Hip Abduction Torque Research Articles

A Novel Low-Impact Resistance Exercise Program Increases Strength and Balance in Females Irrespective of Menopause Status.

The reduction in sex hormone production across the menopause transition is thought to accelerate age-related decline in muscle mass, strength, and stability, increasing the risk of falls and fractures. We aimed to investigate whether a novel low-impact resistance exercise program could improve strength, balance, and body composition and whether any improvement was affected by menopause status. Seventy healthy, moderately active pre- (PRE; 46.7 ± (SD) 3.2 years), peri- (PERI; 52.3 ± 2.2 years) or post- (POST; 57.0 ± 2.5 years) menopausal females, not taking hormone replacement therapy (HRT), were randomised to continue habitual physical activity (CON; n = 25) or complete a supervised resistance exercise program 4 days/week for 12 weeks (EXC; n = 45). Strength at the hip and shoulder (isokinetic dynamometer), dynamic balance (Y-balance), flexibility (sit-and-reach & back-scratch), muscle thickness (rectus femoris, vastus intermedius (VI) and medial deltoid), and lean and %body fat (dual-energy X-ray absorptiometry) were measured before and after training. Results: Hip abduction and flexion peak torque (19 ± 48 and 20 ± 17%, respectively, P < 0.05), posterolateral and posteromedial balance (12 ± 15 and 13 ± 15%, respectively, P < 0.001), flexibility (21 ± 36%, P < 0.001), VI thickness (12 ± 19%, P = 0.032), lean mass (2 ± 2%, P = 0.007), all increased over 12 weeks in EXC, but not CON, with no difference in response between PRE, PERI or POST. The changes in shoulder strength and body mass over 12 weeks were not different between CON and EXC. This is the first study to demonstrate that the decline in sex hormones, and increase in age, across the menopause transition does not affect the ability of lower limb (hip) strength and balance to adapt to a low-impact resistance exercise training program in females not taking HRT.

The relationship of hip strength to walking and balance performance in unilateral lower limb prosthesis users differs by amputation level.

Safe and efficient locomotion is a frequently stated goal of lower limb prosthesis users, for which hip strength may play a central yet poorly understood role. Additional research to identify associations between hip strength, balance, and mobility among transtibial and transfemoral prosthesis users is required. To test whether residual and/or intact limb isometric hip strength was associated with lower limb prosthesis users' walking speed, endurance, and balance. Cross-sectional study. Research laboratory. Convivence sample of 14 transtibial and 14 transfemoral prosthesis users. Multiple linear regression was used to evaluate the relationship between isometric measures of residual and intact limb hip strength and walking and balance performance. Measures of isometric hip muscle strength, including peak torque, average torque, torque impulse, and torque steadiness (i.e. consistency with which an isometric torque can be sustained) were derived from maximum voluntary hip flexion, extension, abduction and adduction torque signals collected with a motor-driven dynamometer. Walking speed, endurance, and balance were assessed by administering the 10-meter walk test, 2-minute walk test, Four Square Step Test, and Narrowing Beam Walking Test, respectively. Residual limb hip extensor max torque and abductor torque steadiness explained between 51% and 69% of the variance in transtibial prosthesis users' walking speed, endurance, and balance. In contrast, intact limb hip abductor torque impulse explained between 33% and 48% of the variance in transfemoral prosthesis users' walking speed, endurance, and balance. Our results suggest that unilateral transtibial and transfemoral prosthesis users' walking and balance performance may depend on different hip muscles, and different facets of hip strength. Amputation level-specific hip strength interventions may therefore be required to improve walking and balance performance in unilateral transtibial and transfemoral prosthesis users. The "intact leg strategy" adopted by transfemoral prosthesis users may be due to a variety of prosthesis and biomechanical factors that limit the efficiency with which transfemoral prosthesis users can exploit the strength of their residual limb hip muscles while walking.

A Novel Design of Unpowered Exoskeleton for Loaded Walking Using Only Hip Abduction Torque

A Novel Design of Unpowered Exoskeleton for Loaded Walking Using Only Hip Abduction Torque

Three-dimensional kinematics of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in subjects with isolated patellofemoral osteoarthritis compared to individually matched controls: Preliminary results.

Objectives: This study aimed to compare three-dimensional kinematic of the trunk, pelvis, hip, and knee during the single-leg squat and hip torque in individuals with and without isolated patellofemoral osteoarthritis (PFOA). Patients and methods: This cross-sectional study evaluated trunk, pelvis, hip, and knee kinematics at 30°, 45°, and 60° knee flexion during the single-leg squat using the Vicon motion capture and analysis system, the Nexus System 2.1.1, and 3D Motion Monitor software. Sixteen individuals (8 males, 8 females; mean age: 49.3±6.2 years; range 40 to 61 years) participated in the study, of which eight were PFOA patients and eight were healthy controls. Isometric hip abductor, extensor, and external rotator torques were evaluated using a handheld dynamometer. Results: The PFOA group exhibited greater hip adduction at 30° (p=0.008), 45° (p=0.005), and 60° (p=0.008) knee flexion in the descending phase of the single-leg squat, as well as at 60° (p=0.009) and 45° (p=0.03) knee flexion in the ascending phase. No significant differences were found between groups for other kinematic variables (p>0.05). The PFOA group exhibited lower isometric hip abductor (p=0.02), extensor (p <0.001), and external rotator (p=0.007) torques. Conclusion: Individuals with PFOA exhibited excessive hip adduction that could increase stress on the lateral patellofemoral joint at 30°, 45°, and 60° knee flexion during the single-leg squat and exhibited weakness of the hip abductors, extensors, and external rotators in comparison to healthy controls.

Tai Chi counteracts age-related somatosensation and postural control declines among older adults

ObjectiveTo investigate the effect of a 16-week Tai Chi practice on strength, tactile sensation, kinesthesia, and static postural control among older adults of different age groups. MethodsThis is a quasi-experimental study. Thirteen participants aged 60–69 years (60–69yr), 11 aged 70–79 years (70–79yr), and 13 aged 80–89 years (80–89yr) completed 16 weeks of 24-form Tai Chi practice. Their ankle and hip peak torque, tactile sensation, ankle and knee kinesthesia, and the root mean square of the center of pressure (Cop-RMS) were measured before (week 0) and after (week 17) practice. Results80–89yr showed less ankle plantar/dorsiflexion and hip abduction peak torques (p = 0.003, p < 0.001, p = 0.001), and a greater ankle plantar/dorsiflexion kinesthesia (p < 0.001, p = 0.002) than 60–69yr and 70–79yr. Greater ankle plantar/dorsiflexion and hip abduction torques (p = 0.011, p < 0.001, p = 0.045), improved arch and heel tactile sensation (p = 0.040, p = 0.009), and lower knee flexion/extension kinesthesia (p < 0.001, p = 0.044) were observed at week 17. The significant group*practice interaction for the fifth metatarsal head tactile sensation (p = 0.027), ankle plantar/dorsiflexion kinesthesia (p < 0.001, p = 0.004), and the CoP-RMS in the mediolateral direction (p = 0.047) only in 80–89yr revealed greater improvement at week 17. ConclusionTai Chi practice increased strength, tactile sensation, kinesthesia, and static postural control among older adults. Tai Chi practice improved tactile, kinesthesia sensations, and static postural control among older adults over 80, who presented with worse strength and kinesthesia than their younger counterparts. Tai Chi practice offers a safe exercise option for those aged over 80 to encourage improvements in sensorimotor control.

Lower limb vertical stiffness and frontal plane angular impulse during perturbation-induced single limb stance and their associations with gait in individuals post-stroke

After stroke, deficits in paretic single limb stance (SLS) are commonly observed and affect walking performance. During SLS, the hip abductor musculature is critical in providing vertical support and regulating balance. Although disrupted paretic hip abduction torque production has been identified in individuals post-stroke, interpretation of previous results is limited due to the discrepancies in weight-bearing conditions. Using a novel perturbation-based assessment that could induce SLS by removing the support surface underneath one limb, we aim to investigate whether deficits in hip abduction torque production, vertical body support, and balance regulation remain detectable during SLS when controlling for weight-bearing, and whether these measures are associated with gait performance. Our results showed that during the perturbation-induced SLS, individuals post-stroke had lower hip abduction torque, less vertical stiffness, and increased frontal plane angular impulse at the paretic limb compared to the non-paretic limb, while no differences were found between the paretic limb and healthy controls. In addition, vertical stiffness during perturbation-induced SLS was positively correlated with single support duration during gait at the paretic limb and predicted self-selected and fast walking speeds in individuals post-stroke. The findings indicate that reduced paretic hip abduction torque during SLS likely affects vertical support and balance control. Enhancing SLS hip abduction torque production could be an important rehabilitation target to improve walking function for individuals post-stroke.

Correlation between hip muscle strength and the lower quarter Y-balance test in athletes following anterior cruciate ligament reconstruction

IntroductionThe lower quarter Y-balance test (YBT-LQ), which measures dynamic postural control, has been reported to be predictive of lower limb injuries in athletes. It requires subjects to control their body while maintaining a single-leg stance, which necessitates sufficient strength of the hip muscles to maintain stability. The purpose of the study was to investigate the correlation between the performance of the YBT-LQ and the hip abductor or extensor muscle strength in athletes following anterior cruciate ligament reconstruction surgery (ACLR). MethodsFifteen athletes with post-ACLR participated in this cross-sectional study. The participants completed the YBT-LQ, followed by isokinetic measurement of the hip abductor and extensor muscles of both the legs. The peak and average torque of the hip abductor and extensor muscles were tallied with the composite score of the YBT-LQ for each limb. ResultsNo correlation was found between the strength of the hip muscles and the YBT-LQ composite score in both injured and non-injured limbs at all velocities except for the eccentric hip abductor and concentric hip extensor torques. The eccentric hip abductor average torque is strongly associated with the YBT-LQ (r = 0.663, p = 0.010) at a speed of 180°/s. The concentric hip extensor peak torque was weakly correlated with balance (r = 0.540, p = 0.046) at a speed of 180°/s. ConclusionOur study demonstrated a positive correlation between the YBT-LQ and eccentric hip abduction and concentric hip extension at higher velocities. This shows the importance of implementing velocity-oriented rehabilitation in an athletic population following ACLR.

Activation, strength, and resistance: Which variables predict the kinematics of women with and without patellofemoral pain?

IntroductionInvestigating the possible relationship between neuromuscular changes and movement alterations could help to describe the mechanisms underlying patellofemoral pain (PFP). ObjectiveTo investigate whether activation and muscle strength of the trunk and lower limb and muscle resistance of the trunk predict the knee frontal and trunk sagittal kinematics in women with and without PFP. MethodSixty women (PFP, n = 30; asymptomatic, n = 30) underwent the single-leg squat test to collect electromyographic and kinematic data. Activation of transversus abdominis/internal oblique, gluteus medius (GMed), and vastus medialis oblique (VMO); knee frontal and trunk sagittal angles were analyzed. Participants also underwent maximal isometric tests to determine lateral trunk, hip abductor, and knee extensor torques and performed a lateral trunk resistance test. Multiple regression was used to determine predictive models. ResultsIn the PFP group, knee frontal angle (R2 = 0.39, p = 0.001) was predicted by GMed activation (β = 0.23, p = 0.000) and hip abductor torque (β = 0.08, p = 0.022). No variable was able to predict trunk sagittal kinematics in this group. In the asymptomatics, knee frontal angle (R2 = 0.16, p = 0.029) was predicted by hip abductor torque (β = 0.07, p = 0.029), while trunk sagittal angle (R2 = 0.24, p = 0.024) was predicted by VMO activation (β = 0.12, p = 0.016). ConclusionKinematics is predicted by the muscles acting in the respective planes, such that hip abductors capacities are related to the knee frontal alignment in both groups, and that of the VMO is related to the trunk sagittal alignment only in asymptomatic women.

Age-Related Differences in Kinematics, Kinetics, and Muscle Synergy Patterns Following a Sudden Gait Perturbation: Changes in Movement Strategies and Implications for Fall Prevention Rehabilitation

Falls in older adults are leading causes of fatal and non-fatal injuries, negatively impacting quality of life among those in this demographic. Most elderly falls occur due to unrecoverable limb collapse during balance control in the single-limb support (SLS) phase. To understand why older adults are more susceptible to falls than younger adults, we investigated age-related differences in lower limb kinematics, kinetics, and muscle synergy patterns during SLS, as well as their relationship to postural control strategies. Thirteen older and thirteen younger healthy adults were compared during the SLS phase of balance recovery following an unexpected surface drop perturbation. Compared to younger adults, older adults demonstrated (1) greater trunk flexion, (2) increased hip extension torque and reduced hip abduction torque of the perturbed leg, and (3) higher postural sway. Trunk flexion was correlated with a delayed latency to the start of lateral-to-medial displacement of center of mass from the perturbation onset. The group-specific muscle synergy revealed that older adults exhibited prominent activation of the hip extensors, while younger adults showed prominent activation of the hip abductors. These findings provide insights into targeted balance rehabilitation and indicate ways to improve postural stability and reduce falls in older adults.

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

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

Effects of a proprioceptive focal stimulation (Equistasi®) on reducing the biomechanical risk factors associated with ACL injury in female footballers.

Football presents a high rate of lower limb injuries and high incidence of Anterior Cruciate Ligament (ACL) rupture, especially in women. Due to this there is the need to optimize current prevention programs. This study aims to verify the possibility to reduce the biomechanical risk factors associated with ACL injury, through the application of proprioceptive stimulation by means of the Equistasi® device. Ten elite female footballers were enrolled and received the device for 4 weeks (5 days/week, 1h/day). Athletes were assessed directly on-field at four time points: T0 and T1 (evaluation without and with the device), T2 (after 2 weeks), T4 (after 4 weeks) while performing two different tasks: Romberg Test, and four sidestep cutting maneuvers bilaterally. Seven video cameras synchronized with a plantar pressure system were used, thirty double colored tapes were applied on anatomical landmarks, and three dimensional coordinates reconstructed. Vertical ground reaction forces and center of pressure data were extracted from the plantar pressure insoles. Hip, knee, and ankle flexion-extension angles and moments were computed as well as abd-adduction joint torques. From the Romberg Test both center of pressure descriptive variables and frequency analysis parameters were extracted. Each variable was compared among the different time frames, T1, T2 and T4, through Friedman Test for non-parametric repeated measures (p<0.05); Wilcoxon Signed Rank Test was used for comparing variables between T0 and T1 (p<0.05) and across the different time frames as follows: T1-T2, T2-T4 and T1-T4. Statistically significant differences in both posturographic and biomechanical variables between the assessment at T0 and T1 were detected. Reduced hip and knee abduction torques were revealed in association with reduced both ground reaction forces and ankle dorsiflexion torque from T1 up to T4. The proprioceptive stimuli showed to have the potential to improve cutting biomechanics mainly with respect to the ligament and quadriceps dominance theories. Results of the present study, even if preliminary and on a small sample size, could be considered promising towards the inclusion of proprioceptive training in injury prevention programs.

Effects of Visual Input Absence on Balance Recovery Responses to Lateral Standing Surface Perturbations in Older and Younger Adults

Although the ability to recover balance in the lateral direction has important implications with regard to fall risk in older adults, the effect of visual input on balance recovery in response to lateral perturbation and the effect of age are not well studied. We investigated the effect of visual input on balance recovery response to unpredictable lateral surface perturbations and its age-related changes. Ten younger and 10 older healthy adults were compared during balance recovery trials performed with the eyes open and eyes closed (EC). Compared with younger adults, older adults showed increased electromyography (EMG) peak amplitude of the soleus and gluteus medius, reduced EMG burst duration of the gluteus maximus and medius, and increased body sway (SD of the body's center of mass acceleration) in EC. In addition, older adults exhibited a smaller % increase (EC-eyes open) of the ankle eversion angle, hip abduction torque, EMG burst duration of the fibularis longus, and a greater % increase of body sway. All kinematics, kinetics, and EMG variables were greater in EC compared with eyes open in both groups. In conclusion, the absence of visual input negatively affects the balance recovery mechanism more in older adults compared with younger adults.

Immediate effects of Dynamic Tape™ on hip muscle activation and torque and on lower limb kinematics: A randomized controlled clinical trial

ABSTRACT This study aimed to evaluate the immediate effect of Dynamic TapeTM (DT) on hip muscle activation and torque and on lower limb kinematics. Forty-five healthy, recreationally active women were randomly assigned to three groups: 1) submitted to the application of DT in the active form in the gluteus medius (GMed) muscle (BG; n = 15), 2) submitted to the application of DT in the placebo form in the GMed muscle (PG; n = 15), and 3) not submitted to any intervention (CG; n = 15). Participants were evaluated for GMed and gluteus maximus (GMax) muscle activation in a maximal voluntary isometric contraction, simultaneously with the assessment of the hip abductor and extensor torques, as well as during two functional tasks – single leg squat (SLS) and jump landing + maximum vertical jump (VJ) – simultaneously with a 2-D kinematic assessment of the lower limb. After DT application in BG, there was a significant decrease in the hip abductor time to peak torque (P = 0.004), hip extensor torque (P = 0.02), excursion to hip adduction (P = 0.007), and to knee flexion (P = 0.02) during the SLS, as well as in GMed activation during VJ (P < 0.05). DT was able to reduce GMed activation and modify lower limb torque and kinematics.

Physical Differences between Injured and Non-Injured Elite Male and Female Futsal Players

Futsal is one of the most harmful sports due to its great physical demands. The asymmetries have been proposed as one of the most important risk factors of suffering an injury. However, no study has analysed the relationship between neuromuscular assessment and its implication on the likelihood of suffering injuries comparing male and female players. The purpose of the study was to analyse the physical fitness differences between elite futsal players (both male and female) who suffered an injury in the following four months after being evaluated with those who did not suffer the injuries. Twenty-six and twenty-two male and female elite futsal players were recruited from four different teams and underwent an evaluation of different neuromuscular assessments (isometric hip abduction and adduction peak torque, flexion-rotation trunk test, hop test, countermovement jump (CMJ), drop vertical jump (DVJ), leg stiffness, 15 m sprint, Y-balance test, and Illinois test) that have been considered potential sport-related injury risk factors during the pre-season. Statistical analysis only showed differences between injured and non-injured players in isometric hip adduction strength and unilateral ratio for the non-dominant leg (p &lt; 0.05). Neuromuscular performance scores showed significant differences (p &lt; 0.001) between male and female futsal players in several variables (hip abduction non-dominant leg, hops, CMJ, DVJ, leg stiffness, sprint, and Illinois test) but not in ratio or asymmetry. Isometric hip adduction and abduction–adduction unilateral ratio deficits for the non-dominant leg might be an important factor toward suffering an injury. Male and female futsal players showed different neuromuscular performances and consequently different training programs should be implemented for them.

Relationship between kinesiophobia, isometric hip and knee torques to pelvic, hip and knee motion during the single-leg drop jump in women with patellofemoral pain: A cross-sectional study

BackgroundIndividuals with patellofemoral pain (PFP) have kinesiophobia and hip and knee strength deficits. These factors may be related to kinematic alterations of pelvic, hip and knee during a more demanding functional activity, such as jumping landing. The aim was to investigate the relationships between kinesiophobia and hip/knee torque to pelvic/hip/knee kinematics during the single-leg drop vertical jump in women with PFP. MethodThirty women with PFP were assessed with Tampa Scale for Kinesiophobia; isokinetic dynamometry of the hip extensor, hip abductor, and knee extensor; and three-dimensional motion analysis system during the single-leg drop vertical jump. A Pearson correlation matrix was used to investigate relationship among variables. ResultsFair correlations were found between increased kinesiophobia and increased peak hip internal rotation angle (r = 0.43; p = 0.018) as well as between greater peak knee extensor torque and greater peak knee flexion (r = 0.41; p = 0.022). Moderate to good correlation was found between increased peak hip abductor torque and increased peak contralateral pelvic drop (r = 0.52; p = 0.003). No other significant correlations were found between variables. ConclusionsKinesiophobia is associated with hip kinematics, but not with knee kinematics, during the single-leg vertical drop jump in women with PFP. The greater hip abductor torque is associated with greater contralateral pelvic drop. The positive relationship between knee extensor torque and knee flexion indicates that rehabilitation programs involving quadriceps muscle strengthening may assist women with PFP in control knee flexion and improve load absorption during jumping landing.

After scaling to body size hip strength of the residual limb exceeds that of the intact limb among unilateral lower limb prosthesis users

BackgroundHip muscles play a prominent role in compensating for the loss of ankle and/or knee muscle function after lower limb amputation. Despite contributions to walking and balance, there is no consensus regarding hip strength deficits in lower limb prosthesis (LLP) users. Identifying patterns of hip muscle weakness in LLP users may increase the specificity of physical therapy interventions (i.e., which muscle group(s) to target), and expedite the search for modifiable factors associated with deficits in hip muscle function among LLP users. The purpose of this study was to test whether hip strength, estimated by maximum voluntary isometric peak torque, differed between the residual and intact limbs of LLP users, and age- and gender-matched controls.MethodsTwenty-eight LLP users (14 transtibial, 14 transfemoral, 7 dysvascular, 13.5 years since amputation), and 28 age- and gender-matched controls participated in a cross-sectional study. Maximum voluntary isometric hip extension, flexion, abduction, and adduction torque were measured with a motorized dynamometer. Participants completed 15 five-second trials with 10-s rest between trials. Peak isometric hip torque was normalized to body mass × thigh length. A 2-way mixed-ANOVA with a between-subject factor of leg (intact, residual, control) and a within-subject factor of muscle group (extensors, flexors, abductors, adductors) tested for differences in strength among combinations of leg and muscle group (α = 0.05). Multiple comparisons were adjusted using Tukey’s Honest-Difference.ResultsA significant 2-way interaction between leg and muscle group indicated normalized peak torque differed among combinations of muscle group and leg (p < 0.001). A significant simple main effect of leg (p = 0.001) indicated peak torque differed between two or more legs per muscle group. Post-hoc comparisons revealed hip extensor, flexor, and abductor peak torque was not significantly different between the residual and control legs (p ≥ 0.067) but torques in both legs were significantly greater than in the intact leg (p < 0.001). Peak hip abductor torque was significantly greater in the control and residual legs than the intact leg (p < 0.001), and significantly greater in the residual than control leg (p < 0.001).ConclusionsOur results suggest that it is the intact, rather than the residual limb, that is weaker. These findings may be due to methodological choices (e.g., normalization), or biomechanical demands placed on residual limb hip muscles. Further research is warranted to both confirm, expand upon, and elucidate possible mechanisms for the present findings; and clarify contributions of intact and residual limb hip muscles to walking and balance in LLP users.Clinical Trial RegistrationN/A.

Association between vertebral fragility fractures, muscle strength and physical performance: A cross-sectional study.

Few studies have investigated the association between vertebral fragility fractures and lower limb muscle strength and physical performance in women with low bone mass. To explore whether the presence of vertebral fracture is independently associated with poor physical performance and decreased lower limb muscle strength. To understand whether lower limb muscle strength is associated with physical performance in women with vertebral fracture. Older women with low bone mass were divided into 2 groups: no vertebral fracture (NF) and presence of vertebral fragility fracture (VFF). Physical performance was evaluated using the Five Times Sit to Stand (5TSS) test, the Timed Up and Go (TUG) test and a 5m walk test (5MWT). Lower limb muscle strength was assessed using an isokinetic dynamometer. We included 94 women with low bone mass (mean age 71.6 [SD 5.7] years, time since menopause 24.4 [7.1] years, mean BMI 27.5 [5.1] kgm-2). VFF was only associated with low peak hip abductor torque (p=0.001) after adjustments. In the VFF group (n= 47), each 1 Nmkg-1 increase: in knee extensor torque was associated with improved 5MWT (p=0.005), TUG (p=0.002) and 5TSS (p=0.005) performances; in knee flexor torque was associated with improved 5MWT speed (p=0.003) and TUG time (p=0.006); in hip abductor torque was associated with improved 5MWT speed (p=0.003); and in hip extensor torque with improved TUG time (p=0.046). VFF was associated with reduced hip abductor strength in older women. However, the number of vertebral fractures influenced the association. Additionally, lower limb muscle strength was associated with physical performance, regardless of the clinical characteristics of the fractures. Therefore, strength and power training programs for the lower limbs could improve physical performance.

The effects of stroke on weight transfer before voluntary lateral and forward steps.

There is a higher rate of falls in the first year after a stroke, and the ability to step in different directions is essential for avoiding a fall and navigating small spaces where falls commonly occur. The lateral transfer of weight is important for stabilizing the body before initiating a step. Hence, understanding the ability to control lateral weight transfer (WT) in different step directions might help understand falls in individuals with stroke. The present study aimed to compare the WT characteristics (onset time, duration, mediolateral center of pressure (ML COP) velocity, and ML COP displacement) and hip abduction torque preceding a lateral and forward voluntary step between individuals with stroke (paretic and non-paretic leg) and controls. Twenty individuals with stroke and ten controls performed voluntary choice reaction tests in the lateral and forward directions. Ten trials (five on each side—right and left) were performed for each step direction. The overall primary findings were that (1) the WT before a lateral step was shorter and initiated earlier, with a larger ML COP displacement and greater hip abductor torque in the stepping leg than the forward step, (2) there was greater hip abductor produced in the stance leg before a forward step than a lateral step, (3) the WT before the lateral step took longer to initiate and was slower to execute in individuals with stroke regardless of the leg (4) the WT before the forward step had more differences in the paretic than the non-paretic leg. Thus, for the first time, it was shown that the WT characteristics and hip abduction torque during the WT are different according to step direction and also appear to be impaired in individuals with stroke. These results have implications for understanding the direction that individuals with stroke are more susceptible to being unable to recover balance and are at risk of falling.

A Soft Exosuit Assisting Hip Abduction for Knee Adduction Moment Reduction During Walking

The knee joint experiences significant torques in the frontal plane to keep the body upright during walking. Excessive loading over time can lead to knee osteoarthritis (OA), the progression of which is correlated with external knee adduction moment (KAM). In this paper, we present a wearable soft robotic exosuit that applies a hip abduction torque and evaluate its ability to reduce KAM. The exosuit uses a portable cable actuation system to generate torque when desired while remaining unrestrictive when unpowered. We explored five different force profiles on healthy participants (N=8) walking on an instrumented treadmill at 1.25 m/s. For each force profile, we tested two peak force levels: 15% and 20% of bodyweight. We observed KAM reductions with two of the five profiles. With Force Profile 2 (FP2), peak KAM was reduced by 9.61% and impulse KAM by 12.76%. With Force Profile 5 (FP5), we saw reductions of peak KAM by 6.14% and impulse KAM by 21.09%. These initial findings show that the device has the ability to change walking biomechanics in a consistent and potentially beneficial way.

Normalization alters the interpretation of hip strength in established unilateral lower limb prosthesis users

BackgroundValid comparisons of muscle strength between individuals or legs that differ in size requires normalization, often by simple anthropometric variables. Few studies of muscle strength in lower-limb prosthesis users have normalized strength data by any anthropometric variable, potentially confounding our understanding of strength deficits in lower-limb prosthesis users. The objective of this pilot study was to determine the need for as well as effectiveness and impact of normalizing hip strength in lower-limb prosthesis users. MethodsPeak isometric hip extension and abduction torques were collected from 28 lower-limb prosthesis users. Allometric scaling was used to determine if hip torque values were significantly associated with, and therefore needed to be adjusted for, body mass, thigh length, or body mass x thigh length, and whether normalization was effective in reducing any associations. Between limb differences in peak hip torque, and correlations with balance ability, were inspected pre- and post-normalization. FindingsHip torques were consistently and significantly associated with body-mass x thigh length. Associations between peak hip torque and body-mass x thigh length were reduced by normalization. After normalization by body-mass x thigh length, between limb differences in hip extension torque, as well as the correlation between hip abduction torque and balance ability, changed from non-significant to significant. InterpretationIn the absence of normalization, hip strength (i.e., peak torque) in lower-limb prosthesis users remains dependent on basic anthropometric variables, masking relationships between hip strength and balance ability, as well as between limb differences.