Hamstring Length Research Articles

Comparison of Medial Hamstring Length Between Harvesting Methods Using Anterior and Posterior Approaches.

Medial hamstring tendons harvesting can be performed through either an anterior or a posterior approach. It has been suggested that using a posterior approach may result in a longer length of harvestable tendon compared with an anterior approach. There would be no difference in the length of the harvestable tendon between the anterior and posterior approaches. Case-control study; Level of evidence, 3. A retrospective study was conducted at the primary institution using prospectively collected data from skeletally mature Chinese patients who underwent medial hamstring tendons harvesting between January 2008 and December 2021. Patients were excluded if they had experienced graft harvesting complication or if only 1 medial hamstring tendon was harvested. One-to-one exact matching was performed between the 2 approaches based on body height and sex. The outcome assessed was the length of the harvested tendon. A total of 536 patients underwent medial hamstring tendons harvesting using an anterior approach, while 58 underwent it using a posterior approach, all of whom met the inclusion criteria. A group of 54 matched pairs were identified. The length of the harvested semitendinosus tendon was 263 ± 29 mm in the anterior approach and 256 ± 28 mm in the posterior approach (P = .09; Student t test). The mean difference in the length of the harvested semitendinosus tendon between the 2 approaches was 7 mm. The length of the gracilis tendon was 226 ± 29 mm and 223 ± 29 mm in the anterior approach and the posterior approach, respectively (P = .30; Student t test). In a retrospective 1:1 case-control study with exact matching of body height and sex, it was found that there was no difference in the length of the semitendinosus tendon and the gracilis tendon harvested using a posterior approach compared with an anterior approach. The mean difference between the 2 approaches was 7 mm for the semitendinosus tendon and 3 mm for the gracilis tendon, respectively.

Optimal cut-off values of the active knee extension test for diagnosing hamstring tightness

BackgroundActive knee extension (AKE) is widely used to assess hamstring length, and an 'AKE >20°' is often used as the criterion for diagnosing tightness. However, the scientific evidence for this is unclear. ObjectiveThis study measured and analysed AKE according to sex in two groups with different exercise participation levels to identify the appropriateness of current criteria. MethodsIn the supine position, 90° flexion of the hip and knee joints was performed. The maximal knee extension was measured using a goniometer. Cut-off values for diagnosing hamstring tightness were calculated in three different ways as 'mean-1SD', 'mean-2SD', and 'mean-3SD'. ResultsThere were significant differences in AKE between groups and between sexes. In group A, representing normal healthy adults, cut-off values defined as mean-1SD and mean-2SD were 33.5° and 19.7° in male participants and 28.0° and 15.7° in female participants, respectively. There was a weak correlation between AKE and body mass index, but not between AKE and height and between AKE and weight. ConclusionThis study found that the level of exercise participation significantly affects AKE, and female participants consistently had high flexibility regardless of exercise participation. Therefore, the current cut-off value, widely used in research and clinical settings, may not be a suitable criterion for diagnosing hamstring tightness.

Increasing Hamstring Range of Motion via Plantar Myofascial Release: A Critically Appraised Topic

Context: The concept of anatomical fascial trains and myofascial release are heavily researched topics independently. However, few studies have determined if myofascial release of remote areas can cause lengthening throughout more distal aspects of these fascial trains. Clinical Question: In healthy individuals, what is the effect of myofascial release on the plantar aspect of the foot in improving flexibility and hamstring length as determined by a sit-and-reach test? Clinical Bottom Line: The usage of myofascial release on the plantar aspect of the foot via a firm object has been shown to improve sit-and-reach distance. Each article included for analysis utilized similar methods of instructing self-myofascial release with regard to time as well as type of object used for the intervention. Though this was consistent between studies, the authors should have implemented secondary outcome measures. Despite the limitations to each of the studies analyzed, there is a Strength of Recommendation Taxonomy (SORT) Level B evidence to support the implementation self-myofascial release to the plantar fascia. This intervention should be considered a concurrent option for individuals with range of motion deficits or fascial restrictions in the upper thigh.

Lumbar and Cervical Concurrent Muscle Activity Analysis During Hamstring Length Testing to Design a Customized Treatment Plan: An Observational Cross-Sectional Study.

Hamstring length plays a significant role in a spectrum of clinical entities, from injury prevention and gait dysfunction to posture correction. Evidence suggests that the prevalence of hamstring tightness (HT)/reduced length is increasing. Despite the number of available tests and treatment protocols, HT is still a functional diagnosis. This study's primary goal is to evaluate concurrent muscle (CM) usage during these testing procedures to design a unique, customized treatment protocol. The study was conducted in two stages. In phase 1, Active Straight Leg Raise (ASLR), Active Total Knee Extension (ATKE), and Active Seated Total Knee Extension (ASTKE) were carried out. Next, two pressure gauges (PGs) were placed to align with the natural lumbar and cervical curvatures while testing ASLR and ATKE. After analyzing the results for pressure gauge placement, phase 2 data were collected for tests ASLR and ATKE with PG. The results of ASLR and ATKE, both with and without PG, indicate a high prevalence rate, whereas the results of ASTKE show no prevalence. Changes in the PG values indicate CM usage. Dichotomization revealed that participants with normal test scores (non-HT group) had increased usage of CM work. Positive and negative changes in PG indicate the involved CM group. In regular practice, most healthcare professionals and fitness trainers prefer ASTKE due to the ease of the testing procedure. Directing co-professionals on their choice of tests is challenging, whereas providing knowledge about CM use paves the way for creating customized treatment plans.

Knee and ankle range of motion and spasticity from childhood into adulthood: a longitudinal cohort study of 3,223 individuals with cerebral palsy.

Reduced range of motion (ROM) and spasticity are common secondary findings in cerebral palsy (CP) affecting gait, positioning, and everyday functioning. These impairments can change over time and lead to various needs for intervention. The aim of this study was to analyze the development path of the changes in hamstring length, knee extension, ankle dorsiflexion, and spasticity in hamstrings and gastrosoleus from childhood into adulthood in individuals with CP at the Gross Motor Function Classification System (GMFCS) levels I-V. A longitudinal cohort study was undertaken of 61,800 measurements in 3,223 individuals with CP, born 1990-2017 and followed for an average of 8.7 years (range 0-26). The age at examination varied between 0 and 30 years. The GMFCS levels I-V, goniometric measurements, and the modified Ashworth scale (MAS) were used for repeated assessments of motor function, ROM, and spasticity. Throughout the follow-up period, knee extension and hamstring length exhibited a consistent decline across all individuals, with more pronounced decreases evident in those classified at GMFCS levels III-V. Ankle dorsiflexion demonstrated a gradual reduction from 15° to 5° (GMFCS I-IV) or 10° (GMFCS V). Spasticity levels in the hamstrings and gastrosoleus peaked between ages 5 and 7, showing a propensity to increase with higher GMFCS levels. Passive ROM continues to decrease to 30 years of age, most pronouncedly for knee extension. Conversely, spasticity reached its peak at a younger age, with a more notable occurrence observed in the gastrosoleus compared with the hamstrings. Less than 50% of individuals had spasticity corresponding to MAS 2-4 at any age.

The effect of chronic leg press exercises on hamstring muscle length and different vertical jump performance

Background and Study Aim. As it is known, chronic resistance exercises cause limitations in some joints and this negatively affects the normal range of motion. In the present study, it was aimed to analyse the quadriceps-hamstring balance by analysing different vertical jump performances after six weeks of leg press exercise. Material and Methods. Eleven university students aged between 18-30 years were included in this study. The hamstring muscle length, 1 repetition maximum (1-RM) leg press performance were analysed before and after six weeks of leg press exercise. In addition, the vertical jump performances of the participants were analysed with My Jump 2 software programme. In this study, counter movement jumps (CMJ) and squat jump (SJ) performances of the participants were determined. Results. According to the findings, 1 repetition maximum (1-RM) leg press performance and hamstring length of the participants improved significantly (t=-7.609, ES: -2.29, p<.001; t=-2.540, -0.76, p=.029, respectively). CMJ and SJ parameters of the participants did not change (p<0.05). It was concluded that the lengthened hamstring length after the leg press exercise programme had a positive relationship with vertical jump height (r=0.656, p=0.028), flight duration (r=0.663, p=0.026), speed (r=0.657, p=0.028), and average speed (r=0.669, p=0.024). These relationships were observed among CMJ parameters following the exercise programme. Likewise, a positive correlation was found between hamstring length, which lengthened after the leg press exercise programme, and vertical jump height (r=0.625, p=0.040), flight duration (r=0.646, p=0.032), speed (r=0.646, p=0.032), and average speed (r=0.637, p=0.035). These correlations were identified among the SJ parameters after the exercise. Conclusions. As a result, it was determined that chronic leg press exercises positively affected hamstring muscle length and muscle strength. Different vertical jump performances such as CMJ and SJ did not change. However, the relationship between hamstring length and vertical jump parameters is interesting.

Effects of Static Hamstring Stretching on Maximal Sprint Speed and Relationship With Nordic Hamstring Strength.

This study aimed to determine the acute effects of static stretching of the hamstrings on maximal sprint speed and its spatiotemporal variables and lower-limb kinematics during the late swing phase, as well as the relationship with Nordic hamstring strength. The study had a within-participant experimental design. Sixteen healthy male college sprinters were asked to sprint 80m without static stretching and with static stretching of the hamstrings for 4 × 30s per leg before the sprint; both conditions were counterbalanced. The knee flexion peak torque was measured using the Nordic hamstring. The differences between no static stretching and static stretching as well as their relationship with Nordic hamstring strength were investigated. The results showed that the touchdown distance (p = .036) significantly increased following static stretching. Although not significant, maximal sprint speed decreased (p = .086), and the theoretical hamstring length (difference between knee angle and hip angle) at ipsilateral touchdown was greater (p = .069) following static stretching. In addition, a lower peak torque of the Nordic hamstring resulted in a more significant decrease in maximal sprint speed following static stretching. Therefore, static stretching of the hamstring just before sprinting may increase the theoretical hamstring length during the late swing phase at maximal sprint speed and induce kinematics that increases the hamstring strain injury risk. Moreover, it is suggested that improving the Nordic hamstring strength may help minimize the negative effects of static stretching on the hamstrings.

Effects of hamstring stretching using pressure bio feedback unit in patients with low back pain

Background: Hamstring tightness can alter lumbar posture, impact pelvic alignment, and exacerbate low back pain. It's important to research whether hamstring stretches with a pressure biofeedback unit work for those with low back pain. Objectives: To determine the effects of hamstring stretching using a pressure biofeedback unit in patients with low back pain. Methodology: A total of n=38 Male and female subjects between the ages of 25-40 years, with >3 months history of low back pain having bilateral hamstring shortening less than 70O, and (ODI) score between 20% to 40% were enrolled in the study. The data was collected from Railway General Hospital and randomly assigned into 2 groups. Group A (n=18) received Active Hamstring stretch with a pressure biofeedback unit (PBU). Group B (n=19) received only Active Hamstring stretch without PBU Outcome measures such as pain, hamstring length, and ODI score were measured at baseline, after the second and fourth weeks. The data was entered and evaluated by using SPSS-25. Results: The results of this study showed no significant difference between group A and group B for ODI individual items as well as ODI overall score p≥0.05. Moreover, no significant difference in NPRS score p≥0.05. however, it showed a significant difference (p<0.05) in hamstring muscle length on both legs p<0.01. Conclusion: It is concluded that hamstring stretching using a PBU causes a greater improvement in the flexibility of hamstring muscles as compared to the flexibility of hamstrings when stretched without PBU. Keywords: flexibility; hamstring muscle; low back pain; pressure bio feedback. ClinicalTrials.gov Identifier: NCT05059496

Effect of knee pain on muscles imbalance and physical limitation in individuals with bilateral knee osteoarthritis: A comparative cross-sectional study

Objectives: When osteoarthritis (OA) affects the knee, it causes muscle imbalance and physical limitations. This study aimed to determine the impact of knee pain on quadriceps strength, hamstring length, and physical limitations in individuals with bilateral knee OA. Methods: A cross-sectional study at Khyber Teaching Hospital and Northwest General Hospital, Peshawar, included individuals aged 50–65, who met the American College of Rheumatology criteria. Subjects diagnosed with bilateral knee OA (grade II or greater on the Kellgren–Lawrence grading scale) and experiencing pain in both knees (numeric pain rating scale [NPRS] score ≥ 1) were selected through purposive sampling (n = 70). Data collection involved the NPRS, modified belt stabilizer hand-held dynamometer, active knee extension test, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) Urdu version questionnaire. Measurements from both knees assessed quadriceps muscle strength, hamstring length, and physical limitations. Results: The median interquartile range (IQR) of quadricep strength for the more painful knee was 0.53 (0.36) Nm/kg and 1.35 (0.34) Nm/kg for the less painful knee showing a significant difference in quadriceps strength (P < 0.01). In terms of hamstring length, the more painful knee had a median (IQR) of 29.0 (2.0) degrees whereas the less painful knee recorded 11.0 (6.0) degrees indicating a significant difference (P < 0.01). Likewise, there was a significant difference in WOMAC scores between the less painful and more painful knees (P < 0.01). Conclusion: This study found that individuals experiencing more knee pain demonstrated decreased quadriceps muscle strength and increased hamstring muscle tightness. In addition, those with more painful knees exhibited greater physical limitations in bilateral knee OA.

Comparing the immediate effects of different neural mobilization exercises on hamstring flexibility in recreational soccer players.

Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Increased tension in the neural structures is a known causative factor for hamstring tightness for which neural mobilization has emerged as a significant adjunct to routine stretching techniques. To compare the short-term effects of neural sliding and neural tensioning on hamstring length in male recreational soccer players with hamstring tightness. Sixty-two participants between ages 18 and 30 years were randomly assigned to one of the two groups viz. neural sliding or neural tensioning. Participants in either group performed the given stretching protocol in three sets. The Active Knee Extension Test (AKET) and Sit and Reach Test (SRT) were recorded before intervention, immediately after intervention, and after 60 min. between- and within group-analysis was done using analysis of variance. Between-group analysis showed that neural tensioning was more effective than neural sliding in improving hamstring length on both measures, however this difference was negligible. Within-group analysis demonstrated that the mean post-test scores on the AKET test and SRT were significantly greater than the pre-test scores in both groups (). A reduction in the post-test scores was observed after 60 min, irrespective of the type of stretching (). There was no difference in short-term effects of neural sliding or neural tensioning on hamstring flexibility in male recreational soccer players. Both groups showed improved flexibility immediately after the intervention with reduction in the effect after 60 min.

Pelvic Tilt in Adults With Cerebral Palsy and Its Relationship With Prior Hamstrings Lengthening.

Current studies assessing the change in pelvic tilt for ambulatory patients with cerebral palsy (CP) after surgical hamstring lengthening (SHL) lack a comparison cohort without prior SHL and are limited to younger patients. This study presents gait data of middle-aged adults with CP, primarily focusing on the pelvis, and compares pelvic tilt, trunk tilt, and knee flexion between those with and without prior SHL. A consecutive series of 54 adults with CP, a mean age of 36±13 years, and Gross Motor Function Classification System (GMFCS) levels I-III were included. Thirty-two (59%) had SHL performed at a mean age of 8±5 years. Three-dimensional gait analysis data prospectively collected at a mean of 28±14 years postoperatively were retrospectively analyzed. Chi-square tests were used to compare demographic and surgical history data and statistical parameter mapping was used to compare knee flexion during stance and pelvic and trunk tilts during the gait cycle between SHL and SHL-naive groups. Age, GMFCS level, sex, race, topography, and ethnicity were not different between the groups (P=.217-.612). Anterior pelvic tilt throughout gait was significantly greater in the SHL group compared with the SHL-naive group (63%-87%; P=.033). This difference was augmented after accounting for other surgical history and revision SHL (0%-32%, P=.019; and 46%-93%, P=.007). Within a cohort of adults with CP, GMFCS levels I-III, and a mean age of 36 years, those with a history of SHL, performed a mean of 28 years prior to 3-dimensional gait analysis, walked with increased anterior pelvic tilt compared with those without a history of SHL. [Orthopedics. 2024;47(5):270-275.].

Comparison of Percutaneous Versus Open Hamstring Lengthening in Patients of Spastic Diplegic Cerebral Palsy - A Randomized Controlled Trial.

Cerebral palsy (CP) often manifests with crouch gait due to hamstring spasticity, necessitating surgical intervention like hamstring lengthening surgery. Percutaneous techniques are emerging as an alternative to traditional open approaches in orthopedic surgeries. This randomized controlled trial aimed to compare the outcomes of percutaneous hamstring lengthening (pHSL) versus open hamstring lengthening (oHSL) in pediatric patients with spastic diplegic CP, focusing on improvements in gait and knee function. One hundred children diagnosed with spastic diplegic CP were randomized into pHSL (n = 50) and oHSL (n = 50) groups. Surgical procedures were performed using single-event multilevel surgery techniques. Pre-operative and post-operative assessments included range of motion, popliteal angle, gross motor function classification system (GMFCS) score, and gait analysis (functional independence measure [FIM], observational gait scale [OGS], physician gait scale). Statistical analyses were conducted using Statistical Packages for the Social Sciences v25. Both pHSL and oHSL groups showed significant improvements in popliteal angle and GMFCS scores postoperatively (P < 0.001 within each group). However, there were no significant differences between the groups in terms of these outcomes (P > 0.05). FIM, OGS, and physician gait scale also showed comparable improvements between groups (P > 0.05). pHSL is as effective as oHSL in improving gait and knee function in pediatric patients with spastic diplegic CP. The percutaneous approach offers a safe and efficient alternative to traditional open surgery, potentially minimizing muscle damage and promoting quicker recovery.

"Coronal Split/Overlap Repair" Patellar Tendon Shortening in Skeletally Immature Patients.

"Coronal split/overlap repair" patellar tendon shortening (PTS) is a technique that is utilized to treat patella alta and can be combined with distal femoral extension osteotomy (DFEO) for the treatment of crouch gait in skeletally immature patients with cerebral palsy. The patellar tendon is split in the coronal plane. The ventral patellar tendon flap is released from its patellar attachment and is reflected distally over its tibial attachment, exposing a dorsal flap. Two patellar/tibial no. 5 Ethibond (Ethicon) sutures are passed through 2 crossing patellar tunnels and 2 parallel tibial tunnels. The patella is then pushed distally until its distal pole lies at the level of the tibiofemoral joint. The Ethibond sutures are tied and tensioned to the desired level. The knee should be able to be passively flexed to 90°. The intact redundant dorsal flap of the patellar tendon is imbricated. Lastly, the ventral flap is advanced proximally and sutured to the anterior surface of the patella and to the edges of the dorsal flap without shortening. A hinged knee brace is utilized postoperatively with a range of motion of 0° to 30°, progressing to 90° by 6 weeks. No resistive quadriceps contractions are permitted for the first 3 weeks. Patellar tendon advancement in skeletally immature patients can be performed by releasing the tibial attachment and the free end is advanced deep to the T-shaped tibial periosteal flap1-3. Other PTS techniques can be grouped into the categories of (1) patellar tendon imbrication4, (2) patellar tendon detaching techniques in which the tendon is detached from the patellar attachment or cut in its midsubstance and shortened2,5-7, and (3) patellar tendon semi-detaching techniques in which patellar tendon flaps are created and shortened8,9. The presently described technique is a semi-detaching technique, preserving a good part of the patellar tendon while avoiding complete dehiscence of the extensor mechanism. Moreover, the 2 patellar/tibial sutures would protect the patellar tendon repair and allow early rehabilitation and knee range-of-motion exercises. Satisfactory correction of the patella alta was reported with PTS techniques with or without DFEO to correct concomitant fixed flexion deformity in patients with cerebral palsy. Furthermore, there was reported improvement of total knee range of motion with restoration of adequate knee extension during the stance phase1,3,8. Reported complications with this technique were mainly superficial infection. Any substantial fixed flexion deformity of the knee (>10°) should be corrected with hamstring lengthening or DFEO prior to PTS.A mid-patellar coronal split is made with use of a no.-15 blade and extended proximally and distally with use of 2 mosquito clips.To avoid difficulties with crossing of the patellar sutures, always keep the straight needle inside the 1st tunnel until the 2nd tunnel is created and its respective suture is passed.To distalize the patella, the patellar/tibial sutures are tied in a simple knot and held by a mosquito clip in order to allow retensioning until the desired patellar height is reached.The 2 patellar/tibial suture knots are slid to the proximal and distal ends of the surgical field. 3DGA = 3-dimensional gait analysisADL = activities of daily livingCP = cerebral palsyCPM = continuous passive motionDFEO = distal femoral extension osteotomyFAQ = Functional Assessment QuestionnaireFMS = Functional Mobility ScaleGMFCS = Gross Motor Function Classification SystemGMFM = Gross Motor Function MeasureGPS = Gait Profile ScoreGVS = Gait Variable ScoreK-wires = Kirschner wiresPTA = patellar tendon advancementPTS = patellar tendon shorteningSEMLS = single event multi-level surgery.

Effect of Diaphragmatic Breathing Exercise on Hamstring Length and Functional Disability in Subjects with Chronic Low Backache: A Quasi-experimental Study

Effect of Diaphragmatic Breathing Exercise on Hamstring Length and Functional Disability in Subjects with Chronic Low Backache: A Quasi-experimental Study

Anterior Distal Femoral Hemiepiphysiodesis Does Not Change Pelvic Tilt in Children With Cerebral Palsy.

Anterior distal femoral hemiepiphysiodesis (ADFH) is a surgical treatment choice to correct flexed knee gait and fixed knee flexion deformities in children with cerebral palsy who are skeletally immature. Increased anterior pelvic tilt has been reported after surgeries that correct knee flexion deformities, including hamstring lengthening (HSL) and distal femoral extension osteotomies, but anterior pelvic tilt has not been studied after ADFH. We hypothesized that anterior pelvic tilt would increase after ADFH, especially when combined with HSL, and it would correlate with the change in minimum knee flexion in stance and dynamic hamstring lengths. Thirty-four eligible participants (age: 13.0, SD: 2.0) were included. Change in mean pelvic tilt across the gait cycle was compared as a function of clinical and gait parameters using linear mixed models. The relationship of change in pelvic tilt to change in other variables was examined using Pearson correlation. Overall, anterior pelvic tilt increased significantly after ADFH by 4.4 degrees ( P = 0.02). Further, the analysis revealed anterior pelvic tilt only increased significantly in the group that had concurrent HSL (11.1 degrees, P < 0.001). Overall, minimum knee flexion significantly decreased (increase in knee extension) in stance (-19.1 degrees, P < 0.001) and there was an increase in maximum normalized dynamic hamstring lengths (0.03, P < 0.001). The anterior pelvic tilt increased significantly in Gross Motor Function Classification System levels III to IV (5.9 degrees, P = 0.02) but did not change significantly in Gross Motor Function Classification System I to II (2.5 degrees, P = 0.37). Change in pelvic tilt was correlated with change in maximum dynamic hamstring lengths ( r = 0.87, P < 0.0001) and change in minimum knee flexion in stance ( r = -0.71, P < 0.0001). Anterior distal hemiepiphysiodesis without concurrent HSL for flexion knee deformities does not result in increased anterior pelvic tilt. Surgeons should consider anterior distal hemiepiphysiodesis in patients with cerebral palsy and flexed knee gait, who preoperatively have long dynamically modeled hamstrings, are skeletally immature, and when maintenance of pelvic tilt is desired. Level III-retrospective comparative study.

The effects of Q angle and Hamstring Length on Balance Performance in Patients with Lumbar Disc Hernia

Aim: Patellafemoral angle (Q angle) and Hamstring length are important measurements to evaluate balance. This study aims to examine the effects of Q angle and Hamstring length on balance performance in patients with lumbar intervertebral disc herniation (LDH). Material and Methods: LDH (n=32) and control group (CG)(n=30) were included in the study. Q angles and hamstring muscle lengths of the participants were measured. Balance was evaluated with Y balance test. Results: As a result of our study, no difference was found between LDH patients and CG groups in terms of hamstring muscle length; Q angle decreased in LDH patients and there was a negative high correlation between Q angle and R -Anterior, R-Posteromedial, R-Posterolateral values on the right and between Q angle and L-Anterior, L-Posteriolmedial, L-Posterolateral values on the left. Conclusion: It was found that Q angle measurements decreased in LDH patients, causing genu varum and leading to impairment in balance, especially in the left anterior, anteromedial and anterolateral.

Examination of the Effect of Somatotype Profiles on Athletic Performance Indicators in Children Aged 48-72 Months.

Physical fitness and anthropometric variables are crucial in achieving success in the field of sports. These variables serve as the foundation and platform for children to showcase their athletic abilities. The aim of this study is to examine the impact of somatotype profiles of children aged 48-72 months on athletic performance in order to contribute to talent selection. A total of 124 students (62 females, 62 males), aged between 48 and 72 months (mean age of females: 5.75±1.00, mean age of males: 5.68±1.15), participated in the study. Somatotype analysis was performed using the Heath-Carter method. Performance measurements of students included a 20-meter sprint test, flexibility, leg strength, push-up tests, crunches, vertical jump, standing long jump, hand strength, back strength, and hamstring length determination tests. In this study, there was a significant difference in favor of mesomorphic endomorph in crunches (F=3.914, p=0.013) and push-up (F=4.864, p=0.004) exercises for female children compared to all somatotypes. In male children, although the central group was dominant in athletic performance measurements, there was no statistically significant difference (p>0.05). Somatotype is a suitable method for enhancing athletic performance and directing individuals to the appropriate sports discipline. Somatotype profiles are not fully developed in children aged 48-72 months. In the later years, children with suitable somatotypes are expected to demonstrate improved athletic performance.

Comparing right and left hamstring flexibility and its association to nonspecific lowr back pain among women of different age groups

Background and objectivesDecreased hamstring flexibility has been associated with LBP (lower back pain). Increased tightness or shortening of hamstring muscle may cause pelvis imbalance or tilt and create instability and increase LBP risk. This study was conducted to pinpoint the differences between right and left hamstring length and their association to LBP in Israeli adult and elderly women. MethodsN = 109 women which were divided into two groups: Adult group, 41 women (aged 45–60) and older group, 68 women (aged 60–75), with LBP that exercise regularly (minimum twice weekly) were selected based on inclusion criteria. Hamstring flexibility was measured using the Passive Straight Leg Raise test and Sit and Reach test, and LBP was measured using the Oswestry Disability Index (OS), the Roland-Morris questionnaire (RM), and a personal information questionnaire. FindingsFindings indicate a statistically significant difference (p < .05) in hamstring flexibility between right and left legs in PSLR test, with the left being shorter than the right. A significant negative correlation was found between hamstring shortening to function in OS and RM questionnaires in the older group, no significant correlation was found between left -right hamstring flexibility differences and reduced function with LBP in the OS and RM questionnaires. Conclusions: Hamstring shortening in adult and elderly women exists despite regular exercise. Future studies must be incorporated to improve hamstring flexibility with emphasis on balance of left and right legs to examine how this will affect LPB reports and compare women who exercise versus women who do not.

Effect of pelvic retroversion on hamstring lengths in adult spinal deformity patients in standing position and during gait

Effect of pelvic retroversion on hamstring lengths in adult spinal deformity patients in standing position and during gait

Botulinum toxin type A for spasticity in cerebral palsy patients: Which impact on popliteal angle to hamstring length? A proof-of-concept study.

Cerebral palsy (CP) is the most common physical disability in childhood. It is a heterogeneous condition in terms of etiology, motor type and severity of impairments. Clinical impairments, such as increased muscle tone (spasticity), muscle weakness and joint stiffness contribute to the abnormal development of functional activities, including gait. The objective of this study was to investigate the popliteal angle to hamstring length after ultrasound guided Incobotulinum toxin A injections for spasticity in CP patients. In this proof-of-concept study, we included outpatients with CP and crouch gait correlated to hamstrings spasticity referred to the Pediatric Rehabilitation outpatient clinic of Umberto I University Hospital, Sapienza University of Rome, in the period between February and October 2018. Modified Ashworth Scale (MAS) of hamstring muscles, Popliteal Angle and Modified Popliteal Angle, Passive Knee Extension and 10 Meter Walk Test (10MWT) were assessed at baseline (T0) and three weeks after ultrasound guided injection (T1) of Incobotulinum Toxin A (dose weight and site dependent). Thirteen patients (5 male and 8 female), mean aged 9.91 ± 3.59, were included. The clinical evaluation at T0 showed hamstring muscles spasticity, with MAS of 2.4 ± 0.6, popliteal angle -51.7∘± 11.0∘, modified popliteal angle of -39.5∘± 11.0∘, passive knee extension of -14.0∘± 8.7∘ and 10MWT of 14.3 ± 4.6 seconds. At T1, hamstring muscles MAS mean value was 1.7 ± 0.6 (p< 0.01), popliteal angle 41.3∘± 7.0∘ (p< 0.001), modified popliteal angle -32.9∘± 10.4∘ (p< 0.001), passive knee extension -4.0∘± 4.2∘ (p< 0.05) and 10MWT 12.6 ± 4.8 seconds (p< 0.05). None of the treated patients reported any adverse event related to Incobotulinum Toxin A injection. Incobotulinum toxin A treatment has been proven to be safe and effective for hamstring muscles spasticity management in CP patients. Further studies with larger samples and longer follow-up are warranted to assess the efficacy of this treatment on the popliteal angle.