transferred tendon was confirmed by MRI in all patients at last follow-up. In the setting of painful chronic hip abductor insufficiency refractory to conservative treatment with advanced muscle degeneration without the possibility of a direct reconstruction the gluteus maximus tendon transfer significantly decreased pain. The effect on hip abductor strength and patient-reported functional outcome scores is limited. Despite the modest results it remains our preferred salvage treatment option for lack of better alternatives. Larger studies are necessary to confirm these findings.

The association between hip/groin pain and hip strength in football players: An exploratory analysis of the FORCe cohort.

Explore associations between peak hip strength in football players with hip/groin pain and healthy controls. Cross-sectional study. Male and female sub-elite football players (soccer and Australian football) with hip/groin pain >6-month duration and players without hip/groin pain were recruited across Melbourne and Brisbane, Australia. Demographic information and two questionnaires; the Copenhagen Hip and Groin Outcome Score and the International Hip Outcome Tool 33 were collected. Hand-held dynamometry was used to measure isometric hip strength for flexion, extension, abduction, adduction, internal rotation, and external rotation. Linear mixed effects models were used to compare strength measures between groups. 190 football players with hip/groin pain (mean ± standard deviation age, 27.8 ± 6.3 years) and 64 controls (age, 27.3 ± 5.6 years) were included in this study. Of these, 291 symptomatic limbs and 128 control limbs were used for analyses. Symptomatic players had lower peak hip adduction (adjusted mean difference = -0.18: 95 % confidence interval -0.27 to -0.08, P : 0.001), external rotation (-0.06: 95 % confidence interval -0.09 to -0.02, P : 0.003), and internal rotation strength (-0.06: 95 % confidence interval -0.10 to -0.03, P : 0.001) compared to controls. A sport-specific interaction was observed for hip abduction strength. When separated by football code, abduction strength was lower in symptomatic Australian football players compared to their same sport peers (-0.20: 95 % confidence interval -0.33 to -0.06, P : 0.004), but not in symptomatic soccer players (-0.05: 95 % confidence interval -0.15 to 0.06, P : 0.382). Hip adduction, internal rotation, and external rotation strength appears lower in football players with hip/groin pain independent of sex and football code. Hip abduction strength was lower in symptomatic Australian football players but not in soccer players.

The title of my abstract: Do women with patellofemoral pain syndrome have weaker hip abductor strength compared to asymptomatic individuals?

The title of my abstract: Do women with patellofemoral pain syndrome have weaker hip abductor strength compared to asymptomatic individuals?

Anterior Total Hip Arthroplasty With Gluteus Medius Repair: A Novel Technique

Introduction: Proper function of the gluteus medius muscle is crucial to performance and outcomes following total hip arthroplasty. Gluteus medius tears are reported in up to 20% of patients undergoing hip replacements. The combination of increasing notoriety for the direct anterior approach and the potential for improved patient outcomes necessitates a technique to address gluteus medius tears in conjunction with total hip arthroplasty. Therefore, we present the following novel technique for transtendinous gluteus medius repair in conjunction with a direct anterior approach for total hip arthroplasty. Technique: The patient is placed supine with the operative leg in slight external rotation. An incision is made to the fascia overlying the tensor fascia latae. Blunt dissection is performed to the tensor fascia latae-sartorius interval. The deep rectus fascia is split, identifying the anterior capsule. Arthroplasty is then performed in the usual manner. Once the arthroplasty is completed, the hip capsule is closed, and the gluteus medius is exposed through an anterolateral approach. Once found, the tear is classified. A split in line with the tendon fibers is made in the mid aspect of the tear. Once visualized, the greater trochanter is decorticated, and suture anchors are placed. Sutures are passed and tied sequentially from distal to proximal. Expected Outcomes: Gluteus medius repair patients experience excellent outcomes, with multiple studies showing decreased pain and restoration in the strength of the abductor complex. In the setting of total hip arthroplasty, most patients display adequate abductor strength and no Trendelenburg gait at 5 years postoperative.

Neuromuscular and Functional Responses Among Males Trained with Free Weights vs. Machines: Implications for Injury Prevention

The purpose of this study was to compare balance, functional performance and isometric hip strength muscle among males practitioners of resistance training (RT) with Free-weights and Machines. Thirty males were recruited and separated into two groups: Free-weights (n = 15) and Machines (n = 15). Free-weights group showed a routine of RE that engaged the whole body with resistance bands, free-weights, dumbbells, and medicine balls. Conversely, machine group trained only exercises on machines. All participants underwent three tests to assess balance, functionality, and isometric muscle strength. All tests were performed in a single assessment session in the following order: Y Balance test; functional performance testing; and maximal isometric hip strength, respectively. The two-way ANOVA yielded main effects for group in the anterior (F1,22= 12.11, p < .002), posteromedial (F1,22= 16.87, p < .0005), posterolateral (F1,22= 15.97, p < .0006) and composite (F1,22= 21.39, p < .0001) in performance during YBT between free-weight vs. machines group for both legs. Single leg step down (SLSD) and Single leg hop (SLH) test demonstrating better functional performance in the free-weight group for both legs (p<.001). Isometric muscle strength of hip abduction and extension showed lower in the machines when compared to free-weight group for both legs. This study showed greater balance, functional performance and isometric muscle strength of hip abduction and extension in males trained with Free-weight. Males trained with machine showed lower functional performance, balance and bilateral asymmetry of the hip extensor muscles strength and risk of injuries.

Contralateral Hip Abductor Muscle Strength Associated with Comfort of Getting into and out of the Car after Total Hip Arthroplasty.

There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) whether lower limb muscle strength affects action comfort. One hundred seventy-two post-THA patients completed the questionnaire in 2020, along with assessments of hip abductor and knee extensor muscle strength before surgery and at discharge. Patients whose overall comfort level was judged as comfortable were defined as the comfort group; others were placed in the discomfort group. Of the 172 patients, 161 reported car usage at a mean of 5.6 years after THA. Of these, 114 and 47 patients were placed in the comfort and discomfort groups, respectively. Patients in the discomfort group were three times more likely to experience discomfort using the contralateral side door than the surgical side door, and about twice as many patients experienced discomfort when entering as when exiting. Lower preoperative contralateral hip abductor muscle strength was the only independent predictor for discomfort. The take-home messages were that prevention of contralateral-side weakness may improve comfort during the action after THA.

Relationship between throwing distance, shoulder joint range of motion, and upper limb muscle strength in boccia athletes

The purpose of this study was to examine the relationship between throwing distance, shoulder joint range of motion and upper limb muscle strength in boccia athletes. Participants were eight boccia athletes (cerebral palsy, cervical spinal cord injury, muscular dystrophy, spinal muscle atrophy) in whom throwing distance, ranges of motion at the shoulder joint, elbow joint and wrist joint and upper limb muscle strength were measured. Throwing distance was measured to the point where the ball landed so to remove any effect of the floor. Upper limb muscle strength was measured by isometric contraction using a handheld dynamometer. No correlation was found between throwing distance and range of motion of the shoulder joint, but correlations were found between throwing distance and strength of shoulder flexors (r = 0.76, p < .05), shoulder abductors (r = 0.84, p < .01), and elbow flexors (r = 0.77, p < .05). Active training to improve muscle strength around the shoulder joint, regardless of the underlying disease, was considered likely to lead to improvements in competitiveness. Due to the severe dysfunction of boccia athletes, training methods are often restricted. Verification of more effective training methods is needed while managing risks according to the physical function of the athlete and the type of disability.

Clinical outcomes of medialized single-row repair with fascia lata graft augmentation for large and massive rotator cuff tears

A high postoperative retear rate after arthroscopic rotator cuff repair (ARCR) of large and massive tears remains a problem. This study evaluated rotator cuff integrity after ARCR with fascia lata graft augmentation for large and massive rotator cuff tears and compared clinical outcomes between patients with intact repairs and retears. Forty-five patients with rotator cuff tears who could not undergo primary repair due to tendon retraction underwent arthroscopic medialized single-row repair with fascia lata graft augmentation. The patients' minimum follow-up was 2 (2-9) years. Supraspinatus cuff integrity was evaluated postoperatively by magnetic resonance imaging. We compared the clinical outcomes of patients with intact repairs vs. retears based on the University of California-Los Angeles (UCLA), Constant, and Japanese Orthopaedic Association (JOA) scores. We also evaluated their range of motion (ROM) and muscle strength. Retears were observed in 11 of 45 patients. UCLA, Constant, and JOA scores significantly improved postoperatively compared to preoperatively in the intact repair (all P<.001) and retear (all P<.036) groups. The intact repair group had significantly higher Constant (75.6 [mean]±9.9 [SD] vs. 69.8±7.9; P=.026) and JOA (94.4±6.9 vs. 89.8±5.9; P=.041) scores than the retear group. Forward elevation, abduction, and the strengths of abduction and external rotation significantly improved in the intact repair group (all P<.003) but not in the retear group (all P>.05). The intact repair group had significantly higher postoperative forward flexion (165°±15° vs. 154°±23°; P=.036), abduction (164°±17° vs. 151°±26°; P=.029), and abduction strength (3.5±2.2 kg vs. 2.3±1.2 kg; P=.017) than the retear group. In the intact repair group (n=34), Sugaya type I:II ratio differed significantly between postoperative 3 months (2:32) and 24 months (24:10) (P<.001). Repaired tendon thickness did not decrease significantly between 3 months (7.1 mm) and 2 years (6.9 mm) (P=.543). ARCR with fascia lata graft augmentation of large and massive rotator cuff tears showed a 24.4% retear rate but significantly improved the clinical scores, ROMs, and muscle strength with excellent cuff integrity in the intact repair group. However, the differences in the Constant and UCLA scores between the intact repair and retear groups were under the minimal clinically important difference, and their clinical significance is uncertain. Our results confirm that ARCR with fascia lata graft augmentation improves patients' postoperative outcomes if the repair site is maintained postoperatively.

Acute Effects of Ice Hockey on Hip Range of Motion, Strength, and Pelvic Tilt in Competitive Male Players.

Ice hockey players are at high risk for hip and groin injury. Several risk factors have been identified or proposed, including lower hip rotation range of motion (ROM), lower hip adductor strength, lower ratio of hip adductor to abductor strength, and lower pelvic tilt angle. It is not known how these risk factors change acutely with ice hockey participation. Acute exposure to ice hockey will result in a reduction in ROM, strength, and pelvic tilt angle in competitive male players. Controlled cohort study. Level 3. Risk factors for hip and groin injury, including isometric hip adductor strength at 0° of flexion, the ratio of hip adductor to abductor strength, total hip rotation passive ROM in supine, and the resting pelvic tilt angle, were assessed immediately before, immediately after, and 24 hours after an ice hockey exposure in 42 competitive male ice hockey players. Rating of perceived exertion (RPE) was collected to identify the intensity of the exposure. There was a significant decrease in total hip rotation ROM (-7.32°, P < 0.01 (-3.91, -10.70)) and hip adductor strength (-4.41 kg, P < 0.01 (-2.81, -6.00) immediately after the exposure, and a significant decrease in total hip rotation ROM (-18.54°, P < 0.01 (-14.35, -22.73)), hip adductor strength (-6.56 kg, P < 0.01 (-4.58, -8.61)), and the ratio of hip adductor to abductor strength (-0.12, P < 0.01 (-0.21, -0.45)) 24 hours after. There was no significant change in pelvic tilt found in this study immediately after or 24 hours after. There was a moderate relationship between changes in hip adductor strength and changes in the ratio of hip adductor to abductor strength (r = 0.433, P < 0.01). RPE was not significantly correlated to any of the changes observed. Risk factors for hip and groin injury in ice hockey players are modifiable after a single ice hockey exposure. The identified fluctuation of injury risk factors for hip and groin injury in ice hockey players has implications for injury risk profiling, rehabilitation, and return-to-competition decision-making.

Efficacy of hip strengthening on varus thrust in knee osteoarthritis

The objective of this study was to investigate the effect of hip strengthening exercises on varus thrust in patients with knee osteoarthritis (OA). A double-blind clinical experimental study was carried out. Eighty-eight of the ninety-three eligible subjects participated. Participants were between 45 to 60 years of age, had a body mass index (BMI) of &lt; 30 kg/m², and medial tibiofemoral OA with a radiographic grade of 2-3 according to Kellgren-Lawrence (KL). Participants were randomly allocated to one of the two groups (control and study group). The control group (n=44; 22 men, 22 women) received only quadriceps strengthening exercise, and stretching exercise for hamstring and calf muscles, while the study group (n=44; 22 men, 22 women) received hip abductor, hip extensor, hip external rotator strengthening exercises in addition to the same exercises of the control group. Patients in both groups received 12 sessions of treatment (3 sessions per week for 4 weeks). The primary outcome was frontal plane projection angle (FPPA), which was measured by a digital video camera and analysed with Kinovea software. Secondary outcomes were muscles strength of hip abductor, hip extensor, hip external rotator and quadriceps measured with a handheld dynamometer (HHD). At baseline, there was no statistically significant difference between both groups regarding tested variables (p &gt; 0.05). After 4 weeks of treatment, both groups showed statistically significant improvements in FPPA, hip abductors, hip extensors, hip external rotators and knee extensor strength, compared to pre-treatment (p &lt; 0.05). However, the study group showed statistically significant improvements in FPPA, hip abductors, hip extensors, and hip external rotators strength compared with the control group (p &lt; 0.05), while there was no statistically significant difference in knee extensor strength between both groups (p &gt; 0.05). Hip strengthening exercises can be added to the treatment programme of varus thrust.

Relationships between self-perceived and clinical expression of pain and function differ based on the underlying pathology of the human hip

BackgroundPatient-reported outcomes are commonly used to assess patient symptoms. The effect of specific hip pathology on relationships between perceived and objectively measured symptoms remains unclear. The purpose of this study was to evaluate differences of function and pain in patients with FAIS and DDH, to assess the correlation between perceived and objective function, and to determine the influence of pain on measures of function.MethodsThis prospective cross-sectional study included 35 pre-operative patients (60% female) with femoroacetabular impingement syndrome (FAIS) and 37 pre-operative patients (92% female) with developmental dysplasia of the hip (DDH). Objectively measured function (6-min walk [6MWT], single leg hop [SLHT], Biodex sway [BST], hip abduction strength [HABST], and STAR excursion balance reach [STAR] tests), patient-reported function (UCLA Activity, Hip Outcome Score [HOS], Short Form 12 [SF-12], and Hip Disability and Osteoarthritis Outcome Score [HOOS]), and patient-reported pain (HOOS Pain, visual analogue scale (VAS), and a pain location scale) were collected during a pre-surgical clinic visit. Between-group comparisons of patient scores were performed using Wilcoxon Rank-Sum tests. Within-group correlations were analyzed using Spearman’s rank correlation coefficients. Statistical correlation strength was defined as low (r = ± 0.1–0.3), moderate (r = ± 0.3–0.5) and strong (r > ± 0.5).ResultsPatients with DDH reported greater pain and lower function compared to patients with FAIS. 6MWT distance was moderately-to-strongly correlated with a number of patient-reported measures of function (FAIS: r = 0.37 to 0.62, DDH: r = 0.36 to 0.55). Additionally, in patients with DDH, SLHT distance was well correlated with patient reported function (r = 0.37 to 0.60). Correlations between patient-reported pain and objectively measured function were sparse in both patient groups. In patients with FAIS, only 6MWT distance and HOOS Pain (r = -0.53) were significantly correlated. In patients with DDH, 6MWT distance was significantly correlated with VAS Average (r = -0.52) and Best (r = -0.53) pain.ConclusionPain is greater and function is lower in patients with DDH compared to patients with FAIS. Moreover, the relationship between pain and function differs between patient groups. Understanding these differences is valuable for informing treatment decisions. We recommend these insights be incorporated within the clinical continuum of care, particularly during evaluation and selection of surgical and therapeutic interventions.

Evaluation of muscle strength recovery following superior capsular reconstruction using a tensor fascia lata graft: A comparison with the unaffected side.

Superior capsular reconstruction (SCR) using a tensor fascia lata graft has been performed in patients with irreparable rotator cuff tears and shoulder pseudoparalysis (PPS), and good clinical results have been reported. This procedure can be indicated for younger patients who are highly active in sports and manual labor from the viewpoint of joint preservation. However, this procedure supplements the defect with a graft that has no muscle contractility; therefore, the extent to which shoulder muscle strength is recovered after SCR remains unclear. We hypothesized that the recovery of muscle strength after SCR would not be normalized and would be only approximately 50% of that of the healthy (unaffected) side. This study aimed to evaluate muscle strength after SCR in patients with PPS due to irreparable rotator cuff tears and the extent of recovery by comparing with that of the unaffected side. In total, 20 patients who underwent SCR for PPS using a tensor fascia lata graft with a minimum 2-year follow-up were included. Shoulder muscle strength in abduction, internal rotation, and external rotation was evaluated using a handheld dynamometer. Muscle strength was compared to that on the unaffected side, and the affected/unaffected ratio was measured. Shoulder range of motion (ROM) and acromiohumeral distance (AHD) were also evaluated. The postoperative ROMs and AHD (4.0 ± 1.4 mm vs. 8.4 ± 1.9 mm, P < .001) were significantly improved compared to those preoperatively. In external and internal rotation, the muscle strength of the affected side was recovered by approximately 80% compared to that of the unaffected side. However, in abduction, the muscle strength of the affected side (2.9 ± 1.5 kg) could not reach 50% (48.0 ± 15.9%, range: 25.0-76.5%) of that of the unaffected side (5.9 ± 1.8 kg). Abduction strength was not sufficiently restored after SCR when compared to that on the unaffected side.

Short term Functional Outcomes of Reverse Shoulder Arthroplasty Following Three-Dimensional Planning is Similar Whether Placed with a Standard Guide or Patient Specific Instrumentation (PSI).

Preoperative assessment of the glenoid and surgical placement of the initial guide wire are important in implant positioning during reverse total shoulder arthroplasty (rTSA). Three-dimensional (3D) computed tomography (CT) and patient specific instrumentation (PSI) have improved the placement of the glenoid component, but the impact on clinical outcomes remains unclear. The purpose of this study was to compare short term clinical outcomes after rTSA based on intraoperative technique for central guidewire placement in a cohort of patients that had preoperative 3D planning. A retrospective matched analysis was performed from a multicenter prospective cohort of patients who underwent rTSA with preoperative 3D planning and a minimum of 2-year clinical follow-up. Patients were divided into 2 cohorts based on the technique utilized for glenoid guide pin placement: 1) Standard manufacture guide (SG) that was not customized or 2) PSI. Patient reported outcomes (PROs), active range of motion (ROM), and strength measures were compared between the groups. The ASES score was used to assess the minimum clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS). One hundred seventy patients met the study criteria, including 56 performed with SGs and 122 with PSI. There was no difference in PROs between cohorts. There were no significant differences in the percentage of patients that achieved an ASES MCID, SCB, or PASS. Improvement in internal rotation to the nearest spinal level (p < .001) and at 90° (p = .002) were higher in the SG group and, but likely explained by differences in glenoid lateralization utilized. Improvement in abduction strength (p < .001) and external rotation strength (p = .010) were higher in the PSI group. rTSA performed following preoperative 3D planning leads to similar improvement in PROs regardless of whether a SG or PSI are utilized intraoperatively for central glenoid wire placement. Greater improvement in postoperative strength was observed with the use of PSI, but the clinical significance of this finding is unclear.

The Importance of Hip Abductor and Adductor Muscles in Balance and Mobility Tasks After a Stroke: A Systematic Review

The aim of this systematic review was to identify the association between muscle strength, activation, and structure of the hip abductor-adductor muscles and balance and mobility tasks in individuals post stroke. The present systematic review is comprised of 37 research articles, with 911 individuals that had a stroke. The extracted data included the study population, sample size, sex, stroke side of paresis, time poststroke, and evaluated measurements. We concluded that stronger hip abductors and adductors (both paretic and nonparetic legs) resulted in quicker voluntary step, and faster walking speed and cadence. Also, stronger paretic hip abductors were associated with a faster completion of the timed up and go test, higher ambulation ability, better control of the centre of mass, and quicker stair climbing. Overall, it demonstrated a lateral induced step to the paretic side, increased muscle activation of the gluteus medius of the paretic leg, and increased nonparetic hip abductor muscle activation. The strength and ability to activate the hip abductor and adductor muscles appears to be related to better performance during balance or mobility tasks in individuals with stroke. Therefore, the present systematic review results suggest that improving muscle strength and activation of the hip abductor and adductor muscles might help individuals with stroke to avoid falls.

Lower extremity muscle volume in females with patellofemoral pain and its relationships to hip and knee torque: A cross-sectional study

ObjectivesCompare lower extremity muscle volume in females with patellofemoral pain (PFP) to a cohort of pain-free females and investigate the relationship between thigh and hip muscle volume and torque. DesignCross-sectional. ParticipantsTwenty-one females, 13 with PFP and 8 pain-free controls. Main outcome measuresWe quantified normalized lower extremity muscle volume (cm3/kg*m) via magnetic resonance imaging and isometric hip and thigh torque (Nm/kg) via a multimodal dynamometer. ResultsVersus pain-free individuals, females with PFP had smaller muscle volume of the anterior hip (P < 0.019; d = 0.97–2.42), deep external rotators (P < 0.006; d = 1.0–3.93), hamstrings (P < 0.009; d = 1.09–2.12), rectus femoris (P < 0.001; d = 1.79), and vastus intermedius (P < 0.001; d = 1.88). There was no difference in muscle volume of the gluteus maximus (P = 0.311; d = 0.22), gluteus medius (P = 0.087; d = 0.87), vastus lateralis (P = 0.22; d = 0.39), and vastus medialis (P = 0.47; d = 0.04). Gluteus maximus volume was moderately correlated to hip abduction torque (r = 0.60; P = 0.03). Vasti muscles and semitendinosus volume were moderately correlated to knee extension (r = 0.57–0.69; P < 0.05) and flexion (r = 0.66; P = 0.01) torque, respectively. ConclusionFemales with PFP present with lesser thigh and hip muscle volumes, with variability in volumetric profiles across participants. Lower extremity knee extension and hip abduction strength are moderately associated with the vasti and gluteus maximus muscle volume, respectively.

Effects of Pilates on Pain, Physical Function, Sleep Quality, and Psychological Factors in Young Women with Dysmenorrhea: A Preliminary Randomized Controlled Study.

The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms, premenstrual syndrome, and risk factors of dysmenorrhea. Thirty young women with primary dysmenorrhea were randomly assigned into a Pilates group (PG; n = 15) and a waitlist control group (CG; n = 15). The Pilates was performed twice a week for 12 weeks. Menstrual pain and symptoms were measured by visual analogue scale (VAS) and the Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed using the premenstrual symptoms screening tool (PSST). Additionally, back flexibility, hip muscle strength, sleep duration and quality, perceived stress, state-trait anxiety, and depression were evaluated. The VAS, CMSS severity and frequency, and PSST symptoms and functional impairments decreased in the PG compared to the CG (p < 0.001 or p < 0.01) with large effect sizes. Back flexibility and the strength of hip flexors, hip extensors, and hip abductors significantly increased in the PG compared to the CG (all p < 0.01) with large effect sizes. Sleep quality (p < 0.01) and stress (p < 0.05) improved in the PG. Sleep duration, anxiety, and depression did not change in either group. In conclusion, the 12-week Pilates intervention ameliorates dysmenorrhea, partly mediated by improved physical function and sleep quality.

Evaluating the effectiveness of interventions targeting only the acetabular side in the surgical treatment of Legg-Calvé-Perthes disease.

This study aims to show the effectiveness of only acetabular-side surgeries for hips affected by Legg-Calvé-Perthes disease. Twelve patients who underwent two different acetabular osteotomies -pembersal osteotomy and triple osteotomy - were evaluated retrospectively. Clinically, patients were examined for hip range of motion, flexion contracture, and hip extensor and abductor strength; the results were evaluated using the Harris hip score. Radiologically, the hips were assessed according to three different radiological parameters: lateral center edge angle, acetabular width, and acetabular head index at the preoperative, early postoperative, and last follow-up periods. The hips were classified according to Herring classification preoperatively and according to Stulberg classification at the last follow-up. Statistically significant improvement was observed in patients both clinically and radiologically. It was observed that pembersal osteotomy significantly corrected the lateral center edge angle better than triple osteotomy while also correcting the other two radiological parameters, but no statistically significant difference was observed between these methods. Only acetabular-side surgeries are effective and safe methods that do not require femoral intervention for hips affected by Legg-Calvé-Perthes disease and that do not show significant complications.

Effect of a Neuromuscular Training on Knee Valgus, Range of Motion and Muscle Strength of Soccer Players With Dynamic Knee Valgus

Background and Aims The present study aims to investigate the effect of a neuromuscular training program on knee valgus angle, and range of motion (ROM) and muscle strength of hip and ankle in male adolescent football players with dynamic knee valgus (DKV). Valgus knee is one of the most common neuromuscular abnormalities that is involved in causing non-contact damage to the anterior cruciate ligament (ACL). Methods This is a quasi-experimental study. Participants were 25 adolescent male football players with DKV who were purposefully selected from Shahin Football Academy in Amol, Iran and randomly divided into two groups of control and training. The existence of DKV was assessed by Squats test and the valgus angle were assessed by jump-landing test and Kinovea software. The abduction and external rotation strength and ROM of hip and the dorsiflexion and plantarflexion strength and ROM of ankle were evaluated with Manual Muscle Testing and a goniometer, respectively. After performing the pre-test assessments, the subjects in the training group performed neuromuscular training for 8 weeks, while the control group also participated in the physical fitness program of Shahin Football Academy. At the end, assessments were performed again in two groups. To examine the differences, repeated measures analysis of variance and Bonferroni post hoc test were used in SPSS software, version 24. The significance level was set at 0.05. Results The results showed a significant difference in knee valgus angle (P=0.001), abduction ROM of hip (P=0.01), external rotation ROM of hip (P=0.01), dorsiflexion ROM of ankle with knee extension (P=0.001), dorsiflexion ROM of ankle with knee flexion (P=0.001), hip abduction strength (P=0.002), hip external rotation strength (P=0.01), and plantarflexion strength of ankle (P=0.03) between the control and training groups. However, the results showed no significant difference in plantarflexion ROM of ankle and dorsiflexion strength of ankle (P&gt;0.05). After one month, the results showed the sustainability of the effect of training on abduction and external rotation ROM of hip, dorsiflexion ROM of ankle with knee extension and flexion, and dorsiflexion and plantarflexion strength of ankle. Conclusion The neuromuscular training can reduce the risk of non-contact ACL injury in male football players with DKV by improving strength and ROM of hip and ankle.

Exploration of the clinical course of frozen shoulder: A longitudinal multicenter prospective study of functional impairments

BackgroundContradictory evidence exists regarding the clinical course of frozen shoulder (FS). ObjectivesTo explore the clinical course of FS regarding disabilities, pain, range of motion (ROM), muscle strength, scapular upward rotation, and proprioception and to establish longitudinal correlations between these variables. MethodsPatients with FS were prospectively followed for 9 months at 3-month intervals. Assessment included the Disabilities of the Arm, Shoulder and Hand questionnaire; visual analogue scale for pain; an inclinometer for shoulder external rotation (ER), internal rotation (IR), flexion, and abduction ROM, and scapular upward rotation and proprioception, as well as handheld dynamometry for muscle strength in shoulder abduction, ER, and IR. ResultsInitially, 149 patients (98 females; mean (SD) age 53 (9) years) were included, with 88 completing all follow-up assessments. Most variables showed early improvement in the clinical course of FS, particularly ER and IR at 90° abduction, which continued to improve from 6 to 9 months of follow-up. Associations were observed between disabilities and pain (r = 0.61), disabilities/pain and ROM (r=-0.62 to -0.59 and r=-0.47 to -0.39, respectively), disabilities/pain and muscle strength (r=-0.24 to -0.35 and r=-0.36 to -0.17, respectively), and between disabilities/pain and scapular upward rotation below shoulder level (r = 0.23 to 0.38 and r = 0.24 to 0.30, respectively). ROM correlated with muscle strength (r = 0.14 to 0.44), while both ROM and ER muscle strength correlated with scapular upward rotation below shoulder level (r=-0.37 to -0.23 and r=-0.17 to -0.12, respectively). Muscle strength correlated with scapular upward rotation above shoulder level (r = 0.28 to 0.38) and lift-off muscle strength correlated with joint repositioning (r=-0.17 to -0.15). ConclusionAlmost all factors improved in the early phase (3–6 months) after baseline assessment, while ER and IR ROM at shoulder level continued to improve long term.