Gluteal Research Articles

Effectiveness of a specific strength program of the gluteus maximus muscle to improve dynamic postural control in female basketball players. A randomized controlled trial

BackgroundBasketball is a team sport in which players perform multidirectional movements, jumps and landings, experiencing abrupt accelerations and decelerations and numerous changes of rhythm. In this sport, speed and intensity are two key factors that are associated with an increased risk of injury. The aim of this randomized controlled trial was to determine the effectiveness of a specific gluteus maximus strength programme as preventive work for young female basketball players, to improve dynamic postural stability and to observe its impact in the rate of lower limb injuries, vertical jump, dynamic knee valgus and pain. Research questionIs effective a strength programme to improve dynamic postural stability, vertical jump and dynamic valgus in female basketball players? MethodsA hundred and thirteen female basketball players that play in professional clubs were recruited, reaching the final stage 92 (46 per group). One group (CG) received conventional injury prevention training while the experimental group (EG) added to the conventional team prevention program, a gluteus maximus strength programme of 5 months composed of 4 exercises/2 days per week/2 sets of 10 repetitions per leg. ResultsThe total injury incidence decreased from 0.33 to 0.16 cases (control group pre=0.43 to post=0.14 cases, EG pre=022 to post=0.19). The EG improved overall (p = 0.000), posterior (p = 0.001), posteromedial (p = 0.001) and posterolateral (p = 0.000) dynamic stability of the right leg; anterior (p = 0.024), medial (p = 0.07) and posteromedial (p = 0.01) of the left leg. Both groups improved vertical jump (GC: p = 0.045 and GE: p = 0.000). There was no significant improvement in pain or valgus. SignificanceThis strength programme is effective in improving dynamic stability especially of the dominant leg and jump height.

A data mining approach for determining biomechanical adaptations in runners who experienced and recovered from patellofemoral pain syndrome

ABSTRACT Patellofemoral pain (PFP) is a common musculoskeletal pain disorder experienced by runners. While biomechanics of those with PFP have been extensively studied, methodological considerations may omit important adaptations exhibited by those experiencing and recovered from pain. Instead of a priori selection of discrete biomechanical variables, a data mining approach was leveraged to account for the high dimensionality of running gait data. Biomechanical data of runners symptomatic for, recovered from, and who had never experienced PFP were collected at the 1st (M1) and 21st (M21) minutes of a treadmill run. Principal component analysis and a logistic regression model were used to classify healthy and symptomatic runners, and a feature ranking process determined the important features. The M1 model achieved an accuracy of 82.76% with features related to knee flexion angle, hip abduction moment and gluteus maximus activation, while the M21 model required an additional nine features to achieve an accuracy of 79.31%. Data for recovered runners were projected onto the models, resulting in five and seven out of twelve symptomatic classifications at M1 and M21, respectively. Following the onset of pain, a greater number of features were required to classify runners with PFP, suggesting they may experience individual pain adaptation strategies.

Clinical Validation of Estimated Muscle Activations during Phases of Elderly Gait

This study validated muscle activation estimations generated by OpenSim during the gait of elderly fallers. Ten healthy elderly participants walked on an instrumented treadmill, monitored by motion capture, force platforms, and 12 surface EMG sensors. Static optimization was used to calculate muscle activations, evaluated through cosine similarity, comparing them with EMG signals from 12 muscles of the right leg. Findings revealed varied similarity levels across muscles and gait phases. During stance phase, tibialis anterior (TIBA), peroneus longus (PERL), soleus (SOL), gastrocnemius lateralis (GASL), semitendinosus (SEMI), tensor fasciae latae (TFL), and rectus femoris (RECF) demonstrated poor similarity (cosim < 0.6), while gluteus medius (GMED), biceps femoris long head (BFLH), and vastus lateralis (VL) exhibited moderate similarity (0.6 ≤ cosim ≤ 0.8), and gluteus maximus (GMAX) and vastus medialis (VASM) displayed high similarity (cosim > 0.8). During the swing phase, only SOL demonstrated inadequate similarity, while GASL, GMAX, GMED, BFLH, SEMI, TFL, RECF, and VASL exhibited moderate similarity, and TIBA, PERL, and VASM showed high similarity. Comparing the different 10% intervals of the gait cycle generally produced more favorable similarity results. For most of the muscles and intervals, good agreement was found. Moderate agreement was estimated in the cases of TIBA (0–10%), PERL (60–70%), GASL (60–70%), TFL (10–20%), RECF (0–10%, 80–100%), and GMED (50–60%). Bad agreement was found in the cases of SOL (60–70%), GASL (0–10%), and TFL (0–10%). In conclusion, the study’s validation outcomes were acceptable in most cases, underlining the potential for user-friendly musculoskeletal modeling routines to study muscle output during elderly gait.

EMG Analysis During Static Balance in Chronic Ankle Instability, Coper and Controls.

Patients with chronic ankle instability (CAI) consistently display postural control alterations, which may result from sensorimotor dysfunction. This study aimed to compare muscle activity in the lower extremity and postural control among individuals with CAI, copers and uninjured controls during a static balance test. A total of 57 physically active participants were categorized into three groups (CAI, copers and controls) and performed a single-leg balance test with two visual conditions: eyes open and eyes closed. Muscle activity in six lower extremity muscles and center of pressure (CoP) variables were recorded and analyzed. Patients with CAI exhibited greater muscle activity in the medial gastrocnemius and gluteus maximus compared to controls or copers, regardless of the visual condition. Copers displayed increased gluteus medius activity compared to controls. Additionally, all groups demonstrated increased muscle activity and CoP variables when visual feedback was disrupted. These findings suggest that patients with CAI may have less effective recruitment of motor units during static balance. On the other hand, greater muscle activity in the gluteus medius in copers may represent a coping mechanism to avoid further ankle injuries. Further research on muscle activity during dynamic postural control is warranted to explore sensorimotor alterations in patients with CAI.

Resection of anorectal fistula cancer associated with Crohn’s disease after preoperative chemoradiotherapy: a case report

BackgroundAnorectal fistula cancer is often diagnosed in an advanced state, and radical resection is difficult when invasion of the pelvic wall is observed. In addition, there is currently no clear evidence for perioperative treatment of locally advanced cases. We report a case of anorectal fistula cancer with widespread infiltration diagnosed during the course of Crohn’s disease, which was curatively resected after preoperative chemoradiotherapy.Case presentationA 49-year-old man who had been diagnosed with Crohn’s disease (ileocolonic type) at the age of 25 and was found to have an anorectal fistula and perianal abscess at the age of 44 was referred to our department with complaints of abdominal pain and diarrhea. Computed tomography (CT) showed anal stenosis due to a pelvic mass. Pathological analysis of a biopsy taken under general anesthesia indicated mucinous carcinoma. Magnetic resonance imaging (MRI) revealed infiltration into the prostate, seminal vesicles, levator ani muscle, and left internal obturator muscle, and the patient was diagnosed with cT4N0M0 cStage IIIB anorectal fistula cancer (UICC TNM classification 8th edition). After performing a laparoscopic sigmoid colostomy, chemoradiation therapy (capecitabine + oxaliplatin, 50.4 Gy/28fr) was initiated. The patient then underwent laparoscopic total pelvic exenteration, colonic conduit diversion, extensive perineal resection, and reconstruction using bilateral gluteus maximus flaps and a right rectus abdominis musculocutaneous flap. The pathological diagnosis was mucinous adenocarcinoma, pT4, and all margins were negative. No recurrence was evident 6 months after the operation without adjuvant chemotherapy.ConclusionWe described a case of curative resection after preoperative chemoradiotherapy for anorectal fistula cancer with extensive invasion that was diagnosed during the course of Crohn’s disease.An accumulation of cases is needed to determine the usefulness of preoperative chemoradiation therapy for local control of anorectal fistula cancer associated with Crohn’s disease.

Acute effects of ipsilateral semitendinosus and gracilis autograft anterior cruciate ligament reconstruction on lower limb muscle activation

There is little information regarding the acute repercussions of anterior cruciate ligament (ACL) reconstruction on muscle activation, especially on the proximal hip muscles. Thus, this study analyzed the acute effects of ACL reconstruction with doubled semitendinosus/gracilis (ST/G) autografts on lower limb muscle activation. Fourteen male recreational athletes that presented a primary unilateral ACL rupture and underwent the ACL reconstruction with an ST/G graft. Surface electromyographic (sEMG) signal were recorded from each participant during the maximal voluntary isometric contraction (MVIC) of the gluteus maximus and gluteus medius, vastus lateralis and vastus medialis, semitendinosus, biceps femoris, and medial gastrocnemius muscles and also during bipodal mini-squatting with open and closed eyes, before surgery and 15 days postoperatively. (sEMG) signal were normalized to isometric peak electromyography.The postoperative assessment showed reduced muscle activation in the gluteus maximus (p = 0.013, d:0.48) in non-operated limb and also in the muscle gluteus medius (p = 0.013, d:0.79), vastus medialis (p = 0.035, d:0.63) semitendinosus (p = 0.001, d:2.46), biceps femoris (p<0.001, d:1.5), and medial gastrocnemius (p = 0.001, d:1.45) during MVIC in the operated limb. The postoperative assessment also revealed alterations in the sEMG activity of the hip and local thigh muscles in the operated and non-operated limbs during mini-squatting with opened eyes and closed eyes (p<0.05). ACL reconstruction surgery with a doubled ST/G autograft may promote immediate changes in lower limb muscle activation of the operated and non-operated limb.

Effects of step lengths on biomechanical characteristics of lower extremity during split squat movement.

Objective: To quantify the effects of increasing the step length of the split squat on changes in kinematics, kinetics, and muscle activation of the lower extremity. Methods: Twenty male college students participated in the test (age: 23.9 ± 3.7, height: 175.1 ± 4.9). Data on kinematics, kinetics, and EMG were collected during split squat exercise at four different step lengths in a non-systematic manner. One-way repeated measurements ANOVA were used to compare characteristic variables of peak angle, moment, and RMS among the four step length conditions. Results: The step length significantly changes the peak angles of the hip (p = 0.011), knee (p = 0.001), ankle (p < 0.001) joint, and the peak extension moment of the hip (p < 0.001), knee (p = 0.002) joint, but does not affect the ankle peak extension moment (p = 0.357) during a split squat. Moreover, a significant difference was observed in the EMG of gluteus maximus (p < 0.001), vastus medialis (p = 0.013), vastus lateralis (p = 0.020), biceps femoris (p = 0.003), Semitendinosus (p < 0.001), medialis gastrocnemius (p = 0.035) and lateralis gastrocnemius (p = 0.005) during four step lengths, but no difference in rectus femoris (p = 0.16). Conclusion: Increases in step length of split squat had a greater activation on the hip extensor muscles while having a limited impact on the knee extensor muscles. The ROM, joint moment, and muscle activation of the lead limb in the split squat all should be considered in cases of individual preventative or rehabilitative prescription of the exercise. Moreover, the optimal step length for strength training in healthy adults appears to be more suitable when it is equal to the length of the individual lower extremity.

Long-Term Effects of Whole-Body Vibration on Hind Limb Muscles, Gait and Pain in Lame Dogs with Borderline-to-Severe Hip Dysplasia-A Pilot Study.

This pilot study aimed to evaluate the long-term effects of Whole-Body Vibration (WBV) on hind limb muscles, gait and pain in lame dogs with borderline-to-severe hip dysplasia. Ten lame client-owned dogs with borderline-to-severe hip dysplasia, aged from 1.5 to 9.0 years and weighing 14.5 to 53.0 kg, were enrolled. The WBV training program consisted of 15 min sessions three times weekly for 16 weeks. Muscles of the hind limbs were evaluated using measurements of thigh circumference, the cross-sectional thickness of selected hind limb muscles by ultrasound assessment, and vastus lateralis muscle activity determined by surface electromyography (EMG). Lameness and clinical signs of pain were assessed by visual lameness scoring, orthopedic examination and an owner-based questionnaire. Kinetic analysis was performed by using a pressure-sensitive walkway. Manual thigh circumference measurements of both hind limbs showed significant increases over the trial period with a greater degree of change observed after week 8. Ultrasound measurements of the left gluteal muscles and the quadriceps femoris muscles of both hind limbs showed significant increases in the cross-section thickness post WBV. Owner's perception of pain also showed a decrease in signs of pain at week 12 and week 16 compared to baseline. Based on graphs of the EMG activity patterns of the vastus lateralis muscle, 65% of the hind limbs had an improvement after 48 WBV sessions when compared to pre-session patterns. However, no significant differences were observed in visual lameness evaluation and kinetic analysis. Therefore, further studies will help to better clarify the role of WBV in canine rehabilitation protocols.

Gluteal Muscle Fatty Atrophy: An Independent Risk Factor for Surgical Treatment in Elderly Patients Diagnosed with Type-III Fragility Fractures of the Pelvis.

Gluteal muscle fatty atrophy (gMFA) might impair pelvic stability and negatively influence remobilization in patients with fragility fractures of the pelvis (FFP). This study aimed to investigate the association between gMFA and surgical indication in patients with FFP. A retrospective analysis of 429 patients (age ≥80) diagnosed with FFP was performed. gMFA of the gluteus maximus, medius, and minimus was evaluated using a standard scoring system based on computer tomography images. No significant difference was found in gMFA between genders or among FFP types. The severity of gMFA did not correlate with age. The severity of gMFA in the gluteus medius was significantly greater than in the gluteus maximus, whereas the most profound gMFA was found in the gluteus minimus. gMFA was significantly more severe in patients who underwent an operation than in conservatively treated patients with type-III FFP, and an independent correlation to surgical indication was found using logistic regression. Our findings imply that gMFA is an independent factor for surgical treatment in patients with type-III FFP. Besides focusing on the fracture pattern, the further evaluation of gMFA could be a feasible parameter for decision making toward either conservative or surgical treatment of type-III FFP.

Effect of continuous and intermittent blood flow restriction deep-squat training on thigh muscle activation and fatigue levels in male handball players

We aimed to investigate acute changes before and after low-intensity continuous and intermittent blood flow restriction (BFR) deep-squat training on thigh muscle activation characteristics and fatigue level under suitable individual arterial occlusion pressure (AOP). Twelve elite male handball players were recruited. Continuous (Program 1) and intermittent (Program 2) BFR deep-squat training was performed with 30% one-repetition maximum load. Program 1 did not include decompression during the intervals, while Program 2 contained decompression during each interval. Electromyography (EMG) was performed before and after two BFR training programs in each period. EMG signals of the quadriceps femoris, posterior femoral muscles, and gluteus maximus, including the root mean square (RMS) and normalized RMS and median frequency (MF) values of each muscle group under maximum voluntary contraction (MVC), before and after training were calculated. The RMS value under MVC (RMSMVC) of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and gluteus maximus (GM) decreased after continuous and intermittent BFR training programs, and those of the biceps femoris (BF) and semitendinosus (SEM) increased; The RMS standard values of the VL, BF, and SEM were significantly increased after continuous and intermittent BFR training (P < 0.05), The RMS value of GM significantly decreased after cuff inflating (P < 0.05). The MF values of RF, VM, VL, and GM decreased significantly after continuous BFR training (P < 0.05). Continuous BFR deep-squat training applied at 50% AOP was more effective than the intermittent BFR training program. Continuous application of BFR induces greater levels of acute fatigue than intermittent BFR that may translate into greater muscular training adaptations over time.

A comparison between therapeutic effects of Salvia Officinalis. Extract, meloxicam and dexamethasone following acute sciatic nerve injury due to analgesic drug injection in rats

BackgroundAn intramuscular (IM) injection into gluteal muscle can lead to iatrogenic trauma to sciatic nerve. The drugs can be injected directly into sciatic or into the tissue adjacent to the nerve. Besides the direct damage to nerve due to needle and drug entrance to nerve tissue, the chemical nature of each drug activates immune system near healthy peripheral nerves in order to remove damaged tissues and start healing process. This immune system response has a great role in creating pathological pain and it makes functional recovery as a major challenge. Material methodIn this study, 25 adults male Fischer- Wistar rats were used. An analgesic drug (diclofenac) was injected in the muscles near sciatic nerve (4 groups) and also in sciatic nerve (1 group, nerve control group). For clinical assessment of sciatic nerves integrity, sciatic functional index test (SFI test) was done before, 1 day and 7 days after surgery. Treatments with meloxicam, dexamethasone and extract of Salvia Officinalis were started for 3 muscle groups and 1 group remained as a control muscle group. After 1 week, all the animals were euthanized under deep anesthesia and the sciatic nerves with surrounding muscles were removed and sent to histopathological examination. Resultsall three treatment groups showed decreased inflammatory process and increased repair regeneration in compare to control group. Although, the amount recovery in the dexamethasone group was significantly higher in compared to the control and other treatment groups. ConclusionThis study showed That IM injection of analgesic drug (Diclofenac), without direct damage to sciatic nerve, causes activation of the immune system and iatrogenic sciatic neuropathy. This study also showed therapeutic effects of two common drugs (NSAID and corticosteroids) and an extract of Salvia Officinalis. Treatment with all three drugs, decreased inflammatory response at injury site and increased recovery but Long-term usage of corticosteroids and NSAIDs can be challenging. The Salvia extract also have showed acceptable improvement effects with minimal side effects.

Osteomyelitis of the Ischium in a Hemodialysis Dependent Adult – A Rare Case Report

Introduction: Osteomyelitis of the pelvis is rare, and the correct diagnosis may be missed during the early stage when the correct treatment would be most beneficial. Osteomyelitis requires multidisciplinary treatment to cure or control symptoms. Case Presentation: A 71-year-old woman, with end stage renal disease on hemodialysis, presented in emergency department for purulent drainage of a right buttock swelling. A pelvic computer tomography (CT) revealed a collection of the gluteal musculature and an activated chronic osteomyelitis with one osteolytic lesion on right ischiopubic branch. The patient underwent surgical treatment, with need of two interventions. First, she was only submitted to surgical drainage of the abscess. She completed a cycle of antibiotic therapy, with good response. Two months later, she returns with fever and drainage of the surgical wound. A pelvic CT showed an area of bone destruction at right ischium, with an increase in bone sequestration. She underwent a partial orchiectomy and surgical debridement of necrotic tissues. A Klebsiella oxytoca, Proteus mirabilis and multidrug-resistant Staphylococcus epidermidis was isolated. She was on antibiotic therapy for 4 months. Three years later, she remains without new symptoms or signs of active osteomyelitis. Conclusion: Pelvic osteomyelitis represents a diagnostic challenge, because the symptoms and signs vary, depending on the initial site of infection, its duration and the direction of its spread. Osteomyelitis of the ischium is generally diagnosed in the late stage with complications. Treatment of pelvic osteomyelitis is challenging due to the anatomic constraints of the pelvis and the high degree of comorbidity in affected patients. A multidisciplinary approach is often required. This case of a chronic abscess with osteomyelitis of the ischium is rare and was neglected for months because of the absence of constitutional symptoms in a hemodialysis dependent woman.

Evaluation of lumbar and hip movement characterization and muscle activities during gait in patients with knee osteoarthritis

Patients with knee osteoarthritis (KOA) might have gait deviations, but few previous studies have discussed gait compensatory movements of the proximal and distal parts of muscle groups related to KOA. The study aimed to measure lumbar and hip movements during gait test and collect muscle activities of the lower extremities. Thirty-four participants with KOA and 28 healthy participants aged over 50 years were recruited for this study. Lumbar and hip motions during walking test were measured using inertial measurement units. Four muscle groups of the lower extremity (erector spinae, gluteus maximus, quadriceps muscle, and gastrocnemius) activities in gait were collected using surface EMGs. KOA patients used an 2.12∘anterior inclined lumbar spine (p = 0.007) and 22.94∘ flexed hip (p = 0.001) in gait compared to healthy participants. The KOA patients had a small hip movement range 30.19∘(p = 0.001) and a higher asymmetric stance time ratio 0.39 (p = 0.006). Patients with KOA showed decreased erector spinae and gluteus maximus muscle activation and increased activation of the quadriceps and gastrocnemius muscles during gait. In conclusion, patients with KOA used a hyperlordotic lumbar and hip flexed strategy, which overactivates distal extensor muscles through the whole gait and might cause overstress on the lower extremity joints.

Safety and Feasibility of Functional Repetitive Neuromuscular Magnetic Stimulation of the Gluteal Muscles in Children and Adolescents with Bilateral Spastic Cerebral Palsy.

Background: For children and adolescents affected by bilateral spastic cerebral palsy (BSCP), non-invasive neurostimulation with repetitive neuromuscular magnetic stimulation (rNMS) combined with physical exercises, conceptualized as functional rNMS (frNMS), represents a novel treatment approach. Methods: In this open-label study, six children and two adolescents (10.4 ± 2.5 years) with BSCP received a frNMS intervention targeting the gluteal muscles (12 sessions within 3 weeks). Results: In 77.1% of the sessions, no side effects were reported. In 16.7%, 6.3% and 5.2% of the sessions, a tingling sensation, feelings of pressure/warmth/cold or very shortly lasting pain appeared, respectively. frNMS was highly accepted by families (100% adherence) and highly feasible (97.9% of treatment per training protocol). A total of 100% of participants would repeat frNMS, and 87.5% would recommend it. The Canadian Occupational Performance Measure demonstrated clinically important benefits for performance in 28% and satisfaction in 42% of mobility-related tasks evaluated by caregivers for at least one follow-up time point (6 days and 6 weeks post intervention). Two patients accomplished goal attainment for one mobility-related goal each. One patient experienced improvement for both predefined goals, and another participant experienced improvement in one and outreach of the other goal as assessed with the goal attainment scale. Conclusions: frNMS is a safe and well-accepted neuromodulatory approach that could improve the quality of life, especially in regard to activity and participation, of children and adolescents with BSCP. Larger-scaled studies are needed to further explore the effects of frNMS in this setting.

Longitudinal changes in magnetic resonance imaging biomarkers of the gluteal muscle groups and functional ability in Duchenne muscular dystrophy: a 12-month cohort study

BackgroundQuantitative magnetic resonance imaging (MRI) is considered an objective biomarker of Duchenne muscular dystrophy (DMD), but the longitudinal progression of MRI biomarkers in gluteal muscle groups and their predictive value for future motor function have not been described.ObjectiveTo explore MRI biomarkers of the gluteal muscle groups as predictors of motor function decline in DMD by characterizing the progression over 12 months.Materials and methodsA total of 112 participants with DMD were enrolled and underwent MRI examination of the gluteal muscles to determine fat fraction and longitudinal relaxation time (T1). Investigations were based on gluteal muscle groups including flexors, extensors, adductors, and abductors. The North Star Ambulatory Assessment and timed functional tests were performed. All participants returned for follow-up at an average of 12 months and were divided into two subgroups (functional stability/decline groups) based on changes in timed functional tests. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with future motor function decline.ResultsFor the functional decline group, all T1 values decreased, while fat fraction values increased significantly over 12 months (P<0.05). For the functional stability group, only the fat fraction of the flexors and abductors increased significantly over 12 months (P<0.05). The baseline T1 value was positively correlated with North Star Ambulatory Assessment and negatively correlated with timed functional tests at the 12-month follow-up (P<0.001), while the baseline fat fraction value was negatively correlated with North Star Ambulatory Assessment and positively correlated with timed functional tests at the 12-month follow-up (P<0.001). Multivariate regression showed that increased fat fraction of the abductors was associated with future motor function decline (model 1: odds ratio [OR]=1.104, 95% confidence interval [CI]: 1.026~1.187, P=0.008; model 2: OR=1.085, 95% CI: 1.013~1.161, P=0.019), with an area under the curve of 0.874.ConclusionFat fraction of the abductors is a powerful predictor of future motor functional decline in DMD patients at 12 months, underscoring the importance of focusing early on this parameter in patients with DMD.

The immediate effect of synergistic muscles kinesio taping on function and balance of volleyball players with functional ankle instability: A randomized controlled trial

ObjectivesTo determine the immediate effect of synergistic muscles Kinesio taping (KT) on the function and balance of volleyball players with functional ankle instability (FAI). DesignParallel, superiority randomized controlled trial. MethodsTwenty-six semi-professional volleyball players with FAI were randomly assigned to either the intervention or control group. All participants received KT of fibularis longus, gastrocnemius, and gluteus maximus muscles for one session. The intervention group received KT with 35 % tension, while the control group received KT without tension. The function was assessed using the side hop and single hop distance tests. Dynamic balance was assessed with the Y Balance test. The outcomes were measured at baseline, 20 min after KT, and 24 h after KT. Statistical analyses were performed using Mixed-model repeated measures analysis of variance (ANOVA) and one-way ANOVA. ResultsThe interactions of time*group for the outcomes of function using the single hop test and stability in the anterior direction of the Y Balance test were significant (p < 0.05). Within-group comparisons showed after KT, both groups experienced significant improvements in all outcomes compared to the baseline. Results of between-group comparisons revealed that the application of KT with tension compared to no tension significantly improved function and balance in the anterior of the Y Balance test. ConclusionsKinesio taping can be an effective treatment option to improve function and balance in FAI. Additionally, Kinesio taping with tension compared to KT without tension had superiority.

Associations of Quantitative and Qualitative Muscle Parameters With Second Hip Fracture Risk in Older Women: A Prospective Cohort Study.

Older women with a first hip fracture exhibit heightened susceptibility and incidence of second fracture and potentially severe consequences. This prospective study was to compare the predictive power of qualitative and quantitative muscle parameters for a second hip fracture in older women with a first hip fracture. A total of 206 subjects were recruited from the longitudinal Chinese Second Hip Fracture Evaluation study. Hip computed tomography (CT) scans were obtained immediately after the first fracture. Muscle fat infiltration was assessed according to the Goutallier classification qualitatively. Quantitative parameters included cross-sectional area and density of gluteus maximus (G.MaxM) and gluteus medius and minimus (G.Med/MinM) muscles. CT X-ray absorptiometry was used to measure the areal bone mineral density (aBMD) of the contralateral femur. Cox proportional hazards models were used to compute hazard ratios (HR) of second hip fracture risk. The mean age of subjects was 74.9 (±9.5) years at baseline. After 4.5 years, 35 had a second hip fracture, 153 without a second hip fracture, and 18 died. Except for the combined G.MinM Goutallier grade 3 and 4 groups before adjustment for covariates (HR = 5.83; 95% confidence interval [CI] 1.49-22.83), there were no significant HRs for qualitative classification to predict a second hip fracture. Among quantitative metrics, after adjustment for covariates, G.Med/MinM density was significant in the original (HR = 1.44; CI 1.02-2.04) and competing risk analyses (HR = 1.46; CI 1.02-2.07). After additional adjustment for femoral neck (FN) aBMD, G.Med/MinM density remained borderline significant for predicting a second hip fracture in competing risk analysis (HR = 1.43; CI 0.99-2.06; p = 0.057). Our study revealed that Goutallier classification was less effective than quantitative muscle metrics for predicting hip second fracture in this elderly female cohort. After adjustment for FN aBMD, G.Med/MinM density is a borderline independent predictor of second hip fracture risk. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Gluteus Maximus Transfer for Irreparable Hip Abductor Deficiency: A Systematic Review and Meta-Analysis

BackgroundGluteus maximus tendon transfer has recently been described as a treatment option for irreparable abductor tendon tears. The purpose of this study was to systematically review outcomes following gluteus maximus tendon transfer for hip abductor deficiency. MethodsThe published literature was queried for outcomes following gluteus maximus transfer in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcomes of interest included preoperative and postoperative functional scores, resolution of pain and gait abnormalities, postoperative rehabilitation protocols, surgical complications, reoperation rates, and postoperative magnetic resonance imaging. In total, 10 studies with a total of 125 patients (76% women) with a mean age of 67 years (range, 30 to 87) were identified for inclusion. ResultsModified Harris Hip Score (+30.1 ± 6.6 [95% confidence interval: +15.5 to +46.5]) and Visual Analog Scale for pain (−4.1 ± 1.1 [95% confidence interval: −7.1 to −1.0]) were improved following gluteus maximus transfer, compared to preoperative levels. No significant improvement was noted in abduction strength and 33% of patients demonstrated a residual Trendelenburg gait postoperatively. The overall complication rate was 5.6% (7 of 125), with a reoperation rate of 1.6% (2 of 125). ConclusionsGluteus maximus tendon transfer for abductor insufficiency has demonstrated reliable outcomes at 3 years, with improvement in hip function and pain. However, patients demonstrate modest improvements in abduction strength, and a significant subset will continue to demonstrate a Trendelenburg gait postoperatively.

MRI quantitative muscle characterization in children with X-linked hypophosphatemia

IntroductionChildren with X Linked Hypophosphatemia (XLH) suffer from carential ricket, bone deformities and lameness. No previous study demonstrated a morphological distinction in muscles in these patients. The aim of this prospective study was to characterize, using Magnetic Resonance Imaging (MRI), the muscle morphology of pelvis, thigh and leg in children with XLH and to compare it with typically developed (TD) children. HypothesisWe hypothesized that lower limbs muscles in children with XLH are different from TD children and could explain limp walking. Material and methodsThree-dimensional reconstructions of the muscles were performed in 11 patients with XLH and 15 TD children. Muscle lengths, sections and volumes were calculated and normalized with height and weight. Mean age was 10. ResultsLengths were all smaller in children with XLH except for the Medius/minimus gluteus muscles (p=0.64). The difference seemed higher in muscles with a long tendinous part as semitendinosus (0.139 vs 0,164; p<0.01). All volumes were significantly inferior in children with XLH. This preliminary study showed significant differences in muscle structures between patients with XLH and TD children. DiscussionMedius/minimus gluteus seemed to be particularly developed in children with XLH. Nevertheless it is not possible to conclude if it is related to XLH or a consequence of bone deformities. Level of proofIV.

The use of gluteus maximus to restore the function of the pelvic diaphragm in the reconstruction of the pelvic outlet after abdomino-perineal resection: a case series

The use of gluteus maximus to restore the function of the pelvic diaphragm in the reconstruction of the pelvic outlet after abdomino-perineal resection: a case series