Hip Abduction Range Of Motion Research Articles

Proximal femoral varus osteotomy for Legg–Calvé–Perthes disease: do age and lateral pillar classifications influence short-to-mid-term clinical and radiological outcomes?

Introduction: Proximal femoral varus osteotomy (FVO) is one of the most used treatment methods with acceptable outcomes for Legg–Calvé–Perthes disease (LCPD). We aimed to investigate the influence of age at disease onset and the Lateral Pillar classification on clinical and radiological outcomes of FVO surgery LCPD patients between 6-12 years of age.Hypothesis: Proximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up, regardless of preoperative age and Herring type.Material and methods: 50 patients with LCPD (Herring groups B, B/C, and C) who underwent FVO were retrospectively reviewed. We evaluated radiological (center-edge angle, extrusion index, epiphyseal index, acetabular index, articulo-trochanteric distance (ATD)) and clinical (hip abduction range of motion (ROM), Trendelenburg sign, pain, and Harris hip score (HHS)) outcomes with a follow-up of 37.3 ± 10.5 months (range: 24 - 180 months). Finally, the overall treatment outcome was assessed using the Stulberg classification.Results: The ROC Curve analysis did not reveal any significant relationship between age and clinical or radiological outcomes, and there was no predictable age cut-off for surgical outcomes (P=0.13). No significant difference was found in Stulberg classification at the follow-up between patients with type B, B/C, and C of the lateral pillar (P>0.05).Discussion: Our results demonstrated that open-wedge proximal FVO surgery in the early fragmentation phase of LCPD patients led to acceptable clinical and radiographic outcomes in a 3-year follow-up. Each sample of our study was very small and a lot of variables were measured, making this result not adequately strong enough to draw a robust conclusion. However, FVO surgery remains a possible suggestion for patients in the early fragmentation phase, and age and lateral pillar type may not be limiting factors.Level of Evidence: IV; Therapeutic Retrospective cohort.

The Neuromuscular Parameters Affecting Static and Dynamic Balance in Adolescent Male Soccer Players with Dynamic Knee Valgus

Background and Aims The anterior cruciate ligament injury in athletes is associated with disorders related to balance and postural control. Poor balance is a predictor of lower limb injury in athletes. This study aims to investigate the different neuromuscular parameters that affect the static and dynamic balance in adolescent male football players with Dynamic Knee Valgus (DKV). Methods This is a correlational study. Participants were 83 adolescent male football players with DKV (age: 12.63±0.72 years, height: 1.69±0.07 meters, weight: 23.23±7.74 58 kg, BMI: 20.32±2.38 kg /m2), who were selected using a purposive sampling method. The presence of DKV was assessed by the squat test. The strength of the trunk and hip muscles was assessed by manual muscle testing (MMT), trunk endurance by the McGill test, and range of motion (ROM) of hip and ankle joints by a goniometer. Moreover, the static and dynamic balances were evaluated by the Bass Stick test and Y balance test, respectively. The Pearson correlation test was used to examine the relationships at a significance level of 0.05. All statistical operations were performed by SPSS software, version 24. Results The results of the present study showed a significant relationship between static balance and the study parameters (P≤0.05) except for trunk flexion strength (P=0.16) and ROM (P<0.05), hip flexion ROM (P=0.83), hip extension ROM (P=0.96), hip abduction ROM (P=0.77) and ankle dorsiflexion ROM (P=0.94). The dynamic balance at anterior-posterior direction had a significant relationship with trunk endurance and left-side plank (P=0.07) and strength (P=0.05), but not with plank test score (P=0.45). The dynamic Y balance at posteromedial direction had a significant relationship with all variables except for 60° flexion (P=0.40), plank (P=0.53), left-side plank (P=0.09), and trunk extension strength (P=0.23). The results of the study also showed the significant relationship of dynamic balance at posterolateral direction and the total score of Y balance test with total trunk endurance test score (P=0.03, P=0.003) and right-side plank (P=0.005, P=0.001). Moreover, trunk extension strength and hip strength variables had a significant relationship with posterolateral dynamic balance and total Y balance test score (P≤0.05). Furthermore, the ROM of ankle dorsiflexion had a significant relationship with balance at the posteromedial (P=0.03), posterolateral (P=0.02) directions and the total Y balance score (P=0.02). Conclusion Static balance of adolescent male soccer players with DKV has a significant relationship with trunk endurance, trunk strength and thigh strength. There is a significant relationship between dynamic balance and trunk endurance, trunk strength, hip strength, and ankle dorsiflexion ROM.

Relation entre les différences perçues et structurelles de longueur des membres inférieurs sur des patients souffrant de dysplasie arthrosique de la hanche

BackgroundOnly few studies have been conducted on leg length discrepancy (LLD) in patients with hip osteoarthritis (OA). This study aimed to examine the relationship between perceived LLD (pLLD) and structural LLD (sLLD) in patients with advanced OA and to determine the factors influencing both LLDs. This retrospective study aimed to answer the following questions: (1) are older adults less likely to perceive LLD than younger adults? (2) Is there a relationship between pLLD and sLLD? and (3) is pLLD associated with patient satisfaction? HypothesisWe hypothesized that older adults are less likely to perceive LLD than younger adults. Patients and methodsWe recruited 125 patients (102 women and 23 men) with hip OA associated with developmental dysplasia of the hip defined as grade 3 or higher according to the Tönnis classification and excluding contralateral grade 2 or higher. The mean age of the patients was 65.2±11.2 (36–85) years. Before surgery, 2-mm and 5-mm thick plates were placed on the floor on the plantar surface of the short leg to measure pLLD. Preoperative computed tomography (CT) was performed, and sLLDs were measured using the 3D planning software ZedHip. The following associated factors were evaluated: age, height, weight, body mass index (BMI), adduction and abduction range of motion (ROM) of the affected hip joint, Crowe classification, standing pelvic inclination in the coronal plane, Cobb angle, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). ResultsThe absolute difference between pLLD and sLLD was modestly positively correlated with age (R=0.206; p<0.05) indicating older patients were less prone to perceive LLD. A strong positive correlation was found between pLLD (4.8±7.3mm; range: –37 to 28mm) and sLLD (6.4±7.0mm; range: –29.9 to 23.7mm) (R=0.714, p<0.05). The greater the pLLD, the smaller the hip abduction ROM (24.8±11.6°; range: 0 to 45°) tended to be, while the greater the sLLD, the smaller the hip abduction and adduction ROM (10.3±5.7°; range: 0 to 25°) tended to be (R=–0.259 and R=–0.297, respectively; p<0.05) The clinical significance of this finding is that pLLD may be improved if hip ROM training is performed before surgery. pLLD was significantly smaller in the group without pelvic inclination (8.0±14.1mm; range: –37 to 22mm) than in the group with pelvic inclination to the affected side (6.9±7.5mm; range: –12 to 28mm) and in the group with no inclination to the affected side (7.3±7.6mm; range: –8 to 25mm) (p<0.05) The clinical significance of this finding is that improving pelvic inclination with hip ROM training or muscle stretching may also reduce pLLD. No significant differences were noted between pLLD and JHEQ total scores or subgroups. DiscussionOlder patients had less pLLD. Preoperative pLLD was strongly correlated with sLLD but not with patient satisfaction. These results may be useful for conservative treatment of OA, preoperative planning, and intraoperative leg length correction. Level of evidenceIV; case control study.

Biomechanics of Topspin Forehand Loop in Table Tennis: An Application of OpenSim Musculoskeletal Modelling.

Topspin is one of the most attacking strokes in table tennis, and topspin forehand loop is an effective way to score. The aim of this study was to investigate the kinematics of the lower extremities in topspin forehand loop between different levels via OpenSim Musculoskeletal Modelling. Ten elite athletes (NL1) and ten medium athletes (NL2) performed the topspin forehand loop without muscle and joint injuries. An eight-camera Vicon motion capture system was used to measure the kinematics data. During the topspin forehand loop, the forward phase (FP) and the entire phase (EP) of the NL1 were significantly shorter than that of the NL2. In the sagittal plane, NL1 significantly had greater hip and ankle flexion and extension at range of motion (ROM) but less hip flexion and knee flexion at FP and less ankle flexion at BP than NL2. In the frontal plane, NL1 displayed less ROM in the hip joint and significantly less hip abduction ROM at the backward phase (BP). In the transverse plane, NL1 had a significantly greater ROM in the hip joint and displayed significantly less hip ROM at the BP. The level differences presented in this study could help table tennis athletes to improve performance and coaches to develop technical training.

EFFECT OF COMPLEMENTARY THERAPY ON HIP ABDUCTION IN CHILDREN WITH CEREBRAL PALSY

Background: Mechanical Horse Riding Simulator (MHRS) is one of the complementary therapy used in the rehabilitation of children with cerebral palsy which produces rhythmical and repetitive movements. It is working under the principles of hippotherapy and considered an alternative method for hippotherapy. Purpose: This study aimed to nd out the effectiveness of a mechanical horse riding simulator on hip abduction range of motion in children with spastic diplegia and evaluate the magnitude of improvement at different periods (2 weeks, 4 weeks, and 6 weeks). This study included 30 childre Methods: n with spastic diplegia and was divided into two groups, the experimental and the control group. The experimental group received 15 minutes of complementary therapy with MHRS, 3 days/ week for 6 weeks along with regular physiotherapy, while the control group received 15 minutes of conventional trunk control exercise along with the regular physiotherapy session. Hip abduction passive range of motion (PROM) was measured with the Goniometer. Pre and postintervention scores were recorded and analyzed with appropriate statistical tools. The baseline characteristics were similar in both Results: groups before the intervention with the p-value (p&gt;0.01). The observed mean value of hip abduction PROM has been improved in both groups over 6 weeks and the experimental group shows signicantly better improvement (p&lt;0.01) than the control group in all the weeks. Conclusion: The study results conrmed that gradual improvement of hip abduction passive range of motion (both sides) was observed in both groups. Children exposed to MHRS show better improvement than the children in the control group. It was concluded that the MHRS is an effective complementary therapy improving hip abduction passive range of motion (both sides) in children with spastic diplegia and the provision of MHRS in longer duration provides more benets than the shorter duration.

Relationship between perceived and structural leg length discrepancies of patients with hip osteoarthritis dysplasia

BackgroundOnly few studies have been conducted on leg length discrepancy (LLD) in patients with hip osteoarthritis (OA). This study aimed to examine the relationship between perceived LLD (pLLD) and structural LLD (sLLD) in patients with advanced OA and to determine the factors influencing both LLDs. This retrospective study aimed to answer the following questions: (1) are older adults less likely to perceive LLD than younger adults? (2) is there a relationship between pLLD and sLLD? and (3) is pLLD associated with patient satisfaction? HypothesisWe hypothesized that older adults are less likely to perceive LLD than younger adults. Patients and methodsWe recruited 125 patients (102 women and 23 men) with hip OA associated with developmental dysplasia of the hip defined as grade 3 or higher according to the Tönnis classification and excluding contralateral grade 2 or higher. The mean age of the patients was 65.2±11.2 (36–85) years. Before surgery, 2-mm and 5-mm thick plates were placed on the floor on the plantar surface of the short leg to measure pLLD. Preoperative computed tomography (CT) was performed and sLLDs were measured using the 3D planning software ZedHip. The following associated factors were evaluated: age, height, weight, body mass index (BMI), adduction and abduction range of motion (ROM) of the affected hip joint, Crowe classification, standing pelvic inclination in the coronal plane, Cobb angle and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). ResultsThe absolute difference between pLLD and sLLD was modestly positively correlated with age (R=0.206; p<0.05) indicating older patients were less prone to perceive LLD. A strong positive correlation was found between pLLD (4.8±7.3mm; range: -37 to 28mm) and sLLD (6.4±7.0mm; range: -29.9 to 23.7mm) (R=0.714, p<0.05). The greater the pLLD, the smaller the hip abduction ROM (24.8±11.6°; range: 0 to 45°) tended to be, while the greater the sLLD, the smaller the hip abduction and adduction ROM (10.3±5.7°; range: 0 to 25°) tended to be (R= -0.259 and R= -0.297, respectively; p<0.05) The clinical significance of this finding is that pLLD may be improved if hip ROM training is performed before surgery. pLLD was significantly smaller in the group without pelvic inclination (8.0±14.1mm; range: -37 to 22mm) than in the group with pelvic inclination to the affected side (6.9±7.5mm; range: -12 to 28mm) and in the group with no inclination to the affected side (7.3±7.6mm; range: -8 to 25mm) (p<0.05) The clinical significance of this finding is that improving pelvic inclination with hip ROM training or muscle stretching may also reduce pLLD. No significant differences were noted between pLLD and JHEQ total scores or subgroups. DiscussionOlder patients had less pLLD. Preoperative pLLD was strongly correlated with sLLD but not with patient satisfaction. These results may be useful for conservative treatment of OA, preoperative planning and intraoperative leg length correction. Level of evidenceIV; case control study.

Hip Strength Profiling of Ice Hockey Athletes Across Various Joint-Specific Angles: Monitoring and Injury Implications.

Secomb, JL, Kelly, M, and Dascombe, BJ. Hip strength profiling of ice hockey athletes across various joint-specific angles: monitoring and injury implications. J Strength Cond Res 37(7): e422-e429, 2023-The purpose of this research was to compare the hip adduction and abduction relative strength, adduction-to-abduction strength ratio (ADD:ABD), and interlimb asymmetries of ice hockey athletes between the typically used bilateral position and 3 unilateral positions in joint-specific angles (0°, 25°, and 50° of hip abduction) relevant to an ice hockey stride. A secondary purpose was to explore any relationships between these measures and hip and groin noncontact injuries, and self-reported pain and disability. Twenty-five semiprofessional male ice hockey athletes (26.7 ± 6.7 years) were assessed for hip abduction range of motion (ROM), hip adduction and abduction relative strength, and completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire. Within-subjects repeated-measures analysis of variance revealed a significant effect for the assessment position for adduction ( F1,24 = 52.4, p < 0.01) and abduction relative strength ( F1,24 = 152.1, p < 0.01), ADD:ABD ( F1,24 = 38.9, p < 0.01), and the interlimb asymmetries for each of these variables ( F1,24 = 9.8-12.3; p < 0.01), with large strength differences observed between the bilateral assessment and all unilateral assessment positions for adduction and abduction relative strength. In addition, 4 athletes experienced a noncontact hip or groin injury within 1 month after testing, and when compared with the rest of the cohort ( n = 21) with Welch's t -tests, demonstrated significantly reduced hip abduction ROM (mean difference [MD] = -8.4 ± 2.5°; p < 0.01), sport subscale score for the HAGOS questionnaire (MD = -33.9 ± 7.1; p < 0.01), and a decline in hip adduction relative strength in the unilateral position of 50° compared with the position of 25° hip abduction (MD = -13.4 ± 3.8; p = 0.04). These results suggest that practitioners working with ice hockey athletes may benefit from profiling hip strength in these unilateral joint-specific angle positions because they provide an evidence base to determine the hip strength needs of ice hockey athletes in positions associated with skating performance and noncontact hip and groin injury mechanisms (between 25° and 50° of hip abduction).

Effect of the Sway Bed on Autonomic Response, Emotional Responses, and Muscle Hardness in Children with Severe Motor and Intellectual Disabilities: A Pilot Study.

This cross-sectional study aimed to examine the effects of being swayed in a sway bed on children with severe motor and intellectual difficulties by examining potential differences in their autonomic and emotional responses, as well as their muscle hardness, and by comparing them with "a control condition without any stimulation". Children's heart rate variability, rectus femoris hardness, and passive hip abduction range of motion (ROM) were measured in two experimental conditions, differentiated by the presence of a 5-min sway stimulus. In each condition, the children's faces were video-recorded and retrospectively rated subjectively by their homeroom teacher concerning the visible expression of eight emotions. Significant intervention-related effects were observed on the heart rate variability and the "Relax" item of the emotional response indicators but not on muscle hardness or hip ROM. Our findings provide evidence that using a motorized sway bed can promote relaxation in children with severe motor and intellectual disabilities by influencing their autonomic response.

Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial

Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.

Immediate effect of MWM adductor stretch, myofascial release, and conventional stretching in asymptomatic individuals with hip adductor tightness: A randomized controlled trial

BackgroundHip adductors are the group of muscles that stabilize the pelvis during weight transfer in lower limbs in a gait cycle. As the full range of motion is seldomly used, this group of muscles commonly go into tightness which in turn may be a predisposing factor in development of back pain and knee pain. Methods54 healthy individuals were selected after screening for bilateral hip adductor tightness by measuring hip abduction range of motion using goniometer. They were randomized to either mobilization with movement (MWM) adductor stretch, myofascial release, or conventional stretching group. All subjects were assessed pre and post intervention. Outcome measure used were hip abduction range of motion and bent knee fall out test. ResultsStatistically significant difference was noted between the experimental and the control group in terms of hip abduction range of motion and bent knee fall out test. ConclusionIntervention showed significant results in all three groups; however, MWM adductor stretch when used in conjunction with conventional stretching has proved to be more effective than myofascial release with foam roller and conventional stretching in increasing the abduction range of motion and bent knee fall out test.

Characterizing femoroacetabular impingement in professional Nordic Skiers

ABSTRACT Objective Studies have shown a high prevalence of femoroacetabular impingement (FAI) among elite athletes yet there is a paucity of data on FAI in Nordic skiers. The purpose of this study was to determine the prevalence of radiographic FAI in professional Nordic Combined Skiers and Ski jumpers compared to controls and assess functional outcomes including hip range of motion (ROM) and pain in patients with radiographic evidence of FAI compared to those without it. Methods A cohort of elite Nordic Skiers underwent medical history, physical examination, and pelvic radiographs at their visit with a fellowship-trained sports medicine physician. On pelvis radiographs, Alpha angle>55 degrees was deemed cam-positive, and positive crossover signs, Tönnis<0, or LCEA>40 were deemed pincer positive. Further stratification was performed by sex, ski event type, hip pain, presence of cam lesions, and presence of pincer lesions. Spearman correlation matrix was performed to measure the association between radiographic measurements and ROM. Results Nineteen Nordic skiers and nineteen age, sex, and BMI matched controls were included in the study. There were no significant differences in age, sex, BMI, and hip pain between groups. While Nordic skiers demonstrated decreased ROM bilaterally on external rotation compared to controls, skiers had larger ROM bilaterally on extension, abduction, adduction compared to controls. Skiers were significantly more likely to have bilateral crossover sign and alpha angles>55 compared to controls. Subgroup analysis showed that Cam positive patients had higher flexion and adduction ROM and pincer positive patients had significantly higher flexion and abduction ROM compared to patients without cam and pincer lesions respectively. Patients with hip pain had significantly lower right hip abduction ROM compared to patients without hip pain. No significant correlations were seen between radiographic measurements and ROM. Conclusion Similar to other elite ‘hip heavy’ sport athletes, Nordic skiers gave a notably higher prevalence of radiographic cam and pincer type morphology and significantly higher ROM compared to nonathletic controls. Clinicians evaluating Nordic skiers should be aware of these baseline findings with respect to a possible elevated long-term risk of symptomatic FAI in these athletes as well as other conditions related to radiographic FAI.

The Characteristic of Dynamic Balance Ability and Hip Flexibility in Soccer Players with a History of the Groin Pain: A Preliminary Study

The purpose of this study was to investigate the characteristic of hip flexibility and dynamic balance ability in the soccer players with the groin pain. The study consisted 17 male college soccer players. All participants were divided into the Groin Pain (GP) group and non-GP group, according to a history of the groin pain. Hip passive Range of Motion (ROM) test and the modified Star Excursion Balance Test (mSEBT) was conducted in all participants. The Mann–Whitney U test or Student’s t-test was selected to identify differences in hip ROMs and results of the mSEBT in kicking keg and supporting leg between groups. Hip abduction angle of kicking leg in the GS group were smaller than that in the non-GS group in the kicking leg (p &lt; 0.05). There were no differences in other hip ROMs between groups (p &gt; 0.05). There was no difference in results of the mSEBT between groups in both legs (p &gt; 0.05). Our results were newly revealed that soccer players with the groin pain had poor hip abduction range of motion in comparison with those without the groin pain. This finding suggested that a poor hip abductor range of motion may affect the kicking biomechanics in soccer players with the groin pain.

Relationship between Perceived Leg Length Discrepancy at One Month and Preoperative Hip Abductor Muscle Elasticity in Patients after Total Hip Arthroplasty

Preoperative factors related to perceived leg length discrepancy (PLLD) after total hip arthroplasty (THA) are not well studied. This study aimed to examine the preoperative factors, including hip abductor modulus, related to PLLD one month after THA. The study included 73 patients diagnosed with osteoarthritis secondary to developmental dysplasia of the hip and a posterior approach to surgery. Multiple logistic regression analysis was performed using the presence or absence of PLLD as the dependent variable and preoperative hip abductor's modulus of elasticity, pain, hip abduction range of motion, hip abductor muscle strength and pelvic obliquity as the independent variable. Additionally, receiver operating characteristic curves were used for the extracted variables for calculating the cutoffs, sensitivity, specificity and area under the curve (AUC) to determine the presence or absence of PLLD. The significance level was set at p<0.05. The hip abductor modulus (odds ratio=1.13; 95% confidence interval=1.06-1.21; p<0.001) was selected as a preoperative factor. The cutoff value to determine the presence or absence of a PLLD was 16.32 kPa. The sensitivity and specificity were 81.8% and 72.5%, respectively, and the AUC was 0.8137. The hip abductor muscle elastic modulus affected PLLD one month after THA. If the preoperative hip abductor elastic modulus is higher than the cutoff value, it may affect the appearance of PLLD at one month postoperatively.

Iatrogenic gluteus medius muscle insertion injury while trochanteric entry nailing due to trochanteric fractures: a comparative study in forty patients with gray-scale ultrasound and shear-wave elastography.

Trochanteric entry nailing potentially causes damage to the gluteus medius (GM) tendon. The aim of this study is to determine the amount of iatrogenic damage to the tendon during reaming by measuring the thickness and stiffness of the GM muscle in patients with trochanteric fractures who are treated with trochanteric entry nails using gray-scale ultrasound (GSUS) and shear-wave elastography (SWE). Thickness and stiffness values of bilateral GM muscles in 40 patients with trochanteric fractures treated with PFN-A were measured using GSUS and SWE at post-operative sixth week or later. Harris Hip Scores and bilateral active hip abduction measurements of the patients were recorded. The data was analyzed using statistical methods to assess the extent and amount of iatrogenic injury that occurred during trochanteric entry. Mean age of the patients was 70. Thirty-three fractures occurred with low-energy trauma. In the SWE evaluation, there was no statistically significant difference between ipsi- and contralateral GM muscle thickness measurements or ipsi- and contralateral GM muscle stiffness measurements. Also, the difference between the clinical evaluation results of the ipsi- and contralateral hip functions was not statistically significant. In this study, we used the Harris Hip Score and hip abduction range of motion in addition to SWE and GSUS in order to assess the patients' functional status. There are studies in the literature that report significant injury to the GM tendon with cephalomedullary nailing. The majority of these studies are cadaver studies with only clinically irrelevant or uncertain evidence. In this study, we aimed to evaluate the potential negative effects of the iatrogenic damage to the bone-tendon junction during nailing, by measuring the stiffness (consistency) and atrophy of the GM muscle alongside the functional evaluation. We have found no statistically significant difference between operated and intact side GM muscles in terms of stiffness, atrophy, and functional evaluation in patients with TFs treated using PFN-A. The results of our study should not be interpreted as trochanteric entry nailing does not cause any damage on the GM tendon.

Restricting ankle dorsiflexion does not mitigate the benefits of external focus of attention on landing biomechanics in healthy females.

Restricted ankle dorsiflexion can promote aberrant biomechanics associated with risk for knee injury during dynamic activities. Attentionally focused instructions have been used to improve high-risk knee biomechanics during landing tasks. Yet, it is unknown whether attentionally focused instruction can effectively improve landing patterns in the presence of a mechanical restriction on the ankle. Therefore, our purpose was to determine whether restricting ankle dorsiflexion by use of bracing mitigated the effects of attentional foci on landing biomechanics in healthy females. We used a crossover design to investigate lower extremity biomechanics in 19 healthy females between the ages of 18-35 during a series of jump-landing tasks. Participants completed 6 blocks of 3 jump-landings on separate force platforms in a randomized order based on brace condition (brace, no brace) and mode of attentional foci (neutral, internal focus [IF], external focus [EF]). Attentionally focused instructions were provided immediately prior to 3 practice jump-landings, followed by 5 test jump-landings with self-controlled feedback only. Ankle bracing decreased peak dorsiflexion and sagittal range of motion (ROM) (mean difference: 5.7-5.8°), and peak inversion and frontal ROM (mean difference: 2.4-3.0°). However, hip flexion ROM (mean difference: 1.8°) increased compared to the no brace condition. Regardless of ankle bracing, EF instruction increased peak hip flexion (mean difference: 4.9°) and hip flexion range of motion (mean difference: 3.8-4.6°), while decreasing peak knee valgus (mean difference: 0.8-1.0°) and knee valgus moment (mean difference: 0.04Nm/kg). Additionally, EF instruction increased peak hip abduction to a similar degree when braced (mean difference: 3.6-4.0°) and not braced (mean difference: 2.1-2.5°). Lastly, EF instruction increased hip abduction ROM only when braced (mean difference: 2.3-2.4°), but decreased peak knee valgus power only when not braced (mean difference: 0.18W/kg). Our findings indicate that mechanically restricting ankle dorsiflexion does not mitigate the ability of EF instruction to enhance jump-landing performance by means of improving hip and knee biomechanics in healthy females. However, our findings suggest an improved ability to control the rate of knee valgus loading when not braced. Therefore, we conclude that EF instruction remains a viable clinical strategy to improve landing patterns in the presence of restricted ankle dorsiflexion, yet this approach may be ineffective to reduce the rate of knee joint loading.

Relación entre dismenorrea y síndrome de dolor miofascial. Perspectiva desde la fisioterapia. Estudio piloto aleatorizado

The term dysmenorrhoea defines different symptoms that women can feel during menstruation, the most common being intense pain. Myofascial pain syndrome (MPS) is the combination of signs and symptoms caused by myofascial trigger points (MTP), at their site or at a distance. Therefore, the objective of this study is to evaluate the efficacy of a treatment for MTP in the abdominal, hip adductor and pelvic floor muscles, from a physiotherapeutic approach, regarding the following outcome measures: pain, sexual function, quality of life, strength and mobility in patients suffering from dysmenorrhoea. Materials and methodsRandomized pilot study. Participants were divided into two groups: A (n = 6), where dry needling and manual therapy was applied to the abdominal, hip adductor and pelvic floor muscles; and B (n = 7), where the participants received thermotherapy and stretching of these muscles. The outcome measures studied were menstrual pain, sexual function, quality of life, hip abduction range of motion, strength of the affected muscles, pelvic floor muscle endurance and finding myofascial trigger points. All the treatments were provided by the same physiotherapist, while a different physiotherapist carried out the evaluations blinded to each patient's group. Resultsin group A, a clinically (1.6 less in VAS) and statistically significant reduction (p = 0.018) in pain was observed in comparison with group B (.4 in VAS, p > 0.05). Quality of life also improved in the first group (p< 0.05). No further significant differences were found in the remaining outcome measures. Conclusionsa significant improvement was observed with regards to pain and quality of life in group A. Thus, we consider that specific treatment for MPS could be more clinically effective.We conclude that this research should be continued with a larger sample of participants, in order to clarify the efficacy of the physiotherapy treatment suggested for the remaining outcome measures.

Acute effects of aerobic activity, static stretching, and explosive exercises on muscular performance and range of motion of young soccer players

The current study aims to investigate the acute effects of light aerobic activity, static stretching (SS), strengthening and explosive exercises on lower-body muscular performance and range of motion (ROM). Dose-response effect of SS on performance and ROM was also studied. Nineteen young male soccer players (age: 13.9 ± 0.46 years) participated in a cross-over randomized trial. Participants performed 5-minute aerobic activity, followed by seven bouts of SS of calf, quadriceps, adductor and hamstring muscles lasting 20 seconds each. Additionally, two sets of strengthening and explosive exercises were performed after SS in the experimental condition. Power and strength were assessed by counter-movement jump (CMJ) and maximal voluntary contraction of hip adductors, while 3 flexibility tests were used for assessing ROM of lower body. Repeated-measures ANOVA revealed an increase in CMJ performance after aerobic activity, followed by a decrease after SS in a dose-dependent manner that continued to be present 15 minutes post-SS. Strengthening and explosive exercises did not neutralize the acute negative effects of SS on CMJ performance. No significant acute effect of selected interventions on maximal and explosive strength of hip adductors was observed. Finally, sit-and-reach and hip abduction ROM increased after aerobic activity and continued to increase throughout the SS protocol, and was preserved 15 minutes post-SS. Our results confirm that SS can impair lower-body power in young soccer players, and that these negative effects last at least 15 minutes. Excessive use of SS, as performed in this study, should be avoided during warm-up of young soccer players.

Posture Stability and Kinematics While Performing a 180° Turning Step in Elderly Individuals With and Without Vertebral Compression Fracture and in Middle-Aged Adults

Older adults with vertebral compression fracture (VCF) have spinal malalignment with large postural sway while standing. The purposes of this study identified the turning strategy of patients with VCF while walking. The study enrolled 18 adults with VCF (VCF group) and 29 older adults (OA group) and 15 middle-aged adults (MA group) without spinal deformity. The Biodex balance system was employed to assess posture stability. An inertia motion system recorded kinematic data during walking. The 180° turning step before sitting was divided into braking, mid-stance, swing, and terminal loading phases for kinematic analysis. Posture stability score showed that the VCF group achieved the lowest stability. The patients with VCF used slower acceleration and less mobility of the head and spine when turning. However, the VCF group had a larger hip abduction range of motion than the OA group; the OA group exhibited larger thoracic rotation than the MA and VCF groups. The VCF group exhibited less gait stability and coordination between the head and thigh on the sagittal plane than the other groups. Additionally, the VCF group had greater head/lower spine acceleration variability on the frontal plane. Kinematic joint modulations were required, depending on the phase of the turn step. The patients with VCF depend more heavily on a hip strategy to maintain gait stability than do other adult groups. To address gait stability and prevent falls for the patients with VCF, a training program should include balance, trunk mobility, and hip abductor muscle strength training.

Treatment of scalene muscles with the Ergon technique can lead to greater improvement in hip abduction range of motion than local hip adductor treatment: a study on deep front line connectivity.

[Purpose] This study aimed to investigate the effects of Ergon® instrument-assisted softtissue mobilization of the upper and lower midpoints of the Deep Front Line (DFL) on hip abduction range of motion (ROM). [Participants and Methods] Forty healthy adults (29.3 ± 6.3 years; height: 175.8 ± 7.4 cm; weight: 77.2 ± 9.2 kg) were randomly divided into two groups and received a single 15-minute Ergon treatment in the upper midpoint (scalene muscles) and the lower midpoint of the DFL (hip adductors) on their dominant side. The non-dominant hip served as a control. Pre-and post-therapy active and passive hip abduction ROM at 0° and 90° flexion was examined using a goniometer. [Results] In both experimental groups, active and passive hip abduction ROM on the treated side improved significantly compared to the control side. Scalene treatment led to significantly greater improvement in active hip abduction ROM at 0° and 90° and in passive ROM at 90° compared to local hip adductor treatment. [Conclusion] The application of the Ergon technique on remote parts of the DFL may lead to a significant increase in hip abduction ROM compared to local hip adductors treatment.

Arthrodiastasis in the management of Perthes disease: a systematic review.

This systematic review explores the relevant literature to assess the efficacy of the use of arthrodiastasis in the management of Perthes disease. Until this moment, arthrodiastasis is not well established for its use in Perthes disease as opposed to other containment procedures. Furthermore, there are no clear indications for its use in this disease. Twelve articles were matched to the inclusion criteria and all articles were reviewed and radiological and clinical data were collected and compiled. As regards the hip flexion range of motion, the average preoperative flexion range of motion was 55.32°, while the postoperative was 90°. The average preoperative hip abduction range of motion was 12.28° and postoperative was 35.28°. Mean preoperative hip internal rotation range of motion was 8.69° and postoperatively was 24.93°. Mean preoperative external rotation range of motion was 21.73°, while the postoperative range was 33.71°. Final Stulberg classification was ascertained showing most patients ending with stages two and three. Complications were also assessed with most of which being superficial pin tract infections. The use of arthrodiastasis is a valid treatment option for Perthes disease; however, more articles need to be produced showing comparative data of arthrodiastasis versus other containment procedures. Level of evidence - level 1: systematic review.