Hip Extension Range Research Articles

Restriction In Hip Internal Rotation During Stance Phase In An Early Stage Of Hip Osteoarthritis

Most studies of gait analysis in hip osteoarthritis (OA) have involved patients with end-stage hip osteoarthritis or after total hip replacement. However, there have been few studies of patients with early stage of hip OA is few investigation. PURPOSE: The purpose of this study was to analyse of gait pattern in the hip joint during stance phase, in patients with early stage of hip OA. METHODS: Data of gait analysis was obtained from medical records of patients. Patients with early stages of hip OA (without acetabular dysplasia [sharp angle 41.9 ± 4.59 deg.], n=22, female, age: 55.4 ± 7.962 [44~70] yrs, height: 156.7 ± 5.14 cm, weight: 51.5 ± 6.75 kg [Hip OA]) and patients with traumatic temporomandibular disorder after a road traffic accident without lower extremity and lower back disorder (n=20, female, age: 51.9 ± 7.95 [40~66] yrs, height: 160.0 ± 5.86 cm, weight: 54.0 ± 8.76 kg [C]) between 2014 and 2019. Two-way ANOVA was used for statistical analysis between group [Hip OA-C] and within subject [side]. RESULTS: Results (mean ± SD) of range (degree) of hip extension to flexion during gait cycle were C 48.0 ± 6.63 and Hip OA 45.3 ± 8.29 (p > .05). Range of hip adduction of Hip OA was significantly smaller than C (F = 4.72, p < .05, ES f = 0.438). Results of range of hip adduction during early stance phase were C 9.1 ± 3.44 and Hip OA 7.2 ± 2.44. Range of hip adduction of Hip OA was significantly smaller than C (F = 4.72, p < .05, ES f = 0.438). Results of range of hip internal rotation during early stance phase were small side C 9.7±3.75, large side C 11.6±3.71, affected side Hip OA 7.50 ± 3.84 and unaffected side Hip OA 11.2 ± 3.62. Results of range of hip internal rotation were observed interaction (F=8.90, p<.01, ES f = 0.472). Unaffected side Hip OA was significantly smaller than unaffected side (F = 80.39, p<.001, ES f = 1.418) and small side of C (F = 3.26, adjusted p < 15, ES f = 0.285). CONCLUSIONS: In patients with early stage of hip OA, hip extension during gait wasn’t restricted, but hip adduction and hip internal rotation during early stance phase of gait were restricted. This hip joint restriction may be influenced by degeneration of ligamentum teres femoris which carries blood supply of femur head. Rotation restriction during stance phase by weight-bearing in early phase of hip OA occurs before hip joint extension restriction.

The Relationship Between Muscle Strength and Range of Motion in Lower Extremity With Balance and Risk of Falling in Elderl

Purpose: The present study examined the relationship between muscle strength and range of motion in lower extremity with balance and risk of falling in the elderly. Methods: This was a cross-sectional study. The statistical population included healthy elderly (Mean±SD age: 65.64±4.95 y) in Rasht City, Iran. The study was conducted on 65 healthy elderly males who met the study inclusion criteria and were selected by convenience sampling method. In this study, to measure static and dynamic balance, Sharpened Romberg test and Get Up and Go test were conducted, respectively. Additionally, the falling risk was measured by the Berg Balance Scale. Moreover, the maximum isometric force of the muscle groups in the lower extremities was measured using a hand-held dynamometer, and the range of motion was measured by a goniometer. The obtained data were analyzed using descriptive and analytical statistics by SPSS. Results: The present study results demonstrated that the muscle strength of hip extension, hip abduction, hamstring, quadriceps, and ankle plantarflexion had a significant relationship with static balance; while being negatively related to dynamic balance (P≤0.05). Furthermore, we observed a significant and negative relationship between the muscle strength of ankle dorsiflexion and dynamic balance and risk of falling (P≤0.05). There was also a positive and significant relationship between the range of motion hip extension, knee flexion, plantar flexion, and ankle dorsiflexion and static balance, while indicating a negative and significant relationship between these variables and dynamic balance and risk of falling (P≤0.05). Conclusion: The muscle strength hip abduction, hip extensions, hamstring, quadriceps, plantar flexion, ankle dorsiflexion and range of motion hip extension, knee flexion, ankle plantar flexion, and dorsiflexion seem to affect balance maintenance and fall risk in the elderly.

Correlation between radiographic sagittal alignment, range of motion, muscle strength, and quality of life in adults with spinal deformities.

[Purpose] The aims of this study were to examine the relationship between range of motion/muscle strength of the spine and lower limbs with 1) radiographic sagittal alignment and 2) quality of life of participants with spinal deformities to adequately target the appropriate factors for effective treatment. [Participants and Methods] This study used an observational cross-sectional correlational design. Participants with spinal deformities and low back pain were recruited for the study. The dependent variables were range of motion/muscle strength of the spine and lower limbs, sagittal alignment, and quality of life. [Results] Regarding alignment, significant correlations were found between hip extension range of motion and sagittal vertebral axis; between occiput-to-wall distance and thoracolumbar kyphosis; and between back extensor endurance and pelvic tilt and pelvic incidence-lumbar lordosis mismatch, also known as the calculated (pelvic incidence) minus (lumbar lordosis) value. With regards to quality of life, significant correlations were found between pain-related disorders and lumbar spine range of motion, and between gait disturbance and knee and hip extension ranges of motion. [Conclusion] Our findings suggest that these factors should be targeted for assessment and treatment of adults with spinal deformities.

Comparison of Countermovement Jump-Derived Reactive Strength Index Modified and Underpinning Force-Time Variables Between Super League and Championship Rugby League Players.

McMahon, JJ, Jones, PA, and Comfort, P. Comparison of countermovement jump-derived reactive strength index modified and underpinning force-time variables between super league and championship rugby league players. J Strength Cond Res 36(1): 226-231, 2022-The countermovement jump (CMJ) is regularly tested in rugby league (RL), with recent work reporting reactive strength index modified (RSImod) to distinguish between levels of play. Differences in CMJ-derived RSImod and underpinning force-time variables between English Super League (SL) and RL Championship (RLC) players are, however, unknown. As SL and RLC teams compete against each other, this study addressed this knowledge gap. Sixty RL players from the English SL (n = 30) and RLC (n = 30) performed 3 CMJs on a force platform at the start of the preseason training. The RSImod was calculated by dividing jump height (JH) by time to take-off (TTT), and several other variables were also extracted from the force-time record. The SL players achieved a significantly higher (large effect) RSImod by performing the CMJ with a significantly shorter (large effect) TTT but a similar (small effect) JH. The SL players achieved the shorter TTT through a significantly reduced (large effects) relative displacement during both the countermovement (combined unweighting and braking displacement) and propulsion phases but a significantly higher (moderate effects) propulsion peak force and power. The relationships between TTT and relative countermovement (r = 0.719, p < 0.001) and propulsion (r = 0.771, p < 0.001) displacement for combined group data were very large. Practitioners working in RL should, therefore, consider reporting RSImod and TTT, alongside JH, after CMJ force-time testing. We also suggest that RL players who produce lower RSImod scores would benefit from being trained to produce larger CMJ propulsion forces over a shallower range of hip, knee, and ankle extension.

Plantar pressure distribution during standing in women with end-stage hip osteoarthritis

BackgroundPatients with hip osteoarthritis (OA) experience abnormal movement patterns and reduced loading of the affected leg. The plantar contacts the ground and receives force from the ground. Plantar pressure distribution may differ in patients with hip OA compared to healthy adults and may influence physical functioning in these patients. Research questionWe investigated whether plantar pressure distribution during standing differed between patients with hip OA and healthy adults. We also analyzed the relationship between plantar pressure distribution and walking ability and the factors affecting plantar pressure distribution. MethodsMaximum plantar pressure distribution during standing for 20 seconds was investigated in patients with hip OA (n = 62; OA group) and in healthy adults (n = 53; Control group). Statistical comparisons between these groups were made using Fisher’s exact test and residual analysis. In the OA group, leg length discrepancy, range of hip extension, leg loading, knee extensor strength, and 10 m walking time were assessed; multiple linear regression and logistic regression analyses were used to examine the relationships between these factors and maximum plantar pressure distribution. ResultsMaximum plantar pressure distribution was different between the OA and control groups. In the OA group, maximum plantar pressure distribution was one of the significant predictors of 10 m walking time. Additionally, leg length discrepancy was a significant predictor of maximum plantar pressure distribution in this group. SignificanceDuring standing, the proportion of patients for whom the maximum plantar pressure region was the heel tended to be lower in the group with hip OA compared to the healthy adults. Plantar pressure distribution may have an importance for evaluating walking ability in patients with hip OA. Correcting leg length discrepancy and loading under the heel could adjust plantar pressure distribution in patients with hip OA.

Greater Lumbar Extension During Dolphin Kick and Psoas Major Tightness in Swimmers With Low Back Pain.

In competitive swimming, many swimmers experience low back pain (LBP). Lumbar hyperextension may cause LBP, and tight hip-flexor muscle may cause lumbar extension during swimming. The purpose of this study was to clarify the features of the elastic moduli of the muscles and the lumbar extension when swimmers with LBP perform a dolphin kick (DK). Cross-sectional study. Single center. Eleven male college swimmers were enrolled as the LBP group (who have LBP when swimming and during a lumbar extension), and 21 male college swimmers were recruited as the control group (no LBP). The elastic moduli of the psoas major, iliacus, teres major, latissimus dorsi, pectoralis major, and pectoralis minor were measured through ultrasonic shear wave elastography. The lumbar and hip extension angles during a DK were measured using a video camera. The passive hip extension and shoulder-flexion range of motion (ROM) were measured using a goniometer. Muscle elastic moduli and lumbar extension angles during DK. The characteristics, muscle elastic moduli, DK motion, and ROM were compared between the 2 groups. LBP group demonstrated significantly higher elastic modulus of the psoas major and lower modulus of pectoralis minor compared with the control group. Also, LBP group showed greater lumbar extension during a DK and less hip extension ROM than the control group. The higher elastic modulus of the psoas major and greater lumbar extension during a DK may be related to the LBP in swimmers.

Predictors of pain intensity and Oswestry Disability Index in prolonged standing service workers with nonspecific chronic low back pain subclassified as active extension pattern

BackgroundBecause patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing. ObjectivePredictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup. MethodsVariables were measured using questionnaires including a visual analog scale (VAS), the Oswestry Disability Index (ODI), Borg Rating of Perceived Exertion (RPE) Scale, and Korean Occupational Stress Scale (KOSS). Postural assessment was performed by measuring pelvic anterior tilting angle (PATA). The smart KEMA measurement system was used to evaluate hip flexion, hip extension (HE), and knee flexion range of motion (ROM), as well as hip extensor strength, hip abductor strength (HArS), hip external rotator strength (HERrS), hip internal rotator strength, knee extensor strength, and knee flexor strength, and lumbopelvic stability (LS) in 78 PSSWs with NSCLBP subclassified as AEP. ResultsIn prediction models, HArS, LS, PATA, KOSS and HE ROM accounted for 40.1% of the variance in the VAS (p < 0.05); predictors of dysfunction included the HERrS and age, which accounted for 11.9% of the variance in the ODI (p < 0.05) in multiple regression models when using a stepwise selection procedure. ConclusionsThe present results indicate that HArS and HERrS, LS, PATA, KOSS, HE ROM and age should be considered for evaluating and predicting NSCLBP subclassified as AEP in PSSWs, and when designing interventions.

Impact of multilevel joint contractures of the hips, knees and ankles on the Gait Profile score in children with cerebral palsy

BackgroundChildren with cerebral palsy are at risk of developing muscle contractures, often contributing to pain, structural deformities and mobility limitations. With the increasing use of gait indices to summarise the findings of three dimensional gait analysis (3DGA), the purpose of this study is to determine whether there is a relationship between multilevel joint contractures and the Gait Profile Score in children with cerebral palsy. MethodsThe Gait Profile Score, calculated from 3D gait analysis, and passive range of motion, strength and spasticity of the hips, knees and ankles in the sagittal plane were measured in 145 children with cerebral palsy (mean age:11 years,4 months; SD:2 years,10 months) (83 males) enrolled in the NSW Paediatric Gait Analysis Service Research Registry from 2011 to 2016. The relationships between these physical measures and the Gait Profile Score were explored using bivariate and multivariate correlations. FindingsReduced hip extension, knee extension and ankle dorsiflexion (knee extended) range of motion were correlated with a higher (worse) Gait Profile Score (r = −0.348 to −0.466, p < .001). Children with all joints contracted had a significantly higher Gait Profile Score (mean 17.5°, SD 6.2°) than those with no contractures (mean 11.0°, SD 2.3°) or ankle contractures only (mean 12.8°, SD 5.1°) (p < .05). Knee flexion weakness, reduced hip extension and ankle dorsiflexion (knee extended) range of motion predicted 47% of the Gait Profile Score. InterpretationThe Gait Profile Score is a sensitive measure for demonstrating the relationship between multilevel sagittal plane joint contractures and kinematic gait. Clinically, this supports the use of the Gait Profile Score as a simplified measure to understand the contribution of contractures to functional gait limitations. Monitoring knee flexion strength, and hip extension and ankle dorsiflexion (knee extended) range of motion may assist clinicians in prioritising interventions to improve gait in this population.

Lower Extremity Strength and Range of Motion in High School Cross-Country Runners.

Cross-country running is becoming an increasingly popular sport, with a significant participation noted at the high school level. The aim of this study was to compare gender and bilateral hip extension range of motion and hip and knee extension strength of high school cross-country runners. 31 participants volunteered from a local high school cross-country team (16 males and 15 females). The modified Thomas test was utilized to measure hip extension range of motion bilaterally using a digital inclinometer. In order to measure hip and knee isometric strengths, an isokinetic dynamometer was employed. A mixed model approach revealed a statistically significant difference in peak hip extension strength between genders but not the side. Male athletes demonstrated a 29.2 Nm/kg (P < 0.05) greater force production than females during isometric hip extension strength testing. There were no significant differences in peak knee extension isometric strength, hip extension range of motion, and the ratio of peak hip and knee strength between genders and the dominant and nondominant leg. Female cross-country runners should focus on increasing hip extension strength to help maintain hip stability during running. This may be beneficial in decreasing the chances of experiencing patellofemoral pain in long-distance runners.

Acute Effects of Two Hip Flexor Stretching Techniques on Knee Joint Position Sense and Balance

Tightness of hip flexor (THF) muscles has been recognized as a risk factor for various musculoskeletal injuries in the lower extremities. Abnormal knee joint position sense (JPS) has also been linked to several orthopedic and musculoskeletal conditions in the knee joint. PURPOSE: To examine the acute effects of two hip flexor stretching techniques on hip extension range of motion (ROM), knee JPS and dynamic balance performance (DB). METHODS: Thirty-six healthy college age students (24 males, 11 females, mean age 22.37 ± 1.63 years, height 171.05 ± 9.64 cm, and weight 72 ± 13.70 kg) with THF participated in this study. Hip extension ROM, knee JPS and DB were measured pre- and post-stretching using a digital inclinometer, an iPod touch and the Y-balance kit, respectively. Subjects were randomly divided into dynamic stretching (DS), and hold-relax proprioceptive neuromuscular facilitation (HR-PNF) groups. Three-way mixed analysis of variance (ANOVA) was used to explore if an interaction existed between the groups (DS vs. HR-PNF), time (pre-and post) and side of hip (right vs. left) in hip extension ROM, knee JPS and DB measurements. RESULTS: There was a significant effect of time on hip extension ROM in both stretching groups (pre = 9.37°, 9.64°, vs post = 0.18°, 0.27°, right and left hips, respectively; p < 0.001). Also, there was a significant effect of stretch type on hip extension ROM (-3.87°, -2.48 °) and (-0.90°, -0.26°) right, left, PNF versus DS group, post- stretching time points, respectively; p = 0.004) favoring HR-PNF over DS. There was a non-significant effect of time on mean knee JPS replication error in both groups. In DB measurement, there was a significant main effect of time and directions of reach on the Y-balance test’s mean distance. The total mean distance of reach to posterolateral direction for both stretching groups (pre = 110.96 %, post = 113.48 %) was larger than the total mean distance of reach to posteromedial direction (pre = 103.82 %, post = 107.94 %) which was in turn larger than the total mean distance of reach to the anterior direction (pre = 66.49 %, post = 65.64 %; p < 0.001). CONCLUSIONS: DS and HR-PNF stretching resulted in a significant acute improvement in hip extension ROM and DB measures. However, knee JPS replication error results showed nonsignificant improvement over time in either stretching group.

Hip extensor mechanics and the evolution of walking and climbing capabilities in humans, apes, and fossil hominins

The evolutionary emergence of humans' remarkably economical walking gait remains a focus of research and debate, but experimentally validated approaches linking locomotor capability to postcranial anatomy are limited. In this study, we integrated 3D morphometrics of hominoid pelvic shape with experimental measurements of hip kinematics and kinetics during walking and climbing, hamstring activity, and passive range of hip extension in humans, apes, and other primates to assess arboreal-terrestrial trade-offs in ischium morphology among living taxa. We show that hamstring-powered hip extension during habitual walking and climbing in living apes and humans is strongly predicted, and likely constrained, by the relative length and orientation of the ischium. Ape pelves permit greater extensor moments at the hip, enhancing climbing capability, but limit their range of hip extension, resulting in a crouched gait. Human pelves reduce hip extensor moments but permit a greater degree of hip extension, which greatly improves walking economy (i.e., distance traveled/energy consumed). Applying these results to fossil pelves suggests that early hominins differed from both humans and extant apes in having an economical walking gait without sacrificing climbing capability. Ardipithecus was capable of nearly human-like hip extension during bipedal walking, but retained the capacity for powerful, ape-like hip extension during vertical climbing. Hip extension capability was essentially human-like in Australopithecus afarensis and Australopithecus africanus, suggesting an economical walking gait but reduced mechanical advantage for powered hip extension during climbing.

Hop Distance Symmetry Does Not Indicate Normal Landing Biomechanics in Adolescent Athletes With Recent Anterior Cruciate Ligament Reconstruction.

Background Return-to-sport protocols after anterior cruciate ligament reconstruction (ACLR) often include assessment of hop distance symmetry. However, it is unclear whether movement deficits are present, regardless of hop symmetry. Objectives To assess biomechanics and symmetry of adolescent athletes following ACLR during a single-leg hop for distance. Methods Forty-six patients with ACLR (5-12 months post surgery; 27 female; mean ± SD age, 15.6 ± 1.7 years) were classified as asymmetric (operative-limb hop distance less than 90% that of nonoperative limb [n = 17]) or symmetric (n = 29) in this retrospective cohort. Lower extremity biomechanics were compared among operative and contralateral limbs and 24 symmetric controls (12 female; mean ± SD age, 14.7 ± 1.5 years) using analysis of variance. Results Compared to controls, asymmetric patients hopped a shorter distance on their operative limb (P<.001), while symmetric patients hopped an intermediate distance on both sides (P≥.12). During landing, the operative limb, regardless of hop distance, exhibited lower knee flexion moments compared to controls and the contralateral side (P≤.04), with lower knee energy absorption than the contralateral side (P≤.006). During takeoff, both symmetric and asymmetric patients had less hip extension and smaller ankle range of motion on the operative side compared with controls (P≤.05). Asymmetric patients also had lower hip range of motion on the operative, compared with the contralateral, side (P = .001). Conclusion Both symmetric and asymmetric patients offloaded the operative knee; symmetric patients achieved symmetry, in part, by hopping a shorter distance on the contralateral side. Therefore, hop distance symmetry may not be an adequate test of single-limb function and return-to-sport readiness. J Orthop Sports Phys Ther 2018;48(8):622-629. Epub 30 Mar 2018. doi:10.2519/jospt.2018.7817.

1-stage bilateral total hip arthroplasty operation in 22 patients with use of short and standard stem length on either side: gait analysis 1 and 2 years after bilateral THA

According to previous gait analyses, insertion of a total hip arthroplasty (THA) will improve the range of hip flexion-extension but not to normal. Use of short stems could have a potential to improve the motion by preservation of more bone and muscular attachments. We evaluated whether a short femoral stem resulted in improved hip motion compared to a conventional stem in patients who underwent 1-stage bilateral THA. The most painful hip was randomised to either design and the 2nd hip was operated with the design not used on the 1st side. Gait analysis was performed with an optical tracking system in 22 patients. The follow-up was performed 1 and 2 years after the operation. The mean age was 59 (SD 7.7) years and body mass index was 27.7 (SD 4.3). 66 subjects without hip pathology served as controls. Minimal differences were observed, between or within the 2 different stem designs during gait at the 2 follow-up occasions. Comparison between each of the 2 stem designs and controls at 2 years revealed reduced stride length (p = 0.009), cadence, hip extension (p<0.001) and hip extension-flexion range (p = 0.021) for both designs. Furthermore, the range of hip adduction-abduction (p = 0.046) and hip abduction moment for both designs in the frontal plane was also reduced bilaterally (p<0.001). We found no difference in gait parameters between the short and the conventional stem after 1-stage bilateral THA. Although both hip joints were operated at the same time motions and moments did not normalise after bilateral 1-stage operations.

Monitoring the effect of football match congestion on hamstring strength and lower limb flexibility: Potential for secondary injury prevention?

ObjectivesTo investigate the effect of competitive football match congestion on hamstring strength and lower limb flexibility. DesignRepeated measures. SettingElite male youth football. ParticipantsFifteen male elite youth football players from the national football association centre of excellence were included (age = 15.81 ±0.65 years, height = 171.95 ±6.89 cm, weight = 65.93 ±7.53 kg). Main outcome measuresHamstring strength and pain, ankle dorsiflexion, hip extension, knee extension and flexion range of motion. ResultsHamstring strength was highest at baseline and significantly reduced at 24 (p = 0.001, mean difference −0.19 Nm/Kg, CI95 −0.28, −0.1) and 48 h post-match 1 (p = 0.002, mean difference −0.16 Nm/Kg, CI95 −0.25, −0.07). Strength recovered by match day 2 before significantly reducing again 24 h post-match 2 (p = 0.012, mean difference −0.17 Nm/Kg, CI95 −0.29, −0.04). Pain was lowest at baseline and increased in the post-match periods (p < 0.05) with standardised effect sizes ranging from 0.07 to 0.42. Passive knee flexion range decreased post-match (p < 0.01) with mean differences of 1.5°–2.7°. The other flexibility measures remained unaffected by match play. ConclusionIsometric hamstring strength and pain can be considered for inclusion in-season to monitor player's post-match hamstring recovery characteristics during congested match fixtures.

The influence of pelvic rotation on clinical measurements of hip flexion and extension range of motion across sex and age

ObjectiveThe purpose of this study was to identify the amount of pelvic rotation associated with hip motion during passive hip flexion and extension goniometric measurements. DesignCross-sectional study. SettingUniversity laboratory. ParticipantsOne hundred healthy adults (males = 45, females = 55) aged 18–66 years participated. Outcome measuresClinical range of motion measurements of hip flexion, and extension during the modified Thomas test, and pelvic sagittal position measured using a device, attached from the PSIS to ASIS, and a fluid-filled inclinometer. ResultsWhen pelvic rotation was subtracted from the clinical measurements, hip flexion measurements were significantly reduced in both sexes (males: 110.8 ± 7.4 to 93.8 ± 7.8°, P < 0.001; females: 121.3 ± 7.2 to 107.3 ± 8.6°, P < 0.001). However, subtracting pelvic rotation from hip extension measurements only significantly reduced the measurements in females (15.5 ± 6.0 to 6.2 ± 6.8°, P < 0.001). No significant differences were found across age groups. ConclusionsClinical measurements of hip flexion exaggerated the range of motion in both sexes. The modified Thomas test appeared to control for rotation of the pelvis during hip extension in men. However, in women, hip extension measurements were exaggerated.

Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial.

Introduction. Osteoarthritis (OA) of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods. 13 women aged ≥ 65 years with hip OA were recruited in this 12-week pilot study. Results. Pain declined significantly over 30% from baseline, and joint function and health-related quality of life improved slightly. Objective assessment of physical functioning showed statistically significant improvement in the maximal isometric leg extensor strength by 20% and in the hip extension range of motion by 30%. Conclusions. The exercise program was found to be safe and feasible. The present evidence indicates that the exercise program is effective in the short term. However, adequate powered RCTs are needed to determine effects of long-term exercise therapy on pain and progression of hip OA.

Gait-like vibration training improves gait abilities: a case report of a 62-year-old person with a chronic incomplete spinal cord injury.

The purpose of this single-subject case study was to quantify the effect of gait-like vibration training on gait abilities after an incomplete spinal cord injury (SCI). A 62-year-old male with a chronic American Spinal Injury Association Impairment Scale D SCI at T11 completed nine sessions of gait-like vibration training in a standing position. Self-selected gait speed and distance covered within 6 min were determined before and after training to evaluate the impact of training on gait performance. Associated changes in gait kinematics were assessed with a three-dimensional motion analysis system. Results showed an improvement of gait speed (0.26 vs 0.35 m s-1) and distance (23 vs 37 m) after nine gait-like vibration training sessions (+34.6%; +60.9%). In addition, more bilateral hip extension and larger left hip range of motion improved hip-knee cyclograms. Gait-like vibration training improved gait abilities in a person with chronic incomplete SCI.

The acute effect of match play on hamstring strength and lower limb flexibility in elite youth football players.

The aim of this study was to investigate the effect of competitive football match play on hamstring strength and lower limb flexibility. Fifteen male international youth football players were included. Hamstring strength and associated pain ratings, ankle dorsiflexion, hip extension, knee extension and flexion range of motion were evaluated immediately post-match and at intervals of 24, 48, and 72h post-match. Strength significantly reduced post-match (P<0.01), mean difference -0.43 (CI95 : -0.56, -0.30) and 24h post (P<0.05) mean difference -0.12Nm/kg (CI95 : -0.20, -0.04). The associated pain scores significantly increased at the post-match (P<0.01, ES=0.61) and 24h (P<0.01, ES=0.55) time intervals. At the 48 and 72h post-match tests no significant difference was found for strength or pain ratings. No significant differences were detected for any of the range of motion measures. Competitive football match play has a significant acute and transient effect on isometric hamstring strength and associated pain levels during resisted knee flexion in male international youth players. Range of motion measures appear to remain relatively unaffected by match play. Isometric hamstring strength testing and associated pain levels might be considered for inclusion in-season to monitor player's post-match hamstring recovery characteristics.

Effect of strengthening versus balance-proprioceptive exercises on lower extremity function in patients with juvenile idiopathic arthritis: a randomized, single-blind clinical trial.

The aim of this study was to investigate the effects of two exercise programs on lower extremity function in patients with juvenile idiopathic arthritis. Thirty patients with juvenile idiopathic arthritis participated in this study. Pain, passive range of motion, muscle strength, balance, and functional abilities were assessed with the Numeric Rating Scale, goniometer, handheld dynamometer, Flamingo Balance Test, Functional Reach Test, 10-meter walking test, 10-stair climbing test, and Childhood Health Assessment Questionnaire. Participants were randomly assigned to the strengthening exercise group (group 1, n = 15) or the proprioceptive-balance exercise group (group 2, n = 15). Intragroup analysis showed statistically significant improvements in all outcome measures except muscle strength in the hip and ankle after strengthening exercises in group 1. However, statistically significant improvements were found in all outcome measures after the proprioceptive-balance exercises in group 2. Intergroup analysis showed statistically significant improvement in all outcome measures in group 2 except for the Numeric Rating Scale, Childhood Health Assessment Questionnaire, and passive range of motion scores and hip extension and knee flexion muscle strengths. This study demonstrates that exercise treatment significantly improves musculoskeletal symptoms in patients with juvenile idiopathic arthritis. However, balance-proprioceptive exercises prove to be effective more than strengthening exercises for improving lower extremity function such as walking, climbing stairs, and balance in patients with juvenile idiopathic arthritis.

Changes in hip flexor passive compliance do not account for improvement in vertical jump performance after hip flexor static stretching.

To date, there is limited research investigating stretching of antagonist muscles and its effects on agonist muscle function. The purpose of this research was to investigate the effects of pre-static stretching (pre-SS) of the hip flexor musculature on passive hip extension range of motion (ROM) and vertical jump height. Fifteen subjects reported to the laboratory on 4 separate days (D1, D2, D3, and D4). D1 was for familiarization, while on D2 to D4, subjects randomly completed 1 of 3 intervention conditions; no stretch (CON), hip flexor stretch (HFS), or hip extensor stretch (HES). Subject's pre- and post-intervention hip extension ROM were measured before performing 3 sets of pre- and post-maximal counter-movement vertical jumps. Vertical jump height was normalized to baseline for data analysis. A repeated-measures ANOVA with post hoc paired sample t-tests revealed a significant increase in vertical jump height in the HFS condition (1.74% ± 0.73; p ≤ 0.05) when compared with CON (-1.34% ± 0.96) or HES (-1.74% ± 0.65) conditions. There was also a significant increase in hip extension ROM after the HFS stretching protocol (6.5 ± 2.75%; p ≤ 0.05) when compared with the CON protocol (-1.73 ± 3.26); however, no significant difference when compared with the HES protocol (1.84 ± 2.79). A correlation analysis showed that the relative hip laxity of each subject had no effect on response to either condition nor did the magnitude of hip ROM change predict improvement in vertical jump. These results suggest that performing SS of the hip flexors may enhance vertical jump performance independent of changes in passive compliance of the hip flexor muscular tendon unit.