Contralateral Pelvic Drop Research Articles

The Running Readiness Scale as an Assessment of Kinematics Related to Knee Injury in Novice Female Runners.

Frontal- and transverse-plane kinematics have been prospectively identified as risk factors for running-related injuries in females. The Running Readiness Scale (RRS) may allow for clinical evaluation of these kinematics. To determine the reliability and validity of the RRS as an assessment of frontal- and transverse-plane running kinematics. Cross-sectional study. University research laboratory. A total of 56 novice female runners (median [interquartile range] age = 34 years [26-47 years]). We collected 3-dimensional kinematics during running and RRS tasks: hopping, plank, step-ups, single-legged squats, and wall sit. Five clinicians assessed RRS performances 3 times each. Interrater and intrarater reliabilities of the total RRS score and individual tasks were calculated using the intraclass correlation coefficient and Fleiss κ, respectively. Pearson product moment correlation coefficients between peak joint angles measured during running and the same angles measured during RRS tasks were computed. Peak joint angles of high- and low-scoring participants were compared. Interrater and intrarater reliabilities of assessment of the total RRS scores were good (intraclass correlation coefficients = 0.75 and 0.80, respectively). Reliability of assessing individual tasks was moderate to almost perfect (κ = 0.58-1.00). Peak hip adduction, contralateral pelvic drop, and knee abduction during running were correlated with the same angles measured during hopping, step-ups, and single-legged squats (r = 0.537-0.939). Peak knee internal rotation during running was correlated with peak knee internal rotation during step-ups (r = 0.831). Runners who scored high on the RRS demonstrated less knee abduction during running (P ≤ .01). The RRS may effectively assess knee abduction in novice runners, but evaluation criteria or tasks may need to be modified to effectively characterize pelvic and transverse-plane knee kinematics.

Lumbar Bone Mineral Adaptation: The Effect of Fast Bowling Technique in Adolescent Cricketers.

Localized bone mineral density (BMD) adaptation of the lumbar spine, particularly on the contralateral side to the bowling arm, has been observed in elite male cricket fast bowlers. No study has investigated this in adolescents, or the role of fast bowling technique on lumbar BMD adaptation. This study aims to investigate lumbar BMD adaptation in adolescent cricket fast bowlers, and its relationship with fast bowling technique. Thirty-nine adolescent fast bowlers underwent anteroposterior dual x-ray absorptiometry scan of their lumbar spine. Hip, lumbopelvic and thoracolumbar joint kinematics, and vertical ground reaction kinetics were determined using three-dimensional motion capture and force plates. Significant partial (covariate: fat-free mass) and bivariate correlations of the technique parameters with whole lumbar (L1-L4) BMD and BMD asymmetry (L3 and L4) were advanced as candidate variables for multiple stepwise linear regression. Adolescent fast bowlers demonstrated high lumbar Z-Scores (+1.0; 95% confidence interval [CI], 0.7-1.4) and significantly greater BMD on the contralateral side of L3 (9.0%; 95% CI, 5.8%-12.1%) and L4 (8.2%; 95% CI, 4.9%-11.5%). Maximum contralateral thoracolumbar rotation and maximum ipsilateral lumbopelvic rotation in the period between back foot contact and ball release (BR), as well as contralateral pelvic drop at front foot contact, were identified as predictors of L1 to L4 BMD, explaining 65% of the variation. Maximum ipsilateral lumbopelvic rotation between back foot contact and BR, as well as ipsilateral lumbopelvic rotation and contralateral thoracolumbar side flexion at BR, were predictors of lumbar asymmetry within L3 and L4. Thoracolumbar and lumbopelvic motion are implicated in the etiology of the unique lumbar bone adaptation observed in fast bowlers whereas vertical ground reaction force, independent of body mass, was not. This may further implicate the osteogenic potential of torsional rather than impact loading in exercise-induced adaptation.

Asymmetries in Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-of-Concept Study.

Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been examined, this cross-sectional study was conducted with the aim to compare DVI between individuals with ACLR and healthy controls. Videos were taken for 12 participants with ACLR and 20 healthy controls when they performed single-leg hopping. One-way ANOVA revealed a higher DVI in the injured limb of the ACLR group when compared to their non-injured limb and to the healthy limb of the control group. As our data showed increased DVI in the injured limb of the ACLR group, the DVI approach accounting for hip and knee kinematics may be used to identify frontal plane movement deficits during single-leg hopping in individuals with ACLR.

Kinematic Characteristics of Male Runners With a History of Recurrent Calf Muscle Strain Injury.

BackgroundCalf muscle strain injuries are a common running injury affecting male runners and are known to have high reoccurrence rates. Currently, limited evidence exists investigating factors associated with this injury with no previous study investigating the running kinematics of male runners with a history of repeat calf muscle strain injuries.PurposeTo investigate whether male runners with a history of repeat calf muscle strain injury demonstrate differences in stance phase running kinematics when compared to healthy controls.Study DesignCase-control investigationLevel of Evidence3bMethodsStance phase kinematics were compared between 15 male runners with a history of calf muscle strain injury and 15 male control participants during treadmill running at 3.2m/s. Independent t-tests were used to compare differences in stance phase kinematic parameters between groups and effect sizes were calculated using Cohen’s d.ResultsThe group with a history of calf muscle strain injury demonstrated a significant 2.1⁰ and 3.1⁰ increase in contralateral pelvic drop and anterior pelvic tilt during mid stance. In addition, this group exhibited longer stance times and a more anterior tilted pelvis, flexed hip and a greater distance between the heel and centre of mass at initial contact. Large effect sizes, greater than 0.8, were observed for all differences. No significant differences were observed for ankle and knee joint kinematics between the groups.ConclusionThis is the first study to identify kinematic characteristics associated with recurrent calf muscle strain injury. While it is not possible to determine causality, the observed kinematic differences may contribute to recurrent nature of this injury. Specifically, it is possible that neuromuscular deficits of the hip and calf muscle complex may lead to increased strain on the calf complex. Rehabilitation interventions which focus on addressing pelvis and hip kinematics may reduce the demands placed upon the calf complex and could prove clinically effective.

Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up.

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14—MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain.

The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Cross-sectional Setting: Academic medical center. A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3]y) participated. None. Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

Biomechanical and clinical outcomes in response to inpatient multidisciplinary hip and groin rehabilitation in UK military personnel

IntroductionHip and groin related pain is a common complaint among the military population across UK Defence Rehabilitation and addressing associated biomechanical dysfunction is a key treatment goal. Personnel are exposed...

A Random Forest Machine Learning Framework to Reduce Running Injuries in Young Triathletes.

Background: The running segment of a triathlon produces 70% of the lower limb injuries. Previous research has shown a clear association between kinematic patterns and specific injuries during running. Methods: After completing a seven-month gait retraining program, a questionnaire was used to assess 19 triathletes for the incidence of injuries. They were also biomechanically analyzed at the beginning and end of the program while running at a speed of 90% of their maximum aerobic speed (MAS) using surface sensor dynamic electromyography and kinematic analysis. We used classification tree (random forest) techniques from the field of artificial intelligence to identify linear and non-linear relationships between different biomechanical patterns and injuries to identify which styles best prevent injuries. Results: Fewer injuries occurred after completing the program, with athletes showing less pelvic fall and greater activation in gluteus medius during the first phase of the float phase, with increased trunk extension, knee flexion, and decreased ankle dorsiflexion during the initial contact with the ground. Conclusions: The triathletes who had suffered the most injuries ran with increased pelvic drop and less activation in gluteus medius during the first phase of the float phase. Contralateral pelvic drop seems to be an important variable in the incidence of injuries in young triathletes.

Do hip strength, flexibility and running biomechanics predict dynamic valgus in female recreational runners?

BackgoundDynamic valgus has been the focus of many studies to identify its association to an increased risk of running-related injuries. However, it is not known which physical and biomechanical variables are associated with this movement dysfunction. Research question: This study aimed to test the correlation between strength, flexibility and biomechanical variables and dynamic valgus in female runners. MethodsTwenty-nine healthy females ran on a treadmill at 2.92 m/s and performed strength, range of motion and endurance tests. Pelvic, hip and ankle kinematics were measured with a 3D motion analysis system. Six multiple linear regression models were used to identify the ability of physical and biomechanical variables to predict excursion and peak of contralateral pelvic drop, hip adduction and internal rotation. ResultsContralateral pelvic drop and hip adduction were positively correlated to ankle eversion and step cadence. Hip internal rotation had a negative correlation with ankle eversion. Despite significance, predictor variables explained less than 30% of dynamic valgus variance during running. No interest variable had significant correlation with the hip strength and hip and ankle passive range of motion. SignificanceThe results showed that distal joint kinematics and spatiotemporal variables should be considered during biomechanical running analysis to identify their possible relationship with joint overload caused by dynamic valgus. Caution should be taken when linking hip disorders during running to posterolateral hip strength and stiffness, core endurance, and ankle dorsiflexion range of motion since no correlation occurred amongstthese variables in this sample of female runners.

Effects of Hip Muscle Resistance Training With and Without Feedback on Trunk, Pelvis, and Lower Extremity Motions

Introduction: The present study aimed to compare hip muscle resistance training with and without feedback on trunk, pelvis, and lower extremity motions in frontal and sagittal planes among active females with dynamic valgus. Materials and Methods: Twenty-Nine active females (Mean±SD age: 22.8±2.4 years, height: 1.70±0.6 m, weight: 69±7.1 kg) were randomly assigned to a hip muscle resistance training with feedback group (n=15) or a hip muscle resistance training without feedback group (n=14). Both training programs lasted 6 weeks (3 sessions/week). The peak angles of lateral trunk flexion, contralateral pelvic drop, hip flexion, knee flexion, and valgus during single-leg drop landing and single-leg vertical drop jump were assessed in the research participants at baseline and 6 weeks post-training. Unipodal functional screening tests were captured with two standard digital video cameras. Results: After 6 weeks, significant differences were observed in knee valgus and lateral trunk flexion, contralateral pelvic drop, and knee flexion angles, i.e., compared between hip muscle resistance training with feedback and hip muscle resistance training without feedback (P<0.05), except for non-dominant leg hip flexion in single-leg vertical drop jump (P>0.05). Conclusion: In the explored active females with dynamic valgus, hip muscle resistance training with feedback seems to be better at improving trunk, pelvis, and lower extremity motions in frontal and sagittal planes, compared to hip muscle resistance training without feedback; however, no significant difference was observed concerning hip flexion during single-leg vertical drop jump between the study groups.

Gait Retraining With Real-Time Visual Feedback to Treat Patellofemoral Pain in Adult Recreational Runners: A Critically Appraised Topic.

Clinical Scenario: Patellofemoral pain (PFP) is a common knee injury in recreational adult runners, possibly caused by faulty mechanics. One possible approach to reduce this pain is to retrain the runner's gait. Current research suggests that no definitive gold standard treatment for PFP exists. Gait retraining utilizing visual feedback may reduce PFP in both the short and long term. Clinical Question: In adult runners diagnosed with PFP, does gait retraining with real-time visual feedback lead to a decrease in pain? Summary of Key Findings: A literature search was performed; 3 relevant studies utilizing gait retraining with visual feedback, pain level as an outcome measure, and follow-up measures of at least 1 month after the intervention were included. All the included studies reported a decrease in short- and long-term pain for participants following visual feedback gait retraining. In addition, biomechanical measures related to PFP, including peak hip adduction angle and the angle of contralateral pelvic drop, improved after the completion of the intervention. Clinical Bottom Line: There is level 2 evidence supporting the implementation of 8 sessions over 2 weeks of visual feedback gait retraining as a means of treating patients diagnosed with PFP. Based on current available evidence, clinicians should identify faulty mechanics of patients and implement a protocol of increasing real-time visual feedback over the first 4 sessions and decreasing visual feedback over the final 4 sessions. Strength of Recommendation: Level 2.

A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months

Background: Aberrant frontal-plane hip and pelvis kinematics have been frequently observed in runners with patellofemoral pain (PFP). Gait retaining interventions have been shown to improve running kinematics and may therefore be beneficial in runners with PFP. Purpose: To investigate whether a 10% increase in the running step rate influences frontal-plane kinematics of the hip and pelvis as well as clinical outcomes in runners with PFP. Study Design: Case series; Level of evidence, 4. Methods: Runners with PFP underwent a 3-dimensional gait analysis to confirm the presence of aberrant frontal-plane hip and/or pelvis kinematics at baseline. A total of 12 participants with frontal-plane hip and/or pelvis kinematics 1 standard deviation above a reference database were invited to undergo the gait retraining intervention. Running kinematics along with clinical outcomes of pain and functional outcomes were recorded at baseline, 4 weeks after retraining, and 3 months. Gait retraining consisted of a single session where step rate was increased by 10% using an audible metronome. Participants were asked to continue their normal running while self-monitoring their step rate using a global positioning system smartwatch and audible metronome. Results: After gait retraining, significant improvements in running kinematics and clinical outcomes were observed at 4-week and 3-month follow-up. Repeated-measures analysis of variance with post hoc Bonferroni correction (P < .016) showed significant reductions in peak contralateral pelvic drop (mean difference [MD], 3.12° [95% CI, 1.88°-4.37°]), hip adduction (MD, 3.99° [95% CI, 2.01°-5.96°]), and knee flexion (MD, 4.09° [95% CI, 0.04°-8.15°]) as well as significant increases in self-reported weekly running volume (MD, 13.78 km [95% CI, 4.62-22.93 km]) and longest run pain-free (MD, 6.84 km [95% CI, 3.05-10.62 km]). Friedman test with a post hoc Wilcoxon signed-rank test showed significant improvements on a numerical rating scale for worst pain in the past week and the Lower Extremity Functional Scale. Conclusion: A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP. These improvements were maintained at 3-month follow-up. It is important to assess for aberrant running kinematics at baseline to ensure that gait interventions are targeted appropriately. Registration: NCT03067545 (ClinicalTrials.gov identifier)

Kinematics and muscle forces in women with patellofemoral pain during the propulsion phase of the single leg triple hop test

BackgroundApproximately 25% of orthopedic knee conditions are related to patellofemoral pain (PFP), with young women being the most affected. It is thought that this condition is associated with modifications in the kinematics and muscle control patterns of the lower limb during weight-bearing support activities, which increases femur movement under the patella. ObjectivesTo compare kinematics and muscle induced acceleration patterns between PFP subjects and healthy controls during the preparation phase of the single leg triple hop test. Study designBiomechanical analysis was performed using OpenSim. Ten physically active women (23.2 ± 4 years, 59.3 ± 5.8 kg, and 1.63 ± 0.06 m) with no history of lower limb injury (CG) and 11 volunteers (23.5 ± 2 years, 55.4 ± 4.9 kg, and 1.66 ± 0.04 m) with PFP (PFPG) were recruited. The participants performed a series of single leg triple hop tests while the ground reaction forces and kinematic data were recorded. ResultsVector field statistical analysis indicated increased lumbar extension, anterior pelvic tilt, contralateral pelvic drop, and lower induced accelerations from the core and hip muscles in PFPG. ConclusionPFP volunteers presented with alterations in lumbar muscle control associated with a possible compensatory pelvic strategy to minimize knee extensor moment.

Two-dimensional video analysis can discriminate differences in running kinematics between recreational runners with and without running-related knee injury

ObjectivesTo determine whether two-dimensional video analysis could discriminate running kinematics between recreational runners with and without a running-related knee injury. DesignCase-control. SettingResearch laboratory. ParticipantsForty-two recreational runners (5 male-13 female injured; 7 male-17 female non-injured). Running-related knee injury was defined as the presence of anterior or lateral knee pain, resulting in altered running activity for at least one week. Main outcome measuresFoot and tibia inclination at initial contact, and lateral trunk position, contralateral pelvic drop, femoral adduction, hip adduction, knee flexion and ankle dorsiflexion at midstance were measured with two-dimensional video analysis during running. Participant characteristics (sex, age, body weight, body length, body mass index, running volume before injury, running speed) and two-dimensional measured angles were compared between groups. ResultsNo significant differences in participant characteristics between groups were identified (P > .05). The injured group ran with greater contralateral pelvic drop (P = .035), femoral adduction (P = .021) and hip adduction (P = .001) at midstance, and significantly smaller foot inclination at initial contact (P = .031). ConclusionTwo-dimensional video analysis can discriminate kinematics between runners with and without running-related knee injury. Greater contralateral pelvic drop, femoral adduction and hip adduction at midstance may provide running retraining targets for runners with running-related knee injury.

The role of hip abductor strength on the frontal plane of gait in subjects with medial knee osteoarthritis.

This study aimed to investigate the relationship of hip abductor strength with external hip and knee adduction moments, pain and physical function, and trunk, pelvis, and hip kinematics in the frontal plane during walking in subjects with medial knee osteoarthritis. Twenty-five subjects with medial knee osteoarthritis were evaluated through an isokinetic strength test for hip abductor, three-dimensional gait analysis (kinetics and kinematics), and pain and physical function scores. Regression models were used to control the influence of other parameters such as pain, age, gender, severity, walking speed, mass, and height. No relationship was found of hip abductor strength with peak of external knee adduction moment and knee adduction angular impulse. Hip abductor strength explained 17% of contralateral pelvic drop and 21% of hip adduction angle. In addition, hip abductor strength explained 4% and 1% of the variance in the WOMAC physical function score and 40-m fast paced walk test, respectively. Considering the relationship of hip abductor strength with contralateral pelvic drop and hip adduction angle, specific exercises might improve physical function and lower limb dynamic alignment during gait.

Comparison of the internal hip abduction moment and the pelvic kinematics during single-leg standing between people with knee osteoarthritis and healthy elderly people

Purpose: A high external knee adduction moment (KAM) during walking is known as the risk factors for progression of knee osteoarthritis (KOA). Recent studies demonstrated that contralateral pelvic drop increased the KAM during walking and single-leg standing. Thus, stabilizing pelvis in the frontal plane is one of the goal for conservative treatments for KOA. In addition, internal hip abduction moment (HAM) explaining hip abductor muscle strength of the stance limb play a role in stabilizing the pelvis. However, few studies investigated HAM and pelvic kinematics during single-leg standing in people with KOA. Single-leg standing is convenient method to assess movement of the pelvis in the frontal plane, such as in the Trendelenburg test. The purpose of the present study was to compare the HAM and the pelvic kinematics during single-leg standing between people with KOA and healthy elderly people. Methods: Nine healthy elderly people (healthy group; age: 61.0 ± 9.0 years, height: 157.0 ± 9.3 cm, weight: 57.3 ± 11.2 kg) and 10 patients with KOA (KOA group; age: 67.8±8.9 years, height:152.8±6.9 cm, weight: 56.8±15.1 kg, K/L grade: 2-3) were recruited for this study. These subjects performed the single-leg standing trials. Subjects stood on two force platforms. They lifted one lower limb off the force plate 'as fast as possible' following a sonic cue, and held the posture. The onset of lift-off point was defined as the time when the vertical component of the ground reaction force became less than 10 N. All data were recorded until 3000ms following the lift-off. The data were collected with a six-camera motion analysis system and two force plates that were temporally synchronized and sampled at 200Hz and 1000Hz, respectively. Helen Hays marker set was used. The peak HAM and peak KAM during the single-leg standing were determined using the SIMM6.0.2 software. The maximum and minimum value of the lateral tilt angle of the pelvis during single-leg standing trials were calculated using the custom Matlab code. The contralateral pelvic elevation was denoted as a positive angle. We compared peak HAM, peak KAM and pelvic tilt angle between groups using unpaired t test. The level of significance was set at 0.05. Results: able 1 shows all kinematics and kinetic data (mean and SD) and statistics. There was no significant difference between groups for peak HAM and peak KAM. Maximum value of the pelvic tilt angle was not significant difference between groups. Minimum value of the pelvic tilt angle was greater in KOA group than in healthy group (p<0.05). Conclusions: People with KOA reduced the contralateral pelvic drop during single-leg standing. In addition, there was no difference peak KAM and peak HAM in KOA group compared with healthy group. People with KOA probably adapted their pelvic kinematics to prevent the increase of peak KAM during single-leg standing. Since hip abductor muscle play a role in stabilizing pelvis, hip abductor muscle strengthening exercises might be effective for rehabilitation program for KOA.

Superior migration of the femoral head in patients with severe hip osteoarthritis influences the gait patterns of the coronal plane.

Patients with hip osteoarthritis (OA) show abnormal movement patterns, including the leaning of the trunk toward the affected limb (Duchenne limp). Patients with severe OA, especially those with OA due to hip dysplasia, show a lateral pelvic drop (Trendelenburg sign). The aim of this preoperative study is to investigate the relationship between superior migration of the arthritic femoral head, pain, and hip abductor muscle strength, and to clarify the relationship between the coronal plane gait patterns with pain and hip abductor muscle strength. The subjects of this study were 18 patients with unilateral hip OA secondary to dysplasia. A radiographic analysis was performed on standardised anteroposterior pelvis films. The abductor muscle strength of the OA hip joint was measured with a handheld dynamometer. The tilt angle of the pelvis and trunk lean angle during gait were obtained using a 3-dimensional motion analysis system. Visual analogue scale (VAS) of pain was obtained after trial. The 2 lateral pelvic angle patterns at the mid-stance of the affected limb during gait were detected. 1 is a pattern that was pelvic rise, and the other was a contralateral pelvic drop. Subjects with pelvic drop showed more superior femoral migration than that with pelvic rise (r = 0.69 p < 0.01). VAS of pain correlate significantly with coronal trunk angle on mid-stance of affected limb during gait (r = 0.761, p < 0.01). The pelvic drop Trendelenburg sign was influenced by superior migration of the femoral head, whereas the trunk lean Duchenne limp was found to be affected by pain.

The FreeD module for the Lokomat facilitates a physiological movement pattern in healthy people \u2013 a proof of concept study

BackgroundA contralateral pelvic drop, a transverse rotation and a lateral translation of the pelvis are essential features of normal human gait. These motions are often restricted in robot-assisted gait devices. The optional FreeD module of the driven gait orthosis Lokomat (Hocoma AG, Switzerland) incorporates guided lateral translation and transverse rotation of the pelvis. It consequently should support weight shifting during walking. This study aimed to investigate the influence of the FreeD module on trunk kinematics and hip and trunk muscle activity.MethodsThirty- one healthy adults participated. A video analysis of their trunk movements was performed to investigate the lateral chest and pelvis displacement within the Lokomat (with and without FreeD), and this was compared to treadmill walking. Furthermore, surface electromyography (sEMG) signals from eight muscles were collected during walking in the Lokomat (with and without FreeD), on the treadmill, and overground. To compare the similarity of the sEMG patterns, Spearman’s correlation analyses were applied.ResultsWalking with FreeD elicited a significantly higher lateral pelvis displacement and a lower lateral chest displacement (relative to the pelvis) compared to walking with a fixated pelvis. No significant differences in the sEMG patterns were found for the Lokomat conditions (with and without FreeD) when comparing it to treadmill or overground walking.ConclusionsThe differences in pelvis displacement act as a proof of concept of the FreeD module. The reduction of relative lateral chest movement corresponds to a decrease in compensatory trunk movements and has its origin in allowing weight shifting through the FreeD module. Both Lokomat conditions showed very similar muscle activity patterns of the trunk and hip compared to overground and treadmill walking. This indicates that the Lokomat allows a physiological muscle activity of the trunk and hip during gait.

Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?

Background: Previous research has demonstrated clear associations between specific running injuries and patterns of lower limb kinematics. However, there has been minimal research investigating whether the same kinematic patterns could underlie multiple different soft tissue running injuries. If they do, such kinematic patterns could be considered global contributors to running injuries. Hypothesis: Injured runners will demonstrate differences in running kinematics when compared with injury-free controls. These kinematic patterns will be consistent among injured subgroups. Study Design: Controlled laboratory study. Methods: The authors studied 72 injured runners and 36 healthy controls. The injured group contained 4 subgroups of runners with either patellofemoral pain, iliotibial band syndrome, medial tibial stress syndrome, or Achilles tendinopathy (n = 18 each). Three-dimensional running kinematics were compared between injured and healthy runners and then between the 4 injured subgroups. A logistic regression model was used to determine which parameters could be used to identify injured runners. Results: The injured runners demonstrated greater contralateral pelvic drop (CPD) and forward trunk lean at midstance and a more extended knee and dorsiflexed ankle at initial contact. The subgroup analysis of variance found that these kinematic patterns were consistent across each of the 4 injured subgroups. CPD was found to be the most important variable predicting the classification of participants as healthy or injured. Importantly, for every 1° increase in pelvic drop, there was an 80% increase in the odds of being classified as injured. Conclusion: This study identified a number of global kinematic contributors to common running injuries. In particular, we found injured runners to run with greater peak CPD and trunk forward lean as well as an extended knee and dorsiflexed ankle at initial contact. CPD appears to be the variable most strongly associated with common running-related injuries. Clinical Relevance: The identified kinematic patterns may prove beneficial for clinicians when assessing for biomechanical contributors to running injuries.

Test-retest reliability of two-dimensional video analysis during running

ObjectivesTo examine test-retest reliability of two-dimensional measured frontal and sagittal plane kinematics during running, and to determine how many steps to include to reach and maintain a stable mean. DesignReliability study. SettingResearch laboratory. ParticipantsTwenty-one recreational runners. Main outcome measuresLateral trunk position, contralateral pelvic drop, femoral adduction, hip adduction, knee flexion and ankle dorsiflexion during midstance, and foot and tibia inclination at initial contact were measured with two-dimensional video analysis during running for 10 consecutive steps for both legs. All participants were tested twice one week apart. A sequential estimation method was used to determine the number of steps needed to reach a stable mean. Intraclass correlation coefficients (ICC) and smallest detectable differences (SDD) were calculated. ResultsThe minimal number of steps was 6.3 ± 0.3. Lateral trunk position, femoral adduction and foot inclination showed excellent reliability (ICC 0.90–0.99; SDD 1.3°–2.3°). Tibia inclination and ankle dorsiflexion showed good to excellent reliability (ICC 0.73–0.92; SDD 2.2°–4.8°). Hip adduction and knee flexion showed good reliability (ICC 0.82–0.89; SDD 2.3°–3.8°). Contralateral pelvic drop showed moderate to good reliability (ICC 0.59–0.77; SDD 2.7°–2.8°). ConclusionTwo-dimensional video analysis is reliable to assess running kinematics on different days. The mean of at least 7 steps should be included.